In patients with aorta-right atrial tunnel, 2-dimensional echocardiography and transesophageal echocardiography are enough to establish clinical diagnosis, but ascending aortography is necessary to differentiate from more common clinical conditions, like ruptured sinus of Valsalva aneurysm and coronary cameral fistula. The rarity of this condition is established by the fact that during the same period of time, we have treated in our institution 66 cases of ruptured sinus of Valsalva aneurysm, which is the most common aorta-right atrial communication. Treatment options are simple ligation or ligation with implantation of coronary ostium or coil embolization. The location of the coronary ostium dictates technical details. Follow-up reveals excellent functional recovery.
Cystic lesions in the neck are common. It is customary to classify them as those arising in the midline and those in the lateral neck. Dermoid cysts are present along the lines of embryonic fusion and hence said to be occurring due to an embryonic accident during the development. Most common locations in the neck are the lateral end of eyebrows and the floor of the mouth in the midline. We present a rare case of dermoid presenting as a mass in the lateral aspect of neck. Our case is unique since even though it was a dermoid cyst, the presentation of the mass was in the upper lateral neck which is very uncommon. A 28-year-old lady presented with a swelling at the junction of the upper one-third and lower two-third of the left sternocleidomastoid muscle. Intraoperatively, the cyst had extension from the lateral aspect of neck along the carotid sheath to the superior mediastinum. Dermoid cysts do present occasionally as lateral neck mass and must be kept in the differential diagnosis. Even though characteristic radiological and histopathological features make the diagnosis of dermoid cyst simple yet it may be difficult to diagnose, if present at unusual locations.
We report the clinical features and surgical management of 7 cases of cervical chemodectoma. Six patients with unilateral sporadic carotid body tumors and 1 with a unilateral tumor of the glomus jugulare were operated on between 1990 and 1994, without cerebrovascular accidents, mortality, or recurrence. Preoperative tumor embolization was employed in 2 cases. Angiography confirmed the diagnosis in all patients.
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