Endofibrosis of the external iliac artery is an uncommon disease affecting primarily young, otherwise healthy, endurance athletes. Thigh pain during maximal exercise with quick resolution postexercise is characteristic of the so-called cyclist's iliac syndrome. We report an unusual case in which the typical endofibrotic plaque was accompanied by dissection of the external iliac artery. The patient was treated surgically with excision of the affected artery segment and placement of an interposition graft. This case highlights an unusual finding in association with external iliac artery endofibrosis and provides an opportunity to briefly review the literature on the subject.
Occult gastrointestinal bleeding frequently frustrates clinicians' attempts to locate the source. Foci of hemorrhage within the small bowel are often found only at laparotomy and can be attributed to Meckel's diverticula, carcinomas, or less frequently, pulsion-type diverticula. We report our experience with two patients whose jejunal diverticula resulted in recurrent episodes of massive gastrointestinal hemorrhage.
Carcinosarcoma of the esophagus is a rare malignant neoplasm, predominantly affecting men in their seventh decade of life. While presenting symptoms and anatomic location of squamous cell and carcinosarcoma of the esophagus are similar, the latter often presents as a large intraluminal polypoid mass on barium esophagram. The more favorable prognosis associated with carcinosarcoma versus other esophageal neoplasms has been attributed to early onset of symptoms, resulting in prompt diagnosis, and a lower propensity for tumor invasion. We report the case of an elderly woman presenting with dysphagia who was initially diagnosed with esophageal leiyomyosarcoma. Final tumor pathology showed esophageal carcinosarcoma.
Proliferating trichilemmal tumors are uncommon neoplasms that are usually benign, but characterized by frequent local recurrence. In this report, we describe a patient who sought treatment at our clinic for a right occiput scalp nodule measuring 1 cm in diameter. The subcutaneous lesion was mobile and without overlying skin ulceration. Excisional biopsy of the mass was performed and the pathologic diagnosis returned as malignant, proliferating trichilemmal (pilar) tumor. Resection margins were free of tumor. On further examination the patient had no evidence of metastatic disease. A schedule of routine follow-up visits was arranged to monitor the site for recurrent disease.
We report the case of a patient with congenital absence of the external carotid artery in whom we performed a carotid endarterectomy. The radiographic features and operative findings are presented. Four similar cases previously reported in the literature are reviewed. A comment on the pathophysiology of atherosclerosis at the carotid bulb in the absence of a bifurcation and a brief discussion on the possible embryologic explanation of this anomaly are discussed.
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