Imaging Characteristics of Occipital Bone Osteoblastoma

Osteoblastoma is a rare benign tumor of the calvarium. We present the case of a 20-year-old female with occipital osteoblastoma and discussion of imaging modalities of calvarial osteoblastoma. To our knowledge, this is the ninth reported case of occipital osteoblastoma. Imaging characterization of osteoblastoma may vary. Plain radiograph, CT, MRI, and CT angiography establish osteoblastoma characterization and vascular supply prior to surgical resection.

Download Full-text

Giant Adrenal Lipoma with Hemorrhage Requiring Extended Surgical Resection

Case Reports in Gastroenterology ◽

10.1159/000520626 ◽

2021 ◽

pp. 978-984

Author(s):

Kanji Otsubo ◽

Shinjiro Kobayashi ◽

Keisuke Ida ◽

Masafumi Katayama ◽

Satoshi Koizumi ◽

...

Keyword(s):

Surgical Resection ◽

Benign Tumor ◽

Case Reports ◽

Treatment Algorithm ◽

Surrounding Tissue ◽

Adrenal Tumors ◽

Active Hemorrhage ◽

Appropriate Treatment ◽

Histopathologic Diagnosis ◽

Rare Benign Tumor

Adrenal lipoma is a rare, benign tumor, reported to account for 0.7% of primary adrenal tumors. A 69-year-old man presented with left lateral abdominal pain. Computed tomography (CT) was performed, and a huge, irregularly shaped retroperitoneal tumor of uneven internal density was identified, with the border between the tumor and the pancreas and kidney being unclear. Active hemorrhage was also depicted. The tumor consisted mainly of fat, with the exception of the hematoma; it measured 200 mm; and the boundary between it and nearby organs, such as the pancreas, was unclear. Despite angiography being performed twice, the responsible vessel was not identified. Thus, for the purpose of both diagnosis and treatment, we resected the tumor, and considering the possibility of a malignancy, such as liposarcoma, we also resected the pancreatic body and tail and the spleen. The final histopathologic diagnosis was benign adrenal lipoma with hemorrhage, with no invasion to surrounding tissue. Hemorrhage within an adrenal tumor is rare. Most adrenal lipomas are small “incidentalomas” and asymptomatic. With development of a large adrenal lipoma comes the possibility of hemorrhage along with the possibility of features suggestive of malignancy. We encountered a giant adrenal lipoma with hemorrhage and, because of the aforementioned features, performed extended surgical resection, seen in retrospect as oversurgery. The widespread use of CT has led to an increased number of reported cases of adrenal lipoma. We anticipate an accumulation of case reports, which will allow for development of an appropriate treatment algorithm.

Download Full-text

Intraoperative Contrast Enhanced Ultrasound (IO-CEUS) and Color Coded Elastography (CCE) for characterization of liver lesion before surgical resection

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0033-1354886 ◽

2013 ◽

Vol 34 (S 01) ◽

Author(s):

N Platz Batista da Silva ◽

M Loss ◽

J Rennert ◽

AG Schreyer ◽

S Farkas ◽

...

Keyword(s):

Surgical Resection ◽

Liver Lesion ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced

Download Full-text

An Invasive Hemolymphangioma of the Pancreas in a Young Woman

Combinatorial Chemistry & High Throughput Screening ◽

10.2174/1386207322666190103110747 ◽

2019 ◽

Vol 21 (10) ◽

pp. 798-800 ◽

Cited By ~ 1

Author(s):

Zhijun Zhang ◽

Qinghong Ke ◽

Weiliang Xia ◽

Xiuming Zhang ◽

Yan Shen ◽

...

Keyword(s):

Computed Tomography ◽

Case Report ◽

Young Woman ◽

Benign Tumor ◽

Abdominal Distension ◽

Accurate Diagnosis ◽

Cystic Tumor ◽

Rare Benign Tumor ◽

Radical Surgical Resection

Background: Hemolymphangioma is a rare benign tumor. To the best of our knowledge, there were only 10 reports of this tumor of the pancreas until March 2018. Case Report: Here, we reported a large invasive hemolymphangioma of the pancreas in a young woman with a complaint of abdominal distension and an epigastric mass about 3 weeks. She was found to have a huge multilocular cystic tumor at the neck and body of pancreas on computed tomography. She was eventually diagnosed with hemolymphangioma of the pancreas after operation. After 2 years of follow-up, there was no signs of recurrence. Conclusion: From our case and literature, we can conclude that hemolymphangioma of the pancreas is uncommon benign tumor, and it is hard to make an accurate diagnosis preoperatively. Radical surgical resection should be performed whenever possible. The prognosis of this disease seems good.

