Iatrogenic arteriovenous fistula of the iliac artery after lumbar discectomy surgery: a systematic review of the last 18 years.

Patients with iatrogenic iliac arteriovenous fistulas (IAVFs) after lumbar discectomy surgeries (LDSs) from our hospital and the published literature were reviewed in order to better understand this clinical phenomenon. Literature from databases about iatrogenic IAVFs after LDSs were retrieved and a patient from our hospital was reviewed with emphasis placed upon the patient's clinical data. From 31 publications and studies of 44 individuals' data, the study revealed L4-L5 and/or L5-S1 intervertebral space levels were mostly involved (62.0%). Most of the patients underwent computed tomography angiography (CTA) and/or digital subtraction angiography (DSA) examinations to confirm the potential diagnosis and rule out other differential diagnosis (86.4%). Most of the patients (63.6%) developed features of high output heart failure months to years after the LDSs, and the majority of them (88.6%) were treated with endovascular repairs. An iatrogenic IAVF after an LDS is a rare occurrence; however, more attention should be paid to it for the purpose of obtaining accurate diagnosis and proper treatment.

Congenital absence of the right coronary artery: A case report and literature review.

RATIONALE: Congenital absence of the right coronary artery (RCA) is a rare congenital malformation of the cardiovascular system which may have fatal consequences. PATIENT CONCERNS: A 63-year-old man with a 5-year history of chest pain after exertion which had aggravated for >1 month was advised for admission and computed tomography angiography (CTA) examination of the coronary artery to screen for coronary artery disease (CAD). DIAGNOSES: The coronary artery CTA showed absence of RCA arising form the aortic root after which a selective coronary angiography (SCA) examination was done that confirmed the diagnosis of congenital absence of RCA. INTERVENTIONS: As the patient refused to receive a coronary artery stent implantation citing his financial condition, only symptomatic treatment was given. OUTCOMES: The patient requested to be discharged from the hospital against the advice of his doctors 1 week later. A query made by the telephone suggested that the patient's symptoms were under control by use of prescribed medications only. LESSONS: Although being a rare condition, a coronary artery CTA examination can be utilized to screen for congenital absence of RCA and other varieties of cardiovascular malformation whereas SCA can be performed to confirm the diagnosis.

Primary malignant non-Hodgkin's lymphoma of the breast: A case report.

Primary malignant lymphoma of the breast (PLB) is a rare disease. Treatment options include surgical resection, systemic chemotherapy, radiation and immunotherapy. At present, the optimum treatment combination remains controversial. The present study reports the case of a 39-year-old female with a six month history of a painless mass in the left breast. The mass was excised following medical examination. A diagnosis of diffuse large B-cell lymphoma was determined as a result of histological and immunohistochemical profile analysis. Further examinations excluded metastatic disease. Thus, finally, PLB (diffuse large B-cell lymphoma type) was diagnosed. The patient was treated with adjuvant systemic chemotherapy and consolidated radiation and a positive response was observed. During the 10 months of follow-up, no evidence of disease recurrence was identified. At present, the patient is scheduled for regular follow-up appointments. As the prevalence of PLB is increasing, the details of this rare case may aid clinicians treating similar patients, and highlight the importance of this disease.