ABSTRACT
Case presentation: We present a case of a patient with a syphilitic popliteal pseudoaneurysm who developed acute lower-limb ischemia secondary to thromboembolism related to the pseudoaneurysm. The diagnosis of a syphilitic popliteal aneurysm was made due to positive syphilitic serological testing and with exclusion of all other potential causes. The pseudoaneurysm was surgically repaired using a great saphenous vein patch angioplasty, which was done without delay to prevent further thromboembolic complications. This was then followed by a course of intravenous benzyl penicillin. Discussion: Peripheral arterial involvement of tertiary syphilis remains exceedingly rare, with the vast majority of reported cases of vascular syphilis relating to aortic involvement. Given the paucity of literature on this condition, there is no good evidence to guide current management. Conclusion: With the globally increasing rates of syphilis, more cases of peripheral arterial involvement may become apparent, as was the case in the early 20th century.
Subject(s)
Aneurysm, False , Aneurysm , Aneurysm, False/diagnostic imaging , Aneurysm, False/etiology , Aneurysm, False/surgery , Humans , Ischemia/diagnostic imaging , Ischemia/etiology , Ischemia/therapy , Popliteal Artery/diagnostic imaging , Popliteal Artery/surgery , Treatment OutcomeSubject(s)
Accidents, Traffic , Aneurysm, False/surgery , Aorta/surgery , Aortic Aneurysm/surgery , Aortic Rupture/surgery , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Vascular System Injuries/surgery , Aneurysm, False/diagnostic imaging , Aneurysm, False/etiology , Angiography, Digital Subtraction , Aorta/diagnostic imaging , Aorta/injuries , Aortic Aneurysm/diagnostic imaging , Aortic Aneurysm/etiology , Aortic Rupture/diagnostic imaging , Aortic Rupture/etiology , Aortography/methods , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/instrumentation , Computed Tomography Angiography , Endovascular Procedures/instrumentation , Humans , Male , Middle Aged , Prosthesis Design , Stents , Treatment Outcome , Vascular System Injuries/diagnostic imaging , Vascular System Injuries/etiologyABSTRACT
AIMS: Document the incidence, stage at presentation and therapy offered to octogenarians with non-small cell lung cancer (NSCLC) over 3 years and compare to those under 80 years old. METHODS: A retrospective analysis of patients with NSCLC managed via a lung cancer multidisciplinary team at Canterbury District Health Board. Follow-up data at one year following presentation was analysed. RESULTS: The study population comprised 124 octogenarians (mean 83.7 years), of whom 54 (42%) were female. Participants presented with adenocarcinoma 48 (38.7%), squamous cell 35 (28.2%) and without tissue diagnoses 41 (33.1%). Stage I and II lung cancer was found in 43 (34%) patients. Surgical resection ensued in six (4.8%), radiotherapy with curative intent in 20 (16.1%), non-curative treatment options in 98 (79%), compared to 106 (15.4%), 112 (15.6%) and 431 (67.2%) respectively of the 635 patients in the under 80 group with NSCLC. All of the surgical group and 15 (75%) in the radiotherapy group of octogenarians were alive at one year; which is comparable to the rest of the cohort, where all patients of the surgical group and 63 (64.2%) of the radiotherapy group were alive at one year. CONCLUSION: Octogenarians who undergo radiotherapy or surgery with curative intent have an excellent one year survival. Because all patients were alive at one year following surgical resection, we conclude that surgery seems to be a viable treatment option in octogenarians, which may be underutilised.
