Preliminary Exploration of the Diagnosis and Treatment of Skull-Based Chondromyxoid Fibromas

2017 ◽  
Vol 15 (3) ◽  
pp. 270-277
Author(s):  
Kangmin He ◽  
Shize Jiang ◽  
Xin Zhang ◽  
Ying Mao ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Diagnosis And Treatment ◽  
Benign Tumors ◽  
Symptom Duration ◽  
Study Cohort ◽  
Imaging Characteristics ◽  
Subtotal Removal ◽  
Base Of The Skull

Abstract BACKGROUND Chondromyxoid fibromas (CMFs) are benign tumors that occur rarely in the skull base. OBJECTIVE To conduct a preliminary exploration of the diagnosis and treatment of cranial CMFs. METHODS A retrospective analysis of 19 cases of CMFs in the base of the skull between 2009 and 2014 in our hospital was conducted. The clinical manifestations, imaging characteristics, pathology, treatment strategies, and outcomes were examined. RESULTS The study cohort included 7 women (36.8%) and 12 men (63.2%), and symptom duration ranged from 1 mo to 5 yr. Of the 19 intracranial CMF cases examined, 15 (78.9%) conformed with the diagnostic criteria for extracranial CMF. Resection operations yielded subtotal removal of 13 tumors (68.4%) and partial removal of 6 tumors (31.6%). Postoperative pathological analysis demonstrated that the tumors were characterized by spindle-shaped or stellate cells arranged in a myxoid matrix without mitoses or permeation. Follow-up (range 2-7.3 yr; mean, 4.4 ± 1.7 yr) revealed that symptoms improved postoperatively in 15 cases (78.9%), were maintained in 2 cases (10.5%), and worsened in 2 cases (10.5%). Imaging follow-up revealed that residual tumors were stable in 18 cases (94.7%) and enlarged in 1 case (5.3%). CONCLUSION An accurate diagnosis should involve comprehensive consideration of clinical, radiological, and pathological features. The treatment strategy for CMFs consists of maximizing tumor removal while protecting adjacent key structures. Postoperative stereotactic radiotherapy is appropriate for residual tumors.

Spinal artery aneurysms: clinical presentation, radiological findings and outcome

2018 ◽  
Vol 10 (7) ◽  
pp. 644-648 ◽  
Author(s):  
Leonardo Renieri ◽  
Eytan Raz ◽  
Giuseppe Lanzino ◽  
Timo Krings ◽  
Maksim Shapiro ◽  
...  
Keyword(s):  
Back Pain ◽  
Retrospective Review ◽  
Clinical Presentation ◽  
Treated Patient ◽  
Demographic Data ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Imaging Characteristics ◽  
Arterial Aneurysms

Background and purposeSpinal arterial aneurysms are a rare cause of spinal subarachnoid hemorrhage (SAH). We performed a retrospective review of spinal arterial aneurysms not associated with spinal arteriovenus shunts from three institutions in order to better understand the clinical and imaging characteristics of these lesions.Materials and methodsWe performed a retrospective review of spinal arterial aneurysms managed at three North American institutions. For each patient, the following information was collected: demographic data, clinical presentation, comorbidities, imaging findings, and neurological status at the last follow-up. Treatment strategies and outcomes were reported.Results11 patients were included; 7 were women and median age was 60 years. The most common presentation was sudden back pain (81.8%). We found 3 aneurysms on the radiculomedullary artery and 8 along the radiculopial arteries. Of the 3 aneurysms on the radiculomedullary artery, 1 was treated conservatively, 1 was treated with coiling of the aneurysm and sacrifice of the radiculomedullary artery, and 1 was treated with surgical trapping. The 8 aneurysms on the radiculopial artery were treated endovascularly in 4 cases, surgically in 1 case, and conservatively in 3 cases. One surgically treated patient had a spinal subdural hematoma. There were no other complications. Mean clinical follow-up time was 20 months, and 87.5% of patients were functionally independent.ConclusionsSpinal arterial aneurysms are lesions which commonly present with sudden back pain and spinal SAH. Conservative, surgical, and endovascular treatment options are safe and effective. Long term outcomes in these patients are generally good.

