In this article, we describe a case of a surgically treated aneurysm of an aberrant right subclavian artery. The historical literature to date is summarized, as are the key concepts relative to the anatomy, embryology, diagnosis, and treatment of this uncommonly occurring entity. Although the topic might be expected to be of concern to only a few specialists, all physicians should be aware that a patient with an enlarging aneurysm of an aberrant subclavian artery may experience dyspnea, dysphagia, or sudden collapse from rupture as the initial manifestations. An asymptomatic patient may have a mediastinal mass detected by roentgenography. The diagnosis may be confirmed with computed tomography or magnetic resonance imaging. As with most aneurysms, surgical treatment is recommended, and the benefit-to-risk analysis depends on individual case factors.

Two-hundred thirteen intravenous digital subtraction angiographic (DSA) examinations were performed on 195 intravenous drug abusers to rule out the possibility of a mycotic aneurysm in a groin, neck, or upper extremity infection. Twenty-three surgically proved cases of mycotic aneurysm were correctly identified with no false positive results. In addition, six cases of major venous occlusion were documented. We present the results of our experience and conclude that DSA is an effective and cost-efficient method of examining this high risk patient population.

An unusual primary extraosseous osteogenic sarcoma is described. The tumor's mammographic appearance was highly suggestive of the correct histologic diagnosis. This case supports the theory that these tumors originate from a totipotent cell.

Though generally nonspecific, the patterns of diaphyseal uptake of bone seeking radionuclides, when correlated with the radiographic findings and clinical histories, often suggest specific diagnoses and may obviate the need for further imaging. Diaphyseal uptake is considered in terms of "hot spots," unilateral long segment lesions and bilateral processes that may be symmetric or asymmetric in distribution. Scintigrams and corresponding radiographs of 18 different lesions are illustrated.

No abstract