ABSTRACT
We describe two unrelated men who both developed teratomas in one testis followed by seminomas in the contralateral testis followed by papillary thyroid carcinomas. Neither man had a family history of cancers. Although random occurrence is possible, genetic predisposition and/or environmental influence would seem a likely explanation for this previously unreported combination of tumours.
Subject(s)
Carcinoma, Papillary/pathology , Neoplasms, Multiple Primary/pathology , Seminoma/pathology , Teratoma/pathology , Testicular Neoplasms/pathology , Thyroid Neoplasms/pathology , Adult , Carcinoma, Papillary/therapy , Humans , Male , Neoplasms, Multiple Primary/therapy , Seminoma/therapy , Teratoma/therapy , Testicular Neoplasms/therapy , Thyroid Neoplasms/therapy , Treatment Outcome , Young AdultABSTRACT
Femoropopliteal bypass graft entrapment by the gastrocnemius muscle and tendons is an unusual cause of graft stenosis or thrombosis. Before graft occlusion occurs, reduced flow may be seen either with the knee in extension or hyperextension or by passive dorsiflexion of the ankle. We report a case of a femoropopliteal bypass graft entrapment causing a thrombus in the distal graft. Duplex imaging, angiography, MRI and graft surveillance programs are useful diagnostic tools. Treatment options include dividing the occluding muscles and tendons and rerouting the graft.
Subject(s)
Blood Vessel Prosthesis/adverse effects , Femoral Artery/surgery , Graft Occlusion, Vascular/complications , Popliteal Artery/surgery , Thrombosis/etiology , Aged , Femoral Artery/diagnostic imaging , Graft Occlusion, Vascular/diagnostic imaging , Graft Occlusion, Vascular/surgery , Humans , Male , Popliteal Artery/diagnostic imaging , Radiography , Thrombosis/surgeryABSTRACT
INTRODUCTION: the diagnosis of thoracic outlet syndrome (TOS) relies heavily on subjective rather than objective assessment criteria. Subsequently, published results after surgical decompression vary considerably. This study aimed to use a symptom-based patient-directed questionnaire to assess the outcome after decompression for TOS. METHODS: sixty patients who underwent decompression procedures were identified from a prospectively maintained vascular database. Patient records were analysed for details regarding initial presentation, investigation, type of procedure used for decompression and management. Outcome questionnaires were sent to all identified patients to give a patient-based outcome measure. RESULTS: eighty-four per cent of patients responded. In 90% of these patients there was an improvement in symptoms post-surgery with a median follow up of 43 months. The results were not influenced by the procedure or approach used. CONCLUSION: surgery remains an effective tool in the management of TOS. A simple patient-directed questionnaire as used in this study could assist in the standardisation of outcome assessment.