scholarly journals Clinical Characteristics of Nodular Fasciitis of Ear in Children

2021 ◽  
Author(s):  
Xiaoxu Wang ◽  
Wei Liu ◽  
Lejian He ◽  
Min Chen ◽  
Jianbo Shao ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Neck Surgery ◽  
Final Diagnosis ◽  
Diagnosis And Treatment ◽  
Nodular Fasciitis ◽  
Gene Test ◽  
The Right

Abstract Purpose Summarized the clinical characteristics and diagnosis and treatment process of three cases of nodular fasciitis of ear, to provide a basis for clinical diagnosis and treatment. Methods Reviewed the clinical manifestations, images, pathology, treatment and postoperative follow up results of three cases of pediatric nodular fasciitis in the Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University from 2018 to 2020. Results The average age at diagnosis were 24 months, with two girls and a boy. Two lesions were found in the left ear and one in the right ear. All cases had a history of biopsy before surgery. Two of three cases showed a sign of rapid growth after biopsy and three of which were ineffective in anti-inflammatory treatment. FISH test for USP6 were performed in two of the three cases with positive results. Three lesions show a hypointensity or isointensity on T1-weighted MRI and a heterogeneous hyperintensity on T2-weighted MRI. ‘‘Fascial tail’’ sign was found on image of all three cases. All lesions underwent surgical resection. Follow-up showed no recurrence and had an intact ear appearance. Conclusion The early misdiagnosis rate of nodular fasciitis of the ear is high. Combine clinical features with imaging findings may improve the accuracy of preoperative diagnosis. Besides the appearance of pathology, USP6 gene test is also an important tool in the diagnosis. The final diagnosis should be based on comprehensive assessment. Complete surgical resection can prevent recurrence.

scholarly journals Feasibility of surgical management in patients with mammary tuberculosis-study of 100 cases.

2018 ◽  
Vol 27 (1) ◽  
pp. 44-49
Author(s):  
RN Laila ◽  
B Islam ◽  
S Banu ◽  
J Raihan
Keyword(s):  
Surgical Intervention ◽  
Treatment Strategies ◽  
Diagnosis And Treatment ◽  
Idiopathic Granulomatous Mastitis ◽  
Breast Tuberculosis ◽  
Chest Disease ◽  
Disease Hospital ◽  
Anti Tubercular Therapy

Tuberculous mastitis is a rare entity in patients with mammary disease even in countries where incidence of tuberculosis is high. In Bangladesh, TB is an endemic disease but breast tuberculosis is rarely reported. Its clinical patterns and treatment strategies are changing day by day. With this study, we aimed to analyze the role of surgery in diagnosis and treatment of hundred (100) cases received care for tuberculous mastitis at the Chest Disease Hospital, Rajshahi, from July’ 2012 to July’ 2016. This is a prospective nonrandomized descriptive study. Diagnosis was made in all patients initially by cytological examination from suspected lesions, which revealed typical tuberculous lesions. In all the patients the diagnosis was confirmed by biopsy of the lesion (open biopsy or core cut biopsy) with histological examination and detection of acid fast bacilli in discharge by Gene x-pert test and Z-N staining to exclude idiopathic granulomatous mastitis, malignancy and very rare concomitant malignancy. Medical therapy with anti-tubercular drugs (ATT) ranging from 9 to 12 months with follow up monthly was the mainstay of treatment. Surgical intervention reserved for selected refractory cases (36%). Extension of anti-tubercular therapy from 9 to 12 or 18 months required in fifty-eight(58) patients on the basis of slow clinical response. Complete resolution obtained in 92 patients but residual tiny mass in eight patients confirmed by repeated FNAC or biopsy to be fibrotic. Surgery play an essential role both in diagnosis and treatment of tubercular mastitis in addition with ATT but beware about unnecessary surgical intervention as majority of patients cured with only ATT.TAJ 2014; 27(1): 44-49

scholarly journals Pure Radial Scars Do Not Require Surgical Excision When Concordant and Benign at Image-guided Breast Biopsy

