Contrast-Enhanced Mammography in the Diagnosis of Breast Angiosarcoma

A 60-year-old female presented for further assessment of a new right breast lump (November 2020). She had a history of a stage I (T1bN0M0) right breast invasive mammary carcinoma, grade 2 (score 7/9) with receptors ER/PR-negative, HER2/neu-positive, diagnosed four years prior to her current presentation. At that time, she was treated with a right breast lumpectomy and local radiation. Breast assessment with contrast-enhanced mammography showed new skin thickening with associated enhancement within the palpable region. Histology of subsequent ultrasound-guided biopsy found radiation-induced breast angiosarcoma. Breast angiosarcoma is a rare entity that represents less than 1% of all breast cancers. To our knowledge, this is the first case describing the imaging findings of breast angiosarcoma on contrast-enhanced mammography.

Download Full-text

Rectal adenocarcinoma with rectoprostatic fistula following prostate brachytherapy

BMJ Case Reports ◽

10.1136/bcr-2018-226151 ◽

2019 ◽

Vol 12 (3) ◽

pp. e226151

Author(s):

Basil Francis Moss ◽

Amjad M Peracha

Keyword(s):

Prostate Cancer ◽

Rare Complication ◽

Rectal Adenocarcinoma ◽

Second Primary ◽

Prostate Brachytherapy ◽

Suprapubic Catheter ◽

Second Primary Cancers ◽

First Case ◽

History Of ◽

Radiation Induced

An 80-year-old man with history of prostate cancer successfully treated with brachytherapy was initially thought to have Fournier’s gangrene until imaging detected a rectoprostatic fistula. Although this is known to be a rare complication of prostate brachytherapy, in this case the aetiology was a new primary rectal adenocarcinoma. It was not possible to catheterise per urethra owing to the fistula, so he was fitted with suprapubic catheter, and underwent palliative loop colostomy. Brachytherapy carries a low risk of second primary cancers, although two previous cases reported such cancers as radiation induced. This is, to our knowledge, the first case of rectal adenocarcinoma following prostate brachytherapy in the literature.

Download Full-text

Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00134-3 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Arti Khatri ◽

Nidhi Mahajan ◽

Niyaz Ahmed Khan ◽

Natasha Gupta

Keyword(s):

Past History ◽

Case Reports ◽

Final Diagnosis ◽

Adrenal Carcinoma ◽

Case Presentation ◽

First Case ◽

Contrast Enhanced ◽

Paediatric Age ◽

History Of ◽

Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

Download Full-text

Radiation-Induced Low Grade Fibromyxoid Sarcoma of the Larynx: a Case Report and Literature Review

Folia Medica ◽

10.3897/folmed.53.e56150 ◽

2021 ◽

Vol 63 (3) ◽

pp. 433-437

Author(s):

Dariya Chivchibashi ◽

Pavel Pavlov ◽

Maria Tzaneva ◽

Nikolay Sapundzhiev ◽

Georgi Davidov

Keyword(s):

Case Report ◽

Latency Period ◽

Metastatic Potential ◽

Low Grade ◽

Imaging Evaluation ◽

First Case ◽

Fibromyxoid Sarcoma ◽

History Of ◽

Radiation Induced ◽

Causes And Risk Factors

Low grade fibromyxoid sarcoma (LGFMS) is an uncommon variant of fibrosarcoma with high risk of local recurrence, immense metastatic potential and frequently protracted period between tumour presentation and metastasis. This unusual malignancy rarely affects the region of the head and neck which makes cases of laryngeal LGFMS extremely infrequent. To date, LGFMS of the larynx has been scatteredly mentioned in the literature. Neither incidence nor causes and risk factors for laryngeal LGFMS have been clarified so far. To the authors’ knowledge, this is the first case report that discusses the clinical course, imaging diagnosis, histopathological evaluation and surgical approach to radiation-induced laryngeal LGFMS.We present a case of a 70-year-old man who developed a LGFMS after previous radiotherapy (RT) for squamous cell carcinoma (SCC) of the larynx. The latency period between the time of radiation exposure and the diagnosis of LGFMS was twenty-seven months. After re-confirming the diagnosis with second biopsy and extensive imaging evaluation the patient was subjected to an open partial resection of the larynx. Owing to the rarity of the tumour, there is no established protocol with follow-up recommendations.This case highlights the importance of considering the RT history of the patient in order to monitor radiotherapy-related complications, including the occurrence of LGFMS.

