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Giant congenital melanocytic nevi in a patient with brain structural malformations and multiple lipomatosis.

We present a 9-year-old boy diagnosed from birth with giant congenital melanocytic nevi. He had central structural brain malformations of hemimegalencephaly of the right frontotemporal lobe and left occipitoparietal lobe, choroid plexus hypertrophy, and a Dandy-Walker variant. In addition, he developed multiple lipomatoses. These lesions were cutaneous except for two at the cerebellopontine angles, which were present from birth. This patient represents a rarely documented example of two histopathologies resulting in serious complications. The diagnostic issues and histopathologic process are discussed.

Brain↗

Fatal acute pulmonary embolism in a patient with pelvic lipomatosis after surgery performed after transatlantic airplane travel.

We describe a case of a 37-yr-old patient who traveled from Europe to the United States and succumbed to a massive pulmonary embolism 6 days after elective pelvic surgery despite routine postoperative thrombotic prophylaxis. In retrospect, he was likely to have developed a deep venous thrombosis during the transatlantic trip to our hospital. Anesthesiologists and other physicians involved in perioperative management need to be aware of the prevalence of venous thromboembolism in patients with a history of recent prolonged air travel. This is particularly true in tertiary referral centers, where patients with rare diseases may have a major surgical intervention within days of prolonged air travel.

Adult↗

Demonstration by magnetic resonance of symptomatic spinal epidural lipomatosis.

In patients with Cushing's syndrome or morbid obesity, excessive accumulation of fat in the hips, upper back, abdomen, and mediastinum is well known (1, 3, 7). Excessive deposition of fat in the epidural space is less common, but must be recognized as a potential cause of neurological deficit (1-8). We report a patient with iatrogenic Cushing's syndrome, in whom magnetic resonance imaging (MRI) established the specific diagnosis of spinal cord compression secondary to excess epidural fat.

Adult↗