2021 ◽  
Author(s):  
Maria Piraner ◽  
Kelly D’Amico ◽  
Lawrence L Gilliland ◽  
Mary S Newell ◽  
Michael A Cohen
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Breast Imaging ◽  
Breast Biopsy ◽  
Surgical Excision ◽  
Study Cohort ◽  
Core Needle ◽  
Imaging Characteristics

Abstract Objective To determine the best management option (surgical excision versus imaging surveillance) following the diagnosis of pure radial scars (RSs) and RSs with associated additional high-risk lesions (HRLs) encountered on percutaneous core-needle breast biopsy. Methods An IRB–approved retrospective review of the breast imaging reporting system database was performed to identify all cases of pure RS alone or RS plus an additional HRL (papilloma, atypia, lobular neoplasia) diagnosed on core-needle biopsy, from 2007 to 2016, at four breast centers in our institution. Cases with associated malignancy, discordant radiologic-pathologic results, or those lost to follow-up were excluded. The remaining cases were evaluated to determine results of either subsequent surgical excision or long-term follow-up imaging (minimum of two years). Additional data recorded included clinical presentation, breast density, personal and family history of breast cancer, lesion imaging characteristics, and biopsy method. Results The study cohort included 111 patients with 111 lesions: 56.8% (63/111) with RS alone (pure) and 43.2% (48/111) with RS plus additional HRL(s). Out of the 63 radiologic-pathologic concordant pure RSs, there were no upgrades to malignancy in 51 subsequent surgical excisions or 12 long-term surveillance cases (0/63, 0%). Out of the 48 RSs plus additional HRL(s), there were 2 upgrades to malignancy (2/48, 4.2%). Conclusion Cases of radiologic-pathologic concordant pure RS diagnosed at core-needle biopsy do not require surgical excision. On the other hand, surgical excision should be considered for RS plus additional HRLs diagnosed at core-needle biopsy.

scholarly journals Solitary Encapsulated Neurofibroma Not Associated with Neurofibromatosis-1 Affecting Tongue in a 73-Year-Old Female

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Sk. Abdul Mahmud ◽  
Neha Shah ◽  
Moumita Chattaraj ◽  
Swagata Gayen
Keyword(s):  
Family History ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
Neurofibromatosis Type ◽  
Clinical Findings ◽  
Benign Tumors ◽  
History Of

Neurofibromas are benign tumors of nerve cell origin arising due to proliferation of Schwann cells and fibroblasts. They are usually asymptomatic and hence remain undiagnosed. They are commonly found on the skin and intraorally tongue is the most common site for their occurrence. Here, we present a unique case of solitary encapsulated neurofibroma in the oral cavity without any clinical manifestations or family history of Neurofibromatosis type 1 in a 73-year-old female patient who presented with a painless swelling on the tongue. The histopathologic findings closely mimicked benign fibrous histiocytoma. In our case, definitive diagnosis of neurofibroma was made based on clinical findings, family history, and histopathological and immunohistochemical evaluation. Through this case report we want to emphasize the role of biopsy and immunohistochemistry in arriving at a confirmatory diagnosis. The patient was treated by surgical excision and showed no signs of recurrence over a follow-up period of 12 months.

Cerebral Hemangioblastoma Without Von Hippel-Lindau Syndrome: A Report of 6 Cases

2020 ◽  
pp. 106689692093399
Author(s):  
Limei Qu ◽  
Chuanqi Lv ◽  
Tiefeng Ji ◽  
Yinping Wang ◽  
Jinlu Yu
Keyword(s):  
Parietal Lobe ◽  
Clinical Manifestations ◽  
Pathological Examination ◽  
Cystic Tumor ◽  
Mixed Tumor ◽  
Wild Type ◽  
Von Hippel Lindau ◽  
Imaging Characteristics ◽  
Von Hippel Lindau Syndrome

