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Background To add to the confusion in the debate on pathogenesis of os-odontoideum, an additional report of its occurrence in two members of the same family is reported. Case Description This is a report of a rare coincidence wherein both father (51 years old) and daughter (25 years old) were diagnosed to have os odontoideum and presented with crippling neurologic deficits. Conclusions Following atlantoaxial fixation, both recovered in their symptoms. Investigations revealed no genetic abnormality. Literature on the subject is briefly reviewed.

Background and importance The article identifies the feasibility of transarticular screw fixation after mobilizing the vertebral artery in cases where it is in a "high-riding" location. Clinical presentation A 42-yr-old male patient had a 4-yr history of progressive quadriparesis. Investigations revealed severe basilar invagination. There was assimilation of atlas and C2-3 fusion. The vertebral artery was "high-riding" into the pedicle-facet of C2 vertebra on both sides. Vertebral artery loop was exposed and mobilized inferiorly on both sides after careful drilling of pedicular bone on the posterior aspect of the dome of the artery. C2 facetal bone on the anterior face of the vertebral artery dome was now available for screw insertion. The C1-2 facets and the articulation were directly in line, making transarticular screw fixation relatively straightforward. The wide bone space available permitted insertion of 2 screws in a transarticular fashion on both sides. The patient had satisfactory clinical improvement. Imaging after 22 mo showed bone fusion across the facets. Conclusion Mobilization of the high-riding vertebral artery loop can help salvage the surgical procedure of lateral mass stabilization.

Pancreatic neuroendocrine tumors (P-NET) are known to involve the spleen, but rarely do they present as a primary splenic mass mimicking as non-lymphoreticular splenic malignancy, i.e. angiosarcoma. The distal portion of the pancreatic tail extends along the course of the splenic artery and vein, and enters into the hilum of the spleen contained within the splenorenal ligament. As a consequence of these anatomical relationships, the spleen and its vasculature may be involved in disorders affecting the pancreas. We report an exceptionally rare and unique presentation of P-NET as a splenic mass leading to misdiagnosis as an even rarer splenic angiosarcoma.