Unusual long survival in a case of heterotaxy and polysplenia

Surg Radiol Anat. 2021 Apr;43(4):607-611. doi: 10.1007/s00276-020-02586-5. Epub 2020 Sep 29.

Abstract

Heterotaxy syndrome with polysplenia is an extremely rare congenital disorder caused by a disruption in the embryonic development that results in an abnormal arrangement of the abdominal and thoracic organs. We present the case of a 59-year-old female patient with invasive ductal carcinoma of the right breast (luminal A type) and CT findings of heterotaxy syndrome with polysplenia. The most remarkable anomalies identified were a left inferior vena cava draining into the hemiazygos vein, absent inferior vena cava at the thoracic level, and hepatic veins directly draining into the right atrium. Moreover, an atrial septal defect was identified, explaining the pulmonary hypertension of unknown cause previously detected in the patient. The relevance of this case lies in the unusual anatomical abnormalities found and the large patient survival, having in to account the great rate of heterotaxy syndrome mortality in the first years of life.

Keywords: Abnormal inferior vena cava; Atrial septal defect; Breast cancer; Case report; Heterotaxy; Polysplenia.

Publication types

  • Case Reports

MeSH terms

  • Bone Neoplasms / diagnosis
  • Bone Neoplasms / secondary
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / therapy
  • Carcinoma, Ductal, Breast / diagnosis
  • Carcinoma, Ductal, Breast / therapy
  • Chemoradiotherapy, Adjuvant
  • Contrast Media / administration & dosage
  • Female
  • Heterotaxy Syndrome / diagnosis*
  • Humans
  • Incidental Findings
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / secondary
  • Mastectomy, Segmental
  • Middle Aged
  • Spleen / abnormalities*
  • Spleen / diagnostic imaging
  • Time Factors
  • Tomography, X-Ray Computed

Substances

  • Contrast Media