Background. Hemangioblastoma occurs mainly in the cerebellum and rarely in the cerebrum. Objective. The present study aimed to analyze the clinical manifestations and radiological and pathological features of cerebral hemangioblastoma, and to improve the recognition of this tumor and avoid misdiagnosis. Methods. The characteristics of 6 patients with cerebral hemangioblastoma were analyzed, and a retrospective review of cerebral hemangioblastoma reported in the literature was performed. Results. All 6 patients were female, aged from 22 to 70 years (55 years on average), and all cases were wild-type sporadic, in which 4 cases occurred in the frontal lobe and 2 cases occurred in the parietal lobe. Imaging revealed a solid tumor in 4 cases, a cystic tumor in 1 case, and a mixed tumor in 1 case. Microscopically, the morphology and immunophenotype of tumor cells were not different from those of classical hemangioblastoma. All 6 patients survived tumor free during the follow-up period. Conclusions. Cerebral hemangioblastoma often simulates the imaging characteristics of meningioma or glioma. Enough attention should be paid to differential diagnosis before the operation, and exact diagnosis relies on the pathological examination.

A new classification and strategies for endovascular treatment of celiac artery aneurysms

Vascular ◽  
2021 ◽  
pp. 170853812110327
Author(s):  
Xu Li ◽  
Wan Zhang ◽  
Min Zhou ◽  
Yong Ding ◽  
Yonggang Wang ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Celiac Artery ◽  
Type I ◽  
Type Ii ◽  
Main Trunk ◽  
Single Center Experience ◽  
Type Ia

Background Endovascular treatment is being increasingly used for celiac artery aneurysms (CAAs), but systematic endovascular treatment strategies have not been defined yet. This study intended to investigate the strategies of endovascular management of CAAs according to a single-center experience. Methods Anatomically, CAAs were classified into two types: Type I CAAs located in the main trunk of celiac artery. Type II CAAs located on the branches of the celiac artery. Type I and Type II CAAs can be further divided into two different subtypes according to fusiform (a) or saccular or (b) morphology: type Ia, type Ib, type IIa, and type IIb. Patient demographics, clinical manifestations, aneurysm characteristics, endovascular intervention procedures, and perioperative and follow-up outcomes were reviewed and analyzed. Results Between August 2012 and August 2020, 18 consecutive patients (12 men; mean age, 56.8 ± 14.5 years) with CAAs were identified and treated with endovascular procedures. There were seven patients with type Ia, three patients with type Ib, four patients with type IIa, and four patients with type IIb CAAs. One patient died of hemorrhagic shock due to a ruptured aneurysm. Technical success was achieved in 16 patients (88.9%). The mean follow-up period was 51.7 ± 19.4 months. No hepatic or intestinal ischemia or death developed perioperatively or during the follow-up period. No aneurysmal expansion was detected on CTA surveillance, except for one patient who was diagnosed with an endoleak during the follow-up and received reintervention. Conclusions The endovascular strategy based on the novel classification of CAAs was safe and effective, with a favorable mid-term clinical outcome.

scholarly journals Appendiceal Neoplasms: Diagnosis, Management and Follow-up

2021 ◽  
Vol 3 (3) ◽  
pp. 274-282
Author(s):  
Ana Pereira ◽  
Joaquim Costa Pereira ◽  
Sandra Martins
Keyword(s):  
Case Reports ◽  
Experimental Studies ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Signet Ring Cell ◽  
Current Data ◽  
Patient Counseling ◽  
Appendiceal Neoplasms ◽  
Recent Classification

Appendicectomy is one of the most performed surgical procedures. Neoplasms of the appendix are identified in approximately 1% of appendiceal specimens, and the incidence seems to be rising. The aim of this review was to summarize the current data on these neoplasms, focusing on the recent classification, clinical manifestations, management, and follow-up of such patients, which remain under debate. A literature search was performed using the database PubMed. The keywords used were related to appendiceal neoplasms, mucocele, pseudomyxoma peritonei and treatment. Records without abstracts, case reports, opinion articles and experimental studies were excluded. The appendix tumors can be classified between epithelial or nonepithelial. The epithelial variant is composed by mucinous neoplasms, nonmucinous adenocarcinoma, and signet ring cell tumors; instead, neuroendocrine tumors, lymphoma, and sarcoma are included in nonepithelial neoplasia. Goblet cell carcinoids share characteristics of both epithelial and nonepithelial tumors. The clinical presentation can be variable and the algorithm for evaluation and treatment is complex. Treatment is based on stage and histology. Our intention is to clarify some questions and help the surgeon in operative decisions, treatment strategies, and patient counseling. Doi: 10.28991/SciMedJ-2021-0303-9 Full Text: PDF

