A 69-year-old male complained of intermittent claudication of the right leg. Computed tomography revealed a right femoral artery stenosis with severe calcification and intimal thickening extending to the superficial and deep femoral arteries. Femoral endarterectomy and decalcification was carried out using the Cavitron Ultrasonic Surgical Aspirator (CUSA). All arteries were repaired by an ePTFE Y-shaped patch. Postoperative CT showed no stenosis and progressive calcification of the common, superficial and deep femoral arteries 2 years after surgery.

Cardiac tumors are rare, and multiple myxomas are even rarer. The latter phenomenon is mostly associated with the Carney complex, a dominantly inherited disease characterized by multiple primary cardiac myxomas, endocrinopathy, and spotty pigmentation of the skin. We report the rare case of a patient who did not have the Carney complex but had multiple primary cardiac tumors. A 78-year-old woman with a past history of breast cancer was referred to our hospital for further examination of multiple cardiac tumors. Echocardiography showed 4 tumors in the left atrium and left ventricle. We could not diagnose them preoperatively and decided to resect them surgically because they were mobile and could have caused embolism and obstruction. The postoperative pathological findings of all 4 tumors were myxomas, although the patient did not meet the diagnostic criteria of the Carney complex. Therefore, a rare case of multiple primary cardiac myxomas was diagnosed.
Aged ; Breast Neoplasms ; Carney Complex* ; Echocardiography ; Embolism ; Female ; Heart Atria ; Heart Neoplasms ; Heart Ventricles ; Humans ; Myxoma* ; Pigmentation ; Skin

A 78-year-old man was diagnosed with adult T-cell leukemia/lymphoma (ATL) and was started on standard chemotherapy 1 year earlier. However, treatment was discontinued because of adverse drug reactions and worsening delirium. Thereafter, he remained stable and was followed up while receiving etoposide. He then visited our hospital because of acute abdominal pain and underwent surgery with a diagnosis of gastrointestinal perforation. Intraoperative observation showed a reddened, concentric wall thickening measuring 4 cm and a perforation site in the ileum, and thus partial resection of the small bowel was performed. The histological diagnosis was small bowel perforation due to tumor cell invasion. Two months postoperatively, he started a less intensive chemotherapy regimen along with palliative care, and died due to the primary disease approximately 5 months postoperatively. ATL involves systemic organs because of its high organ-affinity. Once it involves the gastrointestinal tract, various gastrointestinal symptoms can occur. Patients with ATL are at risk of developing gastrointestinal perforation at any time during the clinical course. Therefore, clinicians should be aware that once gastrointestinal perforation develops, the prognosis becomes extremely poor. Assessment of the disease state, early detection of gastrointestinal lesions, and prevention of opportunistic infections appear to be important in the management of patients with ATL.