Unilateral giant renal angiomyolipoma and pulmonary lymphangioleiomyomatosis

Angiomyolipomas (AMLs) are mesenchymal neoplasms, named so because of the complex tissue composition represented by variable proportions of mature adipose tissue, smooth muscle cells, and dysmorphic blood vessels. Although AMLs may rise in different sites of the body, they are mostly observed in the kidney and liver. In the case of renal AMLs, they are described in two types: isolated AMLs and AMLs associated with tuberous sclerosis (TS). While most cases of AMLs are found incidentally during imaging examinations and are asymptomatic, others may reach huge proportions causing symptoms. Pulmonary lymphangioleiomyomatosis (LAM) is a rare benign disease characterized by cystic changes in the pulmonary parenchyma and smooth muscle proliferation, leading to a mixed picture of interstitial and obstructive disease. AML and LAM constitute major features of tuberous sclerosis complex (TSC), a multisystem autosomal dominant tumor-suppressor gene complex diagnosis. The authors report the case of a young female patient who presented a huge abdominal tumor, which at computed tomography (CT) show a fat predominance. The tumor displaced the right kidney and remaining abdominal viscera to the left. Chest CT also disclosed pulmonary lesions compatible with lymphangioleiomyomatosis. Because of sudden abdominal pain accompanied by a fall in the hemoglobin level, the patient underwent an urgent laparotomy. The excised tumor was shown to be a giant renal AML with signs of bleeding in its interior. The authors call attention to the diagnosis of AML and the huge proportions that the tumor can reach, as well as for ruling out the TSC diagnosis, once it may impose genetic counseling implications.

Nested central volcanism related to rift development and giant landsliding in oceanic islands

Centro Superior de Investigaciones Científicas, Museo Nacional de Ciencias Naturales, Estación Volcanológica de Canarias

One small scan for radiology, one giant leap for forensic medicine - Post-mortem imaging replaces forensic autopsy in a case of traumatic aortic laceration

The questions of cause and manner of death are the most pressing ones in any forensic investigation. Traditionally, autopsy is the means to provide answers to these questions and despite the increasing use of CT and MR in the post-mortem setting, imaging has usually been an adjunct to forensic autopsy. Here we describe a case where post-mortem CT and MR were performed instead of autopsy, at the request of the responsible public prosecutor. The forensic conclusions derived from imaging, including cause and manner of death were accepted by the legal authorities, thereby setting precedence for future cases. This case represents a landmark in forensic medicine and is another step toward the full realization of minimally invasive forensic autopsy.

Giant aneurysm after aortic coarctation: repair without circulatory arrest

We describe the case of a 23-year-old patient presenting for redo aortic arch surgery because of recoarctation and poststenotic aneurysm formation after patch aortoplasty in infancy. Using the hemi-clamshell approach, the entire aortic arch was replaced and the supraaortic branches were reimplanted. The applied surgical technique using hypothermic extracorporeal circulation without cardiac arrest allowed an uninterrupted cerebral and spinal cord perfusion due to stepwise clamping of the aortic arch during reconstruction and resulted in an excellent neurologic outcome at six-month follow-up.?

Clues on the frequency of giant planets in wide orbits

The available results of deep imaging searches for planetary companions around nearby stars provide us useful constraints on the frequencies of giant planets in very wide orbits. Here we present some preliminary results of the Monte Carlo simulation which compare the published detection limits with the generated planetary masses and orbital parameters. This allow us to consider the impications of the null detection, which comes from the direct imaging techniques, on the distributions of mass and semimajor axis derived from the results of the other search techniques and also to check the agreement of the observations with the available planetary formation models.

The Extremely Red, Young L Dwarf PSO J318.5338-22.8603: a Free-Floating Planetary-Mass Analog to Directly Imaged Young Gas-Giant Planets

We have discovered using Pan-STARRS1 an extremely red late-L dwarf, which has (J - K)(MKO) = 2.78 and (J - K) (2MASS) = 2.84, making it the reddest known field dwarf and second only to 2MASS J1207-39b among substellar companions. Near-IR spectroscopy shows a spectral type of L7 +/- 1 and reveals a triangular H-band continuum and weak alkali (K I and Na I) lines, hallmarks of low surface gravity. Near-IR astrometry from the Hawaii Infrared Parallax Program gives a distance of 24.6 +/- 1.4 pc and indicates a much fainter J-band absolute magnitude than field L dwarfs. The position and kinematics of PSO J318.5-22 point to membership in the beta Pic moving group. Evolutionary models give a temperature of 1160(-40)(+30) K and a mass of 6.5(-1.0)(+1.3) M-Jup, making PSO J318.5-22 one of the lowest mass free-floating objects in the solar neighborhood. This object adds to the growing list of low-gravity field L dwarfs and is the first to be strongly deficient in methane relative to its estimated temperature. Comparing their spectra suggests that young L dwarfs with similar ages and temperatures can have different spectral signatures of youth. For the two objects with well constrained ages (PSO J318.5-22 and 2MASS J0355+11), we find their temperatures are approximate to 400 K cooler than field objects of similar spectral type but their luminosities are similar, i.e., these young L dwarfs are very red and unusually cool but not "underluminous." Altogether, PSO J318.5-22 is the first free-floating object with the colors, magnitudes, spectrum, luminosity, and mass that overlap the young dusty planets around HR 8799 and 2MASS J1207-39