scholarly journals Pancreatic Leiomyosarcoma With Schistosomiasis Hematobia: A Case Report and Literature Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Qiang Li ◽  
Daniel Staiculescu ◽  
Yurong Zhou ◽  
Jiang Chen
Keyword(s):  
Case Report ◽  
Tumor Resection ◽  
Clinical Manifestations ◽  
Malignant Neoplasm ◽  
The Body ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri ◽  
The Relationship ◽  
Ct And Mri

Pancreatic leiomyosarcoma (PL) is a very rare, malignant neoplasm with a very poor prognosis. Here, we examine a novel case of PL with schistosomiasis hematobia. The patient had been initially misdiagnosed by the first magnetic resonance imaging (MRI). The second imaging examination demonstrated an enlarged heterogeneous tumor mass in the body-tail of pancreas. Following image analysis, the patient underwent a pancreatectomy, splenectomy and lymph node dissections. Sixteen months after the tumor resection, follow-up computed tomography (CT) and MRI revealed tumor metastasis in the liver and lung. PL has non-specific clinical manifestations and imaging characteristics, making early diagnosis very challenging. When it is difficult to distinguish between benign and malignant pancreatic lesions, short-term imaging follow-up is preferred. In this case report, we discuss the relationship between PL and schistosomiasis hematobia.

Actual Problems and Perspectives of the Application of Nuclear Medicine Techniques in the Diagnostic and Treatment of Hepatocellular Carcinoma: Analytical Review

2019 ◽  
Vol 64 (5) ◽  
pp. 58-68
Author(s):  
Андрей Бушманов ◽  
Andrey Bushmanov ◽  
О. Клементьева ◽  
O. Klement'eva ◽  
А. Лабушкина ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Nuclear Medicine ◽  
Radiation Therapy ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Distant Metastases ◽  
Diagnosis And Treatment ◽  
Traditional Methods ◽  
Early Results

In the presented review of publications, together with a brief analysis of the incidence, risk factors for the occurrence and methods of diagnosis of hepatocellular carcinoma (HCC), current problems and prospects for the application of nuclear medicine methods in the diagnosis and treatment of this disease are indicated. Hepatocellular carcinoma is one of the most common malignant tumors of the liver and is characterized by a rapidly progressing course with an unfavorable life expectancy. A variety of clinical manifestations of the disease creates certain difficulties in the early diagnosis of HCC. Although HCC screening is most commonly used to determine the level of alpha-fetoprotein (AFP), ultrasound (US), bolus CT and MRI, experience in the use of radionuclide imaging diagnostics, including positron emission tomography, is important in clinical practice (PET), which, not being the main method of primary diagnosis of HCC, however, confirmed their relevance in the differential diagnosis between a benign tumor and metastasis with unclear diagnostic data, as well as in the process of monitoring treatment and in the diagnosis of distant metastases. Conceptual issues in determining the treatment strategy of patients with HCC, depending on the staging of the disease, the prospects for optimizing treatment strategies and traditional methods of treating HCC in detail and in depth are covered in various publications, including publications of domestic authors. Based on this, the authors of the article limited themselves to a brief analysis of the use of embolization and radiation therapy methods for treating HCC, the active development of which in the last decade, as well as promising early results of treatment, suggest that radiation therapy can be considered as the main treatment method for HCC traditional methods. Further study and development of radionuclide methods for the diagnosis and therapy of HCC, as well as the search and study of new radiopharmaceuticals for diagnosis and regional intraarterial radiotherapy is one of the promising directions in modern approaches to the diagnosis and treatment of HCC.

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