Download Full-text

Partial visual recovery from radiation-induced optic neuropathy after hyperbaric oxygen therapy in a patient with Cushing disease

Acta Endocrinologica ◽

10.1530/eje.1.02161 ◽

2006 ◽

Vol 154 (6) ◽

pp. 813-818 ◽

Cited By ~ 26

Author(s):

Mara Boschetti ◽

Massimo De Lucchi ◽

Massimo Giusti ◽

Claudio Spena ◽

Guido Corallo ◽

...

Keyword(s):

Hyperbaric Oxygen ◽

Optic Neuropathy ◽

Corticosteroid Treatment ◽

Rapid Progression ◽

Cushing Disease ◽

Contrast Enhanced ◽

History Of ◽

Radiation Induced ◽

Optic Pathways ◽

The Right

Here we describe the case of a 41-year-old woman with a history of Cushing disease who had previously undergone unsuccessful neurosurgery, followed by stereotactic radiosurgery. More than 4 years after this treatment, she presented severe visual impairment, which started in the left eye and was documented by neuro-ophthalmic evaluation. Radiological assessment by contrast-enhanced magnetic resonance (MR) imaging initially suggested the diagnosis of glioma of the optic nerve and the patient started corticosteroid treatment (first with prednisone, 80 mg/day, followed by dexamethasone, 8 mg/day). Despite the therapy, vision in the left eye rapidly worsened until light was no longer perceptible; similar symptoms and signs also developed in the right eye, evolving to complete temporal hemianopsia. The clinical evidence was confirmed by the rapid progression of the MR picture, which showed homogeneous enhancement of the chiasm and optic nerves. On the basis of these findings, the original diagnosis of glioma was excluded, and radiation-induced optic neuropathy was diagnosed. As corticosteroids had proved inefficacious, hyperbaric oxygen (HBO) therapy was promptly instituted and vision steadily started to improve. This improvement was documented and confirmed by the progressive recovery of the visual field in the right eye and the changes in the sequential follow-up MR scanning. Optic neuropathy is an infrequent but dramatic complication of radiation therapy. Symptoms develop, on average, 12 months after treatment, and the onset may be acute and characterized by the progressive loss of vision in one or both eyes. HBO has already been used to treat this complication, but its efficacy is still controversial. Here, in addition to describing this particular case, which presented a significantly delayed radiation injury of the optic pathways, we provide a brief literature review and discuss some important points.

Download Full-text

Thyroid, Renal, and Breast Carcinomas, Chondrosarcoma, Colon Adenomas, and Ganglioneuroma: A New Cancer Syndrome, FAP, or Just Coincidence

Case Reports in Medicine ◽

10.1155/2016/2928084 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5

Author(s):

Ihab Shafek Atta ◽

Fahd Nasser AlQahtani

Keyword(s):

Malignant Tumors ◽

Familial Cancer ◽

Breast Cancers ◽

Cancer Syndrome ◽

Colon Adenomas ◽

Invasive Mammary Carcinoma ◽

History Of ◽

Familial Cancer Syndromes ◽

Cancer Syndromes ◽

Carcinoma Renal Cell

We are presenting a case associated with papillary thyroid carcinoma, renal cell carcinoma, invasive mammary carcinoma, chondrosarcoma, benign ganglioneuroma, and numerous colon adenomas. The patient had a family history of colon cancer, kidney and bladder cancers, lung cancer, thyroid cancer, leukemia, and throat and mouth cancers. She was diagnosed with colonic villous adenoma at the age of 41 followed by thyroid, renal, and breast cancers and chondrosarcoma at the ages of 48, 64, 71, and 74, respectively. Additionally, we included a table with the most common familial cancer syndromes with one or more benign or malignant tumors diagnosed in our case, namely, FAP, HNPCC, Cowden, Peutz-Jeghers, renal cancer, tuberous sclerosis, VHL, breast/other, breast/ovarian, Carney, Werner’s, Bloom, Li-Fraumeni, xeroderma pigmentosum, ataxia-telangiectasia, osteochondromatosis, retinoblastoma, and MEN2A.

