Intra-ocular melanoma metastatic to an axillary lymph node: a case report.

BACKGROUND: Unusual metastatic presentation of intra-ocular melanoma. STUDY DESIGN: Case report. DISCUSSION: Extra-regional lymphatic spread of intra-ocular melanoma has not been reported previously in the literature. The usual pattern of metastasis for intra-ocular melanoma is hematogenous. There are few reports of regional spread to the maxillofacial bones. We report an interesting case of a 51 year old female with prior history of right eye melanoma, now presenting with metastasis to the left axilla, which is an extra-regional nodal basin. CONCLUSION: In female patients presenting with an isolated axillary mass, with a negative breast work up and known prior history of melanoma, the differential diagnosis should include possible metastatic melanoma. Core biopsy will confirm the diagnosis and tailor subsequent management.

Lymphoma of the breast: a mimic of inflammatory breast cancer.

BACKGROUND: Unusual presentation of breast lymphoma with signs and symptoms suggestive of inflammatory breast cancer. DISCUSSION: Lymphoma of the breast is uncommon whether it is primary or secondary. Most breast lymphomas are of B cell origin. The most frequent mode of presentation is a painless breast mass. The clinical presentation of localized left breast erythema and edema with an associated left breast mass is common for an inflammatory breast cancer but highly unusual for lymphoma of the breast. CONCLUSION: In patients with a left breast mass associated with erythema and edema, the differential diagnosis should include breast lymphoma in addition.

Primary squamous cell carcinoma of the breast: a case report and review of the literature.

Primary squamous cell carcinoma of the breast is a rare tumor. The prognosis is poor, and hence there is a clinical trend to offer multi-modal treatment options of surgery, chemotherapy, and radiation therapy. There is no consensus on treatment options due to the paucity of available data. We are reporting the case of a 68-year-old lady who presented with a right breast mass. Upon core biopsy and further workup, she was noted to have primary squamous cell carcinoma of the breast. She was successfully treated with surgical therapy alone without disease recurrence at 36 months. Primary squamous cell carcinoma of the breast can be treated successfully with surgical therapy alone. The role of adjuvant chemotherapy, radiation therapy, and anti-estrogen therapy should be questioned as these modalities can lead to significant treatment-related morbidities and might not be contributing to disease-free interval or overall survival from this unusual tumor subtype.

Spontaneous rupture of hypogastric artery aneurysm into the bladder: a case report and review of the literature.

Isolated internal iliac artery (hypogastric) aneurysms are rare. The incidence is less than 0.9%. They are usually asymptomatic. Symptoms can be due to compression of adjacent pelvic structures such as the bladder, ureters, and colon. Rupture of hypogastric artery aneurysms into the bladder has rarely been reported and, when present, is associated with prior abdominal instrumentation or trauma. There is one case where an arteriovesicular fistula formed spontaneously without any instrumentation or trauma, similar to our case. We describe an unusual case of an 81-year-old male with spontaneous rupture of a hypogastric artery aneurysm into the urinary bladder presenting as gross hematuria. This case illustrates the importance of a high index of suspicion in diagnosis and early treatment to reduce morbidity and mortality.

Inferior vena cava duplication and deep venous thrombosis: case report and review of literature.

Duplications of the inferior vena cava (IVC) are seen with an incidence of 0.2% to 3.0%. Duplications causing symptoms are rare, with only six reported cases of IVC duplication associated with a deep venous thrombosis. We present a 78-year-old caucasian woman with an IVC duplication who developed a deep venous thrombosis. The etiologies of IVC duplication include failure of anastomosis between the primitive cardinal veins and failure of regression of the left supracardinal vein. When asymptomatic, treatment includes observation, placing filters in both systems, or coil-embolization of the duplicated segment plus placing a filter in the right IVC. For our patient, we chose to coil-embolize the communication to the duplicated segment as well as place a filter in the main right IVC system.