Download Full-text

Testicular fibroma: A case report

Archive of oncology ◽

10.2298/aoo1304139s ◽

2013 ◽

Vol 21 (3-4) ◽

pp. 139-140

Author(s):

Sunita Shere ◽

Anjali Kulkarni ◽

Shubhjyoti Pore ◽

Rajan Bindu

Keyword(s):

Case Report ◽

Benign Tumor ◽

Histopathological Diagnosis ◽

Testicular Mass ◽

Rare Benign Tumor ◽

Testicular Malignancy ◽

Slow Growing

Testicular fibroma of gonadal stromal origin is a rare benign tumor of testis, which usually presents as a slow growing testicular mass. Intratesticular fibroma of gonadal stromal origin, with or without minor sex cord elements, must be considered, analogous to similar tumors in ovary, as a benign tumor. Until now, only 25 cases of testicular fibroma have been reported in the literature. We reported a case of testicular fibroma in a 20 years male who presented with painless right testicular enlargement since two years. Ultrasonography (USG) showed heterogeneous mass in right scrotum suggestive of testicular malignancy. Right orchidectomy was done. Histopathological diagnosis was testicular fibroma, which was confirmed by immunohistochemistry.

Download Full-text

Is the Rationale of Anatomical Liver Resection for Hepatocellular Carcinoma Universally Adoptable? A Hypothesis-Driven Review

Medicina ◽

10.3390/medicina57020131 ◽

2021 ◽

Vol 57 (2) ◽

pp. 131

Author(s):

Young-Jen Lin ◽

Cheng-Maw Ho

Keyword(s):

Hepatocellular Carcinoma ◽

Tumor Microenvironment ◽

Surgical Resection ◽

Tumor Recurrence ◽

Hepatic Metastases ◽

Vascular Supply ◽

Tumor Ablation ◽

Supporting Evidence ◽

En Bloc ◽

Margin Width

Surgical resection is the first-line curative treatment modality for resectable hepatocellular carcinoma (HCC). Anatomical resection (AR), described as systematic removal of a liver segment confined by tumor-bearing portal tributaries, may improve survival by reducing the risk of tumor recurrence compared with non-AR. In this article, we propose the rationale for AR and its universal adoption by providing supporting evidence from the advanced understanding of a tumor microenvironment and accumulating clinical experiences of locoregional tumor ablation therapeutics. AR may be advantageous because it completely removes the en-bloc by interrupting tumor vascular supply and thus extirpates the spreading of tumor microthrombi, if they ever exist, within the supplying portal vein. However, HCC is a hypervascular tumor that can promote neoangiogenesis in the local tumor microenvironment, which in itself can break through the anatomical boundary within the liver and even retrieve nourishment from extrahepatic vessels, such as inferior phrenic or omental arteries. Additionally, increasing clinical evidence for locoregional tumor ablation therapies, such as radiofrequency ablation, predominantly performed as a non-anatomical approach, suggests comparable outcomes for surgical resection, particularly in small HCC and colorectal, hepatic metastases. Moreover, liver transplantation for HCC, which can be considered as AR of the whole liver followed by implantation of a new graft, is not universally free from post-transplant tumor recurrence. Overall, AR should not be considered the gold standard among all surgical resection methods. Surgical resection is fundamentally reliant on choosing the optimal margin width to achieve en-bloc tumor niche removal while balancing between oncological radicality and the preservation of postoperative liver function. The importance of this is to liberate surgical resilience in hepatocellular carcinoma. The overall success of HCC treatment is determined by the clearance of the theoretical niche. Developing biomolecular-guided navigation device/technologies may provide surgical guidance toward the total removal of microscopic tumor niche to achieve superior oncological outcomes.

Download Full-text

Management of Basal Cell Adenoma of Accessory Parotid Gland Through Transoral Approach: Report of a Rare Case With Review

Craniomaxillofacial Trauma & Reconstruction Open ◽

10.1177/24727512211030839 ◽

2021 ◽

Vol 6 ◽

pp. 247275122110308

Author(s):

Charudatta Naik ◽

Sanjay Joshi ◽

Bhupendra Mhatre ◽

Sneha Punamiya

Keyword(s):

Parotid Gland ◽

Basal Cell ◽

Benign Tumor ◽

Transoral Approach ◽

Surgical Approaches ◽

Basal Cell Adenoma ◽

Diagnostic Dilemma ◽

Cell Adenoma ◽

Rare Benign Tumor ◽

Accessory Parotid Gland

Diagnosis of mid-cheek mass has always been a diagnostic dilemma for clinicians. The incidence of the accessory parotid gland (APG) has been well documented in the literature. However, a diverse spectrum of pathologies can arise from this accessory parotid tissue. Basal cell adenoma is a rare benign tumor that predominantly affects the parotid gland. Its occurrence in the accessory parotid gland has been documented in 9 cases till date. Surgical approaches for the management of such APG lesions have been in debate. This report documents a case of Basal Cell Adenoma arising in accessory parotid tissue in a 55-year-old woman who was treated by transoral excision. This paper also reviews previously documented cases of all APG lesions and attempts to elucidate the rationale for selecting an appropriate surgical approach.

