Retroclavicular

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Pseudoaneurysm of the subclavian-vertebral artery junction (SVJ) is a rare complication of internal jugular vein catheter placement. Because of its retroclavicular location, arterial injury at the SVJ poses a significant therapeutic challenge. A case report and review of the literature are presented.

UNLABELLED: Surgical neck exploration is usually made in primary hyperparathyroidism (PHPT). Localization of the adenoma or detection of hyperplasia may reduce the operation period and limit the extent of the surgery. In this study the effficacy of preoperative Tc-99m MIBI scintigraphy and intraoperative gamma probe was evaluated. MATERIALS AND METHODS: Six patients with PHPT had preoperative Tc-99m MIBI parathyroid scintigraphy and intraoperative gamma probe (IGP) was used in surgical neck exploration...

Neurogenic dumbbell tumors occur more frequently in the cervical than in the thoracic or lumbar spine. Cervical paravertebral masses usually do not become exceptionally large because they are superficial and are palpated easily. Thoracic tumors can become large before they are detected. The authors describe a large intrathoracic dumbbell tumor arising from the C8 nerve root. The intraspinal tumor was resected through a posterior approach. In the second stage, dividing the clavicle, the intrathoracic component was resected by separating it from the lung...

Subclavian vein occlusion limits insertion of pacing electrodes in children and adults. The concern is greatest in children with a long-term need for pacing systems necessitating use of the contralateral vein and potential bilateral loss of access in the future. We describe an operative technique to provide ipsilateral access in chronic subclavian vein occlusion in five consecutive pediatric (n = 4, mean age 6.5 years) and adult (n = 1, age 70 with bilateral subclavian vein occlusion) patients in whom this condition was noted at the time of pacemaker or ICD implant...

We report the case of a 77 year old woman with a giant proliferating trichilemmal cyst of the scalp and a central squamous-cell carcinoma. Six months after radical tumor-excision and dissection of the locoregionary lymph nodes the patient developed retroclavicular lymph node metastases. The tumor develops from cells of the hair matrix and tends to recur after excision; in rare cases malignant transformation may occur. We suggest radical excision and complete histological examination of the tumor. In cases of malignancy, lymph node-dissection is sometimes necessary...

BACKGROUND: Paraneoplastic pemphigus was first described in 1990 in 5 patients with extensive mucocutaneous erosions, a distinct set of autoantibodies, and underlying neoplasia. Since then, patients described have been middle-aged, have suffered from prognostically unfavorable malignant neoplasms, and have responded poorly to immunosuppressive agents. OBSERVATION: A 16-year-old boy was examined with extensive oral erosions, halitosis that interfered with his quality of life, and rapid weight loss...

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Thyroid carcinoma may invade the upper mediastinum by direct extension of the primary or metastases to the paratracheal or retroclavicular-parajugular lymph nodes. From 1962 to 1994, 24 (16 papillary, 3 follicular, 3 medullary, and 2 undifferentiated) of 1204 thyroid cancer patients (2%) received trans-sternal cervico-mediastinal tumor resection. The tumor was resected totally in 16 patients, and residual at the time of initial operation in 8 patients. 9 patients were recived radiation therapy after surgery...

Clavicular fractures are occasionally responsible for lesions of the brachial plexus. The symptoms are usually delayed and due to compression by hypertrophic callus, nonunion or a subclavian pseudoaneurysm. We describe a patient in whom a displaced bone fragment was pressing on the retroclavicular part of the brachial plexus, leading to early symptoms of a lesion of the posterior cord. Internal fixation of the clavicle and external neurolysis of the brachial plexus gave an almost full recovery.

We report a case of an extraosseous aneurysmal cyst arising in the left retroclavicular soft tissue of a 29-year-old woman. A magnetic resonance imaging (MRI) scan showed a solid lesion within soft tissue, abutting the clavicle without bone involvement. An incisional biopsy was interpreted as showing osteoclast rich nodular fasciitis with prominent vascularity. A second MRI 5 months later showed intralesional cystic change with areas of increased signal on T2-weighted images, still without any bony defect. The lesion was excised...

Brachial plexopathies are a common diagnostic problem: conventional imaging techniques can be useful in the detection of associated conditions (Pancoast tumors, first rib or clavicle fractures, etc.) but they cannot visualize brachial plexus structures directly. Also Computed Tomography (CT) is limited in the study of the retroclavicular region because of the artifacts due to the presence of the humeral heads in the slice. CT myelography exhibits very high accuracy in posttraumatic brachial plexopathies but fails to reveal the postganglionic plexus...

Seven cases are presented to illustrate four cervical surgical approaches to the upper mediastinum and thorax. These surgical approaches are described and illustrated, and we have termed these the retrosternal, retroclavicular, posterior, and lateral approaches. Two cases of thymic cyst, one of recurrent metastatic pretracheal adenopathy, a case of tracheal stenosis, a foreign body of the left subclavian artery, a large Zenker's diverticulum, and a neoglottic reconstruction are presented to illustrate the surgical anatomy, dissection technique, and postoperative complications...

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No abstract text is available yet for this article.