This case report describes a 75 year-old woman who presents with a post-traumatic thoracic aortic pseudoaneurysm (TAPA), approximately 40 years later. Due to the rarity of this condition, no standardized approach exists. We describe the successful treatment of this disease with Carotid-Subclavian bypass followed by thoracic endovascular vascular aortic repair (TEVAR) of the pseudoaneurysm.

Patients who have multivessel coronary artery stenosis on catheterization are good candidates for Coronary Artery Bypass Graft because stenting is less efficacious in reducing mortality when involving more than two coronary vessels. We present a patient who complains of chest pain status post coronary artery bypass graft using the left internal mammary artery over 10 years prior. The patient is diagnosed with coronary-subclavian steal syndrome via Doppler ultrasound and catheterization. The patient is treated surgically via carotid distal subclavian/axillary bypass grafting due to extensive stenosis of the subclavian graft.

The prevalence of melanoma is on the rise in western society especially as the younger generation ages. Although considered a malignancy of the skin, melanoma can spread to multiple systems throughout the body due to the location of melanocytes in multiple organ systems. Therefore, it is essential for physicians to detect malignant melanoma at the earliest stage in order to decrease the risk of metastasis. We describe a case of a 69-year-old gentleman with a significant past medical history of stage 1a melanoma diagnosed 5 years ago, who presents with multiple nodal masses. The patient is diagnosed with metastatic melanoma after discovery of enhancing lesions on CT imaging of the head, neck, and abdomen confirmed via biopsy of the supraclavicular node. Although the stage 1a melanoma has a low rate of recurrence and metastasis, it is paramount that physicians continue to due serial, thorough dermatologic exams even after successful excision of the primary tumor.

The worst fear for any cancer patient to hear is the word metastasis. Melanoma is highly associated with metastasis and the higher the staging, the less likely the patient is to survive. We discuss a 46-year-old gentleman who presents with recurrent pleural effusions and shortness of breath with a previous diagnosis of metastatic melanoma. He had an initial lesion on his deltoid, which was excised with wide margins but was found to have an enlarged lymph node that was confirmed by pathology to be metastatic melanoma. Further diagnostic workup came back normal. Nodular melanoma has a worse prognosis due to lesions having already metastasized by the time of diagnosis. Due to the aggressive behavior, many suggest adjuvant chemotherapy with surgical excision of any lesions.