Download Full-text

Case Report: Management of a Patient with mTBI and Vestibular Hypofunction with the Binasal Occlusion Technique

Vision Development & Rehabilitation ◽

10.31707/vdr2018.4.2.p87 ◽

2018 ◽

pp. 87-90

Keyword(s):

Case Report ◽

Visual Motion ◽

Hand Movement ◽

Motion Sensitivity ◽

Vestibular Hypofunction ◽

First Case ◽

Neurological Exam ◽

History Of ◽

Occlusion Technique ◽

Visual Vertigo

Background: Binasal Occlusion (BNO) is a clinical technique used by many neurorehabilitative optometrists in patients with mild traumatic brain injury (mTBI) and increased visual motion sensitivity (VMS) or visual vertigo. BNO is a technique in which partial occluders are added to the spectacle lenses to suppress the abnormal peripheral visual motion information. This technique helps in reducing VMS symptoms (i.e., nausea, dizziness, balance difficulty, visual confusion). Case Report: A 44-year-old AA female presented for a routine eye exam with a history of mTBI approximately 33 years ago. She was suffering from severe dizziness for the last two years that was adversely impacting her ADLs. The dizziness occurred in all body positions and all environments throughout the day. She was diagnosed with vestibular hypofunction and had undergone vestibular therapy but reported little improvement. Neurological exam revealed dizziness with both OKN drum and hand movement, especially in the left visual field. BNO technique resulted in immediate relief of her dizziness symptoms. Conclusion: To our knowledge, this is the first case that illustrates how the BNO technique in isolation can be beneficial for patients with mTBI and vestibular hypofunction. It demonstrates the success that BNO has in filtering abnormal peripheral visual motion in these patients.

Download Full-text

Adenoid Cystic Carcinoma of the Breast detected with Contrast-Enhanced Spectral Mammography: A Case Report

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616666201009144337 ◽

2020 ◽

Vol 16 ◽

Author(s):

Yun-Chung Cheung ◽

Shir-Hwa Ueng ◽

Shu-Hang Ng ◽

Wen-Lin Kuo

Keyword(s):

Left Breast ◽

Breast Cancers ◽

Resonance Imaging ◽

Carcinoma Of The Breast ◽

Outer Quadrant ◽

Additional Information ◽

Adenoid Cystic ◽

Modern Technique ◽

Contrast Enhanced ◽

Rim Enhancement

Background: Contrast-enhanced spectral mammogram (CESM) is a modern technique providing additional information to detect or diagnose the breast cancers. Introduction: We present a rare ACC of breast on CESM. Methods: A 49-year-old woman with surgicopathological proved ACC is reported with features on CESM, sonography and contrast-enhanced magnetic resonance imaging (CE-MRI). Results: Sonography revealed a 1.4 cm × 1.2 cm × 1 cm circumscribe round mass in the upper outer quadrant of the left breast that was diagnosed to fibroadenoma. The mammogram did not show any discernible mass, however the recombined subtracted images displayed a circumscribe mass with thin rim enhancement and enhanced internal patches that were resembling to CE-MRI. Finally, the mass was proved to ACC. Conclusion: CESM facilitates detection of an isodense cancer and provides the enhanced features for differential diagnosis. Resembling CE-MRI, CESM displayed rim enhancement and internal enhanced patches as diagnostic clues for this case of ACC.