Download Full-text

Quantification and Characterization of Carotid Calcium with Multi-detector CT-angiography

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2006.02.019 ◽

2006 ◽

Vol 32 (5) ◽

pp. 561-567 ◽

Cited By ~ 50

Author(s):

M. Miralles ◽

J. Merino ◽

M. Busto ◽

X. Perich ◽

C. Barranco ◽

...

Keyword(s):

Ct Angiography

Download Full-text

Robotic, totally endoscopic excision of mitral valve papillary fibroelastoma

10.1510/mmcts.2021.045 ◽

2021 ◽

Keyword(s):

Mitral Valve ◽

Aortic Valve ◽

Tricuspid Valve ◽

Benign Tumor ◽

Pulmonary Valve ◽

Papillary Fibroelastoma ◽

Robotic Assisted ◽

Endoscopic Excision ◽

Rare Benign Tumor ◽

Sixth Decade

Papillary fibroelastoma is a rare, benign tumor that affects males more frequently than females and that tends to be diagnosed during the fifth or sixth decade of life. It tends to arise on cardiac valves, with the aortic valve being the most frequent location followed by the mitral valve, the tricuspid valve, and the pulmonary valve. We present the case of a robotic-assisted, totally endoscopic excision of a mitral valve papillary fibroelastoma.

Download Full-text

Abstract 1122‐000172: High Resolution Vessel Wall Imaging and Cerebrovascular Plaques: Comparison with DSA, MRA, and CTA

Stroke: Vascular and Interventional Neurology ◽

10.1161/svin.01.suppl_1.000172 ◽

2021 ◽

Vol 1 (S1) ◽

Author(s):

Rami Fakih ◽

Alberto Miller ◽

Ashrita Raghuram ◽

Sebastian Herrera ◽

Sedat Kandemirli ◽

...

Keyword(s):

Vessel Wall ◽

The Other ◽

Imaging Modalities ◽

Plaque Burden ◽

Rater Agreement ◽

Cross Sectional ◽

Tof Mra ◽

Plaque Detection ◽

Wall Imaging

Introduction : Current imaging modalities might underestimate the presence and severity of intracranial atherosclerosis (ICAD). High resolution vessel wall imaging (HR‐VWI) MRI emerged as a powerful tool to diagnose plaques not detected on routine imaging. We aim to compare different imaging modalities (HR‐VWI MRI; digital subtraction angiogram (DSA); Time‐of‐flight (TOF) MRA; and CTA) in the identification and characterization of intracranial atherosclerotic culprit plaques. Methods : Patients diagnosed with ICAD were prospectively imaged with HR‐VWI MRI. Culprit plaques were identified based on the likelihood of causing the stroke. Using cross‐sectional images of intracranial vessels, regions of interest (ROI) were delineated. Then, diameters and ROI areas were measured for the purpose of calculating the following variables: degree of stenosis (DS) at the plaque level, plaque burden (PB), and remodeling index (RI). Additional imaging modalities (DSA, TOF MRA, and CTA) were identified retrospectively for each patient. The sensitivity of detecting a culprit plaque as well as the correlations between the different variables were analyzed for each modality. Linear regression analysis was used to determine the association of DS with PB and RI. Interobserver agreement on the determination of a culprit plaque on every imaging modality was evaluated. Results : A total of 44 patients who underwent HR‐VWI had ICAD and were included in the final analysis. Of those, 34 had CTA, 18 had TOF‐MRA, and 18 had DSA. Using HR‐VWI as gold standard, the sensitivity for culprit plaque detection was 88% for DSA, 78% for TOF MRA, and 76% for CTA. We found no difference between the DS in all four modalities using measured cross‐sectional diameters, but difference was found when measuring ROI areas to calculate DS. There was a significant positive correlation between PB and DS on HR‐VWI MRI (p<0.001), but not on the DSA (p = 0.168), MRA (p = 0.144), or CTA (p = 0.253), and a significant negative correlation between RI and DS on HR‐VWI MRI (p = 0.003), but not on DSA (p = 0.783), MRA (p = 0.405), or CTA (p = 0.751). PB and RI predicted the degrees of stenosis on HR‐VWI, but not on the other modalities. There was good inter‐rater agreement for culprit plaque detection on HR‐VWI (k = 0.48, p = 0.001), but no agreement was found on the other modalities. Conclusions : HR‐VWI MRI can locate otherwise undetectable plaques on conventional imaging through the ability to measure plaque burden, an essential component for characterization of plaques severity and a strong predictor of stenosis. HR‐VWI also showed more accurate measurements of degree of stenosis through measurement of ROI areas, and had good inter‐rater agreement for accurate plaque detection, compared to DSA, MRA, and CTA.

Download Full-text