Tin Man Syndromes or Ectopia cordis Interna

By Dr Deepu

The following case was reported by Dr Matt Skalski in radiopedia.
The chest X ray was done on a person for employment screeing. The chest X ray showed no heart. Rare isn't it. On enquiry he didnt have any symptoms other than gastric reflux. Then a CT was done which showed heart inside the stomach.
This was the X ray picture

Now let us compare this X ray with a normal one.
The heart shadow is absent in the previous X rays compared to this.
This condition is called as Tin Man syndrome or Ectopia cardiac internalis, meaning heart is present at a different site inside the body.
Let us have a look at the CT films of the abdomen.






The CT images shows heart in the  abdomen.
Now let's know the historical aspects of TIN MAN syndrome which is extremely rare.


This picture is  of Da Vincis organ newotks of the thoracoabdominal cavity.There remains debate as to whether Leonardo Da Vinci's "Organ networks of the thoracoabdominal cavity" illustration (c.1502) was based off a corpse with ectopia cordis interna, or whether his depiction of the heart's location was a deliberate distortion of reality. Most legitimate scholars believe Da Vinci created the work as a flight of anatomical fancy.           
The first ever description of the condition in the medical literature was in a controversial monograph submitted to the Royal Society in 1874 by Dr. Nohear Lubdub. Entitled "An unusual case of ectopia cardia epigasticum in a Haryana boy", the monograph was later retracted when accusations were made that the images accompanying the text had been doctored.
It was not until 1908 that Dr Lubdub's work was vindicated when existence of the condition was confirmed during the early years of chest radiography. Unfortunately, Dr Lubdub had fallen into a deep depression following his expulsion from the Royal Society, only occasionally seen wandering the streets of Chandigarh mumbling "and yet it beats". His death was unrecorded. 

Disclaimer : this was a April Fool Case published in Radiopedia.org and is Imaginary.
Case courtesy of Dr Matt Skalski, 

Radiopaedia.org. From the case rID: 33437

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