Pulmonary venous aneurysm presenting as a mediastinal mass in ischemic cardiomyopathy.

True aneurysm of the pulmonary vein is a rare lesion and may present as a mediastinal mass. Acquired aneurysm of the right superior pulmonary vein presenting as a middle mediastinal mass in a patient with ischemic cardiomyopathy associated with severe mitral regurgitation and dilated left atrium is described. Though the natural history of this lesion is uncertain, it may progressively enlarge and become symptomatic. Presence of this lesion in this patient with cardiomyopathy may require a modification of surgical technique at cardiac transplantation or surgical resection of an aneurysm without cardiopulmonary bypass.     

Leaking abdominal aortic aneurysm presenting as an inguinal mass.

Two patients with leaking abdominal aortic aneurysm (AAA) presenting as a tender inguinal mass are reported. Unusual presentations such as this often cause delays in definitive surgery which result in increased morbidity and mortality. It follows that the diagnosis of a leaking AAA should be considered in all patients with a tender pulsatile abdominal mass regardless of the presentation.     

Thrombosed giant coronary artery aneurysm presenting as an intracardiac mass

Giant coronary artery aneurysms are rare in adults and are usually found in association with Kawasaki's disease arising in childhood. We report a case of a thrombosed giant right coronary artery aneurysm presenting as an intracardiac mass detected after inferior wall myocardial infarction. Histologic analysis indicated that fibromuscular dysplasia was the underlying cause of the aneurysm.     

Pulmonary arterial aneurysm

Trell, E. (1973).Thorax, 28, 644-649. Pulmonary arterial aneurysm. This is the case report of the clinical, radiographic, and physiological progress of a patient with increasing aneurysmal dilatation of the main pulmonary arteries, followed over a period of 10 years.     

Leaking iliac aneurysm presenting as pelvic mass

A case report of a pelvic mass as a manifestation of a bleeding iliac artery aneurysm is presented, as well as a discussion of other pelvic lesions which might alter configuration of the bladder.     

Gestational choriocarcinoma presenting as endobronchial carcinoma.

A patient is reported who presented with features of bronchial obstruction due to endobronchial tumour. Failure to recognise this as being due to choriocarcinoma led to a delay in diagnosis and effective treatment which, given earlier, may have proved lifesaving.     

Splenic artery aneurysm presenting as left renal mass

A case of splenic artery aneurysm presenting as a left upper quadrant mass represents a diagnostic challenge due to its paucity of clinical signs and symptoms. The condition must be distinguished from urologic pathology. Celiac angiography is necessary for diagnostic confirmation. Surgical resection is advised for most patients.     

Cryptococcal granuloma presenting as an intracranial mass.

A case of cryptococcosis of the central nervous system presenting as an intracranial space occupying lesion is described. The world literature and epidemiology of this unusual disease are surveyed. Problems in the diagnosis and the use of modern diagnostic techniques are discussed. The authors suggest that cryptococcosis should be included in the differential diagnosis of an intracranial space occupying lesion.     

Breast cancer presenting as an axillary mass.

Experience with breast cancer presenting as an axillary mass in 42 patients has been reviewed according to initial clinical findings, treatment and survival. In the absence of an obvious inflammatory lesion, an axillary node may prove to be the first sign of breast cancer. It has been demonstrated that such a node should be biopsied and if positive for adenocarcinoma, a radical mastectomy performed presuming other primary sites have been ruled out. The survival rate after surgery in this group of patients is better than in those who present with a palpable breast mass and have axillary metastases.     

Non-Hodgkin's lymphoma, presenting as an isolated endobronchial mass after bilateral lung transplantation: a case report

BACKGROUND: Lymphoma is a serious complication following solid organ transplantation. Endobronchial involvement of non-Hodgkin's lymphoma (NHL) is rare usually occurring in the setting of widely disseminated disease. Only a few cases of isolated endobronchial NHL have been reported. They were mostly confined to the main bronchi. METHODS: Herein we have described a case of an obstructive endobronchial NHL lesion in a young patient, which developed 6 years after bilateral lung transplantation for cystic fibrosis. RESULTS: Successful treatment was obtained with endoscopic resection of the lesion followed by chemotherapy. CONCLUSIONS: In rare cases NHL may present as an isolated endobronchial mass in the main bronchi. Because in these cases the prognosis seems to be better, early diagnosis is essential. Rigid bronchoscopy offers the opportunity to safely obtain large amounts of tissue for complete histological diagnosis and to de-obstruct the airway to relieve the symptoms.     

Leigh's disease presenting as an intramedullary mass lesion.

An unusual presentation of Leigh's disease consisting of rapid progression of leg weakness in a young child is discussed. Magnetic resonance imaging revealed an intramedullary mass lesion of the conus medullaris. Surgical exploration revealed only necrosis and inflammation. Subsequent studies revealed pathology in the cerebrum as well as the spinal cord. Metabolic abnormalities confirmed the diagnosis of Leigh's disease. The differential diagnosis of intramedullary mass lesions demonstrated by magnetic resonance imaging should include metabolic, inflammatory, and ischemic processes as well as neoplastic disease.     

Ruptured right coronary artery aneurysm presenting as a myocardial mass

Rupture of a coronary artery aneurysm may result in a contained hematoma and an intramyocardial mass. We present a case of a contained coronary artery aneurysm rupture presenting as a mass in the right ventricle. The mass was suspected in a preoperative transthoracic echocardiogram and identified at the time of elective coronary artery bypass surgery. We discuss the pathophysiology, clinical presentation, diagnostic features, and management of this uncommon clinical presentation.     

Innominate venous aneurysm presenting as a rapidly expanding mediastinal mass

Thoracic venous aneurysms are extremely rare conditions. Only 14 innominate venous aneurysms have been reported in the literature. We report a case of a 13-year-old girl who presented with a mediastinal mass on chest roentgenogram, which was performed because the patient was postoperatively tachypneic after a routine appendectomy. Further investigations revealed a large left innominate venous aneurysm that was growing rapidly. The patient underwent aneurysmectomy and reconstruction of the innominate vein. The patient's postoperative course was uneventful, and her respiratory symptoms resolved.