Situs inversus totalis and single coronary ostium: A coincidence or a pattern?

Situs inversus totalis and single coronary ostium are rare congenital anomalies, and no ontogenic connection has been described between them. Only three cases of association of single coronary ostium and situs inversus have been reported in the literature, all found on angiography. Here we present the first case of this association discovered at autopsy. Based on the apparently higher than expected frequency of this finding, an underlying pathologic connection between these conditions is proposed.

A case of familial angiolipomatosis with Lisch nodules.

Familial angiolipomatosis is a rare syndrome that may be confused clinically with neurofibromatosis type 1. This condition is most often inherited in an autosomal recessive manner; however, several reports have been published suggesting an autosomal dominant mode of inheritance. Angiolipomatosis, although somewhat disfiguring, is a benign condition with no known association with malignant neoplasms. This is in contradistinction to neurofibromatosis, an autosomal dominant syndrome associated with a myriad of benign and malignant neoplasms. It is, therefore, important to discriminate this entity from neurofibromatosis when a patient presents with multiple subcutaneous tumors and a family history of similar lesions. Described is a case of a prison inmate with a history of seizures and "neurofibromatosis" without clinical documentation. Lisch nodules were noted on the irides. Postmortem examination showed multiple subcutaneous yellow tumors on the chest and arms. Fine-needle aspiration of 1 mass yielded adipose tissue with prominent vessels; histologic sections of another mass showed angiolipoma. The remainder of the autopsy showed significant coronary artery disease and a remote cerebral infarction of the temporal lobe but no signs of neurofibromatosis. We feel that the presence of multiple angiolipomas in combination with Lisch nodules lends credence to the proposed relationship between fatty tumors and neurofibromatosis suggested by other authors.

Suicide using a compound bow and arrow.

Accidental, suicidal, and homicidal injuries have been caused by arrows fired from crossbows. To our knowledge, a case of suicide using a full-size compound bow to fire a projectile has not been reported in the English literature. Described is a case of a 17-year-old man who shot himself in the chest with a broadhead hunting arrow fired from a compound bow. Examination of the footwear suggests that the decedent drew the bowstring with his left foot while holding the bow in his hands. The mechanism of injury is discussed. When dealing with a longbow-related fatality, examination of the weaponry used and reenactment of the fatal methodology are critical in determining whether self-inflicted injury is a probability.