Unusual clinical presentation and complications following preoperative embolization of a large adrenal tumor

Authors present a case of a young female presenting with secondary amenorrhea which on further investigation revealed a large intra-abdominal mass, likely arising from the left adrenal gland. As the tumor was highly vascular with large feeders, she was referred for pre-operative embolization to reduce the blood loss during surgery. Post embolization, the patient suffered from an unusual complication of tumor rupture along with excessive secretion of catecholamines resulting in myocarditis and myocardial infarction. Patient ultimately died of the myocardial infarction. Preoperative embolization of a large, hypervascular adrenal mass lesion is not devoid of unusual complications like tumor rupture and subsequent cardiovascular complications even if the tumor is hormonally inactive. This complication is extremely rare and has never been reported in adrenal tumors after embolization.

Isolated sternal hypoplasia: a rare cause of kyphoscoliosis

In most cases, kyphoscoliosis is idiopathic. However, this is a diagnosis of exclusion and can be made only if no cause can be identified. Kyphoscoliosis can occur due to various causes. Isolated sternal anomalies may also cause kyphoscoliosis secondary to the bony deformity though this has not previously been reported in literature. We have reported a case of kyphoscoliosis secondary to isolated sternal hypoplasia with complete absence of bony and cartilaginous elements of the body and xiphoid process of the sternum without any associated deformities of mediastinal structures, lung parenchyma or soft tissues in a young male patient. Careful evaluation of patients with kyphoscoliosis can ensure timely diagnosis of unusual and potentially treatable causes for the same such as sternal anomalies. Addition of lateral chest radiographs to the imaging protocol for evaluation of kyphoscoliosis can play a major role in timely diagnosis of such cases.

An Unusual Anomaly Of Deep Venous System In The Lower Limb: Complete Unilateral Agenesis Of Iliofemoral Veins In The Absence Of Persistent Sciatic Vein

Venous anomalies are the most common congenital vascular anomalies. The rarest of these is complete deep venous agenesis. Here, we report a case of a 15-year-old male patient evaluated on color Doppler and computed tomographic venogram with complete right iliofemoral deep venous agenesis with the inferior vena cava continuing as the left common iliac vein and the right popliteal vein draining into superficial anomalous veins of the thigh. These superficial veins were seen to drain through a superficial suprapubic arcuate connector vein into the dilated left common femoral vein. Uniquely in our case, there was no persistent embryonic sciatic vein and no demonstrable reflux into the superficial connector vein, suggesting an uncommon embryological mechanism underlying its pathogenesis. Surgical resection of the dilated superficial veins is absolutely contraindicated in cases of deep venous agenesis and hence accurate diagnosis by the radiologist is absolutely essential in such cases