Sudden death due to ruptured pseudoaneurysm of femoral artery in injected drug abusers - report of four cases at autopsy and review of literature.

Pseudoaneurysm in injected drug abusers occurs due to traumatic damage by the repeated injections and infections. It most commonly involves the femoral artery that requires intensive management. When medical attention is delayed, the victim is prone to have massive bleeding from the ruptured artery, resulting in death. Although pseudoaneurysms in injected drug abusers are known, there is paucity of autopsy study on sudden deaths due to its rupture. We report four such cases with different presentations of the pseudoaneurysm that had ruptured spontaneously. The paper highlights the case history and autopsy findings of these cases with review of literature of this catastrophic event in injected drug abusers.

Metastasis of a cecal adenocarcinoma to the prostate five years after a right hemicolectomy: a case report.

INTRODUCTION: Prostatic metastasis from a primary bowel adenocarcinoma has been only rarely reported in the medical literature. The case reported here is rare in the fact that the primary tumor was from a right-sided bowel adenocarcinoma. It is unusual because initial immunostaining was not fully conclusive, and so a relatively new method of immunostaining, CDX2, was used to ascertain its histopathology. CASE PRESENTATION: We describe the case of a 54-year-old Caucasian man who had a right hemicolectomy for a primary cecal adenocarcinoma, which was completely excised. Following the procedure, he received adjuvant chemotherapy. Computed tomography scans showed no evidence of local recurrence or metastatic disease. Then, five years later, he presented to his general practitioner with urinary symptoms. An abnormal prostate was palpated on digital rectal examination. Trans-rectal prostatic biopsies were performed, which showed colorectal metastases within the prostate gland. This was confirmed with CDX2 immunohistochemistry. There was no further evidence of distant metastases on positron emission tomography-computed tomography scans. CONCLUSIONS: This case demonstrates a rare isolated hematogenous spread to the prostate from a primary cecal adenocarcinoma, several years after definitive treatment and excision. This highlights the importance of accurate immunohistochemistry and imaging in planning further management and treatment.