Download Full-text

Scales and Units

10.1093/oso/9780190657543.003.0011 ◽

2018 ◽

Author(s):

Kathryn M. de Luna

Keyword(s):

Language Change ◽

Historical Linguistics ◽

Bantu Languages ◽

The North ◽

First Case ◽

Linguistic Evidence ◽

River Region ◽

History Of ◽

Alternative Approaches

This chapter uses two case studies to explore how historians study language movement and change through comparative historical linguistics. The first case study stands as a short chapter in the larger history of the expansion of Bantu languages across eastern, central, and southern Africa. It focuses on the expansion of proto-Kafue, ca. 950–1250, from a linguistic homeland in the middle Kafue River region to lands beyond the Lukanga swamps to the north and the Zambezi River to the south. This expansion was made possible by a dramatic reconfiguration of ties of kinship. The second case study explores linguistic evidence for ridicule along the Lozi-Botatwe frontier in the mid- to late 19th century. Significantly, the units and scales of language movement and change in precolonial periods rendered visible through comparative historical linguistics bring to our attention alternative approaches to language change and movement in contemporary Africa.

Download Full-text

Estrogens and Progestogens in Triple Negative Breast Cancer: Do They Harm?

Cancers ◽

10.3390/cancers13112506 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2506

Author(s):

Mark van Barele ◽

Bernadette A. M. Heemskerk-Gerritsen ◽

Yvonne V. Louwers ◽

Mijntje B. Vastbinder ◽

John W. M. Martens ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative ◽

Hormone Replacement ◽

Breast Cancers ◽

Younger Women ◽

Alternative Pathways ◽

Increased Risk ◽

History Of ◽

Hormone Sensitive

Triple-negative breast cancers (TNBC) occur more frequently in younger women and do not express estrogen receptor (ER) nor progesterone receptor (PR), and are therefore often considered hormone-insensitive. Treatment of premenopausal TNBC patients almost always includes chemotherapy, which may lead to premature ovarian insufficiency (POI) and can severely impact quality of life. Hormone replacement therapy (HRT) is contraindicated for patients with a history of hormone-sensitive breast cancer, but the data on safety for TNBC patients is inconclusive, with a few randomized trials showing increased risk-ratios with wide confidence intervals for recurrence after HRT. Here, we review the literature on alternative pathways from the classical ER/PR. We find that for both estrogens and progestogens, potential alternatives exist for exerting their effects on TNBC, ranging from receptor conversion, to alternative receptors capable of binding estrogens, as well as paracrine pathways, such as RANK/RANKL, which can cause progestogens to indirectly stimulate growth and metastasis of TNBC. Finally, HRT may also influence other hormones, such as androgens, and their effects on TNBCs expressing androgen receptors (AR). Concluding, the assumption that TNBC is completely hormone-insensitive is incorrect. However, the direction of the effects of the alternative pathways is not always clear, and will need to be investigated further.

Download Full-text

Immediate post partum macular subretinal bleeding in a highly myopic patient: a case report

BMC Ophthalmology ◽

10.1186/s12886-021-01814-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Karen Bitton ◽

J.-L. Bacquet ◽

F. Amoroso ◽

S. Mrejen ◽

M. Paques ◽

...

Keyword(s):

Valsalva Maneuver ◽

Post Partum ◽

Pathologic Myopia ◽

Pathological Myopia ◽

Case Presentation ◽

Sudden Loss ◽

Corrected Visual Acuity ◽

First Case ◽

History Of ◽

Macular Hemorrhage

Abstract Background Pathologic myopia is a major cause of visual impairment and blindness. Case presentation We report a case of an immediate post partum macular subretinal bleeding observed in a highly myopic patient. A 30-years-old woman presented two days after childbirth for sudden loss of vision in her right eye. Multimodal imaging showed macular hemorrhage masking a subtle yellowish linear lesion corresponding to lacker crack. Due to the lack of evidence for choroidal neovascularization, a simple clinical and imaging monitoring was recommended. Six weeks later, we noted an improvement in her best-corrected visual acuity and a decreased in size of the macular hemorrhage. Conclusions This is the first case reporting a macular subretinal bleeding on macular lacquer cracks in a highly myopic patient in immediate post partum. Valsalva maneuver associated with vaginal delivery could explain the occurrence of the hemorrhage associated with lacquer crack. However, natural history of pathological myopia could not be excluded.

Download Full-text