Unusual Autopsy Findings Research Articles

Hemorrhage in Sternocleidomastoid and Other Strap Muscles in a Case of Hanging: An Unusual Autopsy Finding

Hemorrhage in Sternocleidomastoid and Other Strap Muscles in a Case of Hanging: An Unusual Autopsy Finding

A Case of Ligature Strangulation in an Agricultural Accident with Unusual Autopsy Findings.

A Case of Ligature Strangulation in an Agricultural Accident with Unusual Autopsy Findings.

Black Esophagus

To the Editor.—I read with great interest the article by Altenburger et al1 on black esophagus. The authors describe unusual autopsy findings in a 45-year-old woman with a history of cocaine and alcohol abuse and believe that the cause of death was acute necrotizing esophagitis. Black esophagus is a rare disease characterized by circumferentially appearing necrosis of the distal esophagus that extends proximally and may involve the entire length of the organ. Its etiology is usually multifactorial, including ischemic phenomenon, chemical injury to the tissue from gastric contents, and a decrease in effective mucosal defense barriers. Mortality is high because of underlying medical conditions (cardiovascular disease, sepsis, malignancy, and multiorgan failure remain major risk factors for the development of black esophagus and for patient fatality) but is not directly related to the esophageal disease, except in the rare cases of perforation, mediastinitis, and esophageal infection in immunocompromised individuals.2 Chronic cocaine and alcohol abuse will easily trigger a significant cardiac event, such as arrhythmia, a more likely cause of death in this patient, with a rather incidental finding of black esophagus.

Unusual autopsy finding in a case of metastatic teratocarcinoma

An unusual autopsy finding was seen in a young case of metastatic teratocarcinoma of the right testis. The patient presented with features of myocardial ischemia and died of sudden cardiac arrest. At autopsy, the lungs were studded with variably sized metastatic nodules composed of glistening hyaline cartilage. Examination of the coronary arteries revealed complete occlusion of the left anterior descending and left circumflex artery lumina by tumor emboli composed of glistening white chondromyxoid material. Histopathology confirmed the presence of mature hyaline cartilage and chondromyxoid material in tumor emboli. The individual died due to severe coronary insufficiency and sudden cardiac arrest secondary to complete luminal occlusion of the left anterior descending and left circumflex artery lumina by tumor emboli composed of hyaline cartilage.

An exceptional case of lethal disulfiram-alcohol reaction

A case of fatal disulfiram-alcohol reaction due to ingestion of ethanol and antabuse is presented. Unusual autopsy findings and toxicological results are described. This case represents a report of corrosion lesion in the lower oesophagus and stomach due to a violent chemical reaction in situ and also the highest blood concentration of acetaldehyde (41 mg/l) ever recorded.

The Nevoid Basal Cell Carcinoma Syndrome

Three of our patients with the nevoid basal cell carcinoma syndrome died as a result of their disease. The clinical and autopsy findings on these patients and others recorded in the literature are the subject of this report. Some of the unusual autopsy findings included direct extension of the basal cell carcinoma into the brain in two cases with metastasis to other parts of the brain and lung in one case, congenital anomalies of the brain in three cases, kidney anomalies in two cases, leiomyomas in three cases, adrenal cortical adenomas in two cases, fibrocystic disease of the breast in two of the three women, and oxyphil cell nodular hyperplasia of the parathyroid gland in one case.