scholarly journals Orbital Pseudocellulitis: A Retinoblastoma-Associated Masquerade Syndrome

2020 ◽  
Vol 6 (6) ◽  
pp. 430-437
Author(s):  
Francesco Martino ◽  
Maria Chiara Gelmi ◽  
Paolo Galluzzi ◽  
Sonia De Francesco ◽  
Clelia Miracco ◽  
...  

<b><i>Introduction:</i></b> A masquerade syndrome is an atypical presentation of a neoplastic process that mimics an inflammatory condition. In this paper, we focus on orbital pseudocellulitis. <b><i>Case Series:</i></b> Our case series includes 5 retinoblastoma patients with orbital pseudocellulitis at presentation. In 3 patients the disease was bilateral, in 1 trilateral, and in 1 unilateral. The eyes with pseudocellulitis were enucleated, while the fellow eyes were treated conservatively, when affected. Four patients responded well to the therapy and showed remission of the tumor. The patient with trilateral retinoblastoma did not respond to therapy and died of disease. <b><i>Discussion:</i></b> Differential diagnosis with infectious orbital cellulitis is extremely important. Patients with orbital cellulitis present with fever, sinusitis, leukocytosis, and raised inflammatory markers, while ophthalmoscopic examination is negative and imaging studies show sinus involvement. On the contrary, patients with retinoblastoma do not show systemic inflammation, while ophthalmoscopic examination reveals leukocoria, buphthalmos, and an intraocular tumor mass associated with retinal detachment. Magnetic resonance imaging shows intralesional calcifications and soft tissue edema without sinus involvement. Histology confirms the diagnosis. <b><i>Conclusions:</i></b> Medical history, physical examination, and imaging studies are crucial in the diagnosis of retinoblastoma-associated orbital pseudocellulitis. Retinoblastoma should be excluded in all patients with signs of pre-septal orbital cellulitis through fundoscopy and/or imaging studies

2019 ◽  
Vol 24 (6) ◽  
pp. 534-537
Author(s):  
Shane C. Rainey ◽  
Nadia Shaikh ◽  
Keith A. Hanson

Gadolinium-based compounds are frequently used in contrast-enhanced magnetic resonance imaging studies. Rarely, adverse events have been reported with administration of these compounds, of which the most common are nausea and vomiting. Although well established in the adult literature, these adverse effects are less well described in the pediatric population, who often need sedation to complete imaging studies. In this case series, we present 3 children who experienced vomiting shortly after contrast administration while under sedation with propofol, which is known to have antiemetic properties. Although all 3 children recovered without complication, this case series illustrates the serious potential consequences of vomiting while sedated, and providers should be aware of these possible adverse events as pediatric sedation becomes more common outside the operating room.


Author(s):  
Vishal Sharma ◽  
Harshal S Mandavdhare ◽  
Harjeet Singh ◽  
Ujjwal Gorsi

Abdominal cocoon is an uncommon entity manifesting as abdominal pain, lump and features of intestinal obstruction. The diagnosis is established by demonstrating a membranous sac covering the small bowel loops which can be seen at the time of surgery or demonstrated by imaging studies like computed tomography (CT) or magnetic resonance imaging. CT has been reported to be of utility in making a preoperative diagnosis. The features may include clumped bowel loops, loculated fluid, cauliflower sign or concertina arrangement of bowel loops. We report on three cases of abdominal cocoon who presented with intestinal obstruction due to three varied etiologies (idiopathic, tuberculosis, malignancy). We also describe a radiological sign, the bottle gourd sign, in these three cases. The sign possibly suggests jejunal obstruction due to formation of abdominal cocoon.


Author(s):  
Tanvi P. Vaidya ◽  
Subhash K. Ramani

AbstractThe male breast can be afflicted with a wide spectrum of benign and malignant masses, similar to the female breast. A systematic radiological evaluation using mammography, ultrasonography, and when appropriate, magnetic resonance imaging, could aid this differentiation and provide clues to the diagnosis. In this article, we present six cases of male breast masses with an emphasis on the role of imaging in characterization and diagnosis.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Harry Knights ◽  
Elizabeth Minas ◽  
Faraan Khan ◽  
Lindsay Shaw ◽  
Muthana Al Obaidi ◽  
...  

Abstract Background The aim of this study was to: (i) describe the abnormalities seen on brain imaging in a group of children with en coup de sabre (EDCS) with/without Parry-Romberg syndrome (PRS); and (ii) identify clinical predictors of brain imaging abnormalities. Methods This was a single centre (Great Ormond Street Hospital, London) retrospective case series of patients with ECDS/PRS seen from 2000 to 2018. We identified patients with cutaneous manifestations consistent with the clinical descriptions of ECDS/PRS. Presenting clinical, laboratory, and radiological brain findings are described. Results are expressed as medians and ranges or frequencies and percentages. Fisher’s exact test was used to identify clinical associations with magnetic resonance imaging (MRI) abnormalities. Results Fourteen patients were studied: 6 males and 8 females; median age 14 years (range 3–20). We observed neuroimaging abnormalities in 2/6 ECDS and 5/8 ECDS/PRS patients. White matter signal abnormality, dystrophic calcification, leptomeningeal enhancement, and sulcal crowding were the typical findings on brain imaging. A total of 50% of patients had no MRI abnormality despite some of these patients having neurological symptoms. The presence of seizures was significantly associated with ipsilateral enhanced white matter signalling on MRI (p < 0.05). Conclusions In summary, we observed several distinct radiographic patterns associated with ECDS/PRS. Seizure disorder was strongly associated with the presence of ipsilateral enhanced white matter signalling. Improved neuroimaging techniques that combine morphological with functional imaging may improve the detection rate of brain involvement in children with ECDS/PRS in the future.


2005 ◽  
Vol 23 (27) ◽  
pp. 6756-6762 ◽  
Author(s):  
Henry J. Mankin ◽  
Francis J. Hornicek ◽  
Eduardo Ortiz-Cruz ◽  
Jorge Villafuerte ◽  
Mark C. Gebhardt

PurposeWe have reviewed a series of 150 aneurysmal bone cysts treated over the last 20 years.Patients and MethodsThe lesions were principally located in the tibia, femur, pelvis, humerus, and spine and, in most cases, presented the imaging appearance originally described by Jaffe and Lichtenstein as a blowout with thin cortices.ResultsOnly one of the patients was believed to have an osteoblastoma of the spine with secondary development of an aneurysmal bone cyst, and none of the patients developed additional lesions. The patients were treated primarily with curettage and implantation of allograft chips or polymethylmethacrylate, but some patients were treated with insertion of autografts or allografts. The local recurrence rate was 20%, which is consistent with that reported by other centers.ConclusionAneurysmal bone cysts are enigmatic lesions of unknown cause and presentation and are difficult to distinguish from other lesions. Overall, the treatment is satisfactory, but it is possible that newer approaches, such as improved magnetic resonance imaging studies, may help diagnose the lesions and allow the physicians to plan for more effective treatment protocols.


2014 ◽  
Vol 128 (9) ◽  
pp. 810-813 ◽  
Author(s):  
J Powell ◽  
M Reda Elbadawey ◽  
I Zammit-Maempel

AbstractBackground:Isolated olfactory dysfunction is a common complaint; the vast majority of cases are benign and untreatable. A common dilemma is whether to image the olfactory tract of affected patients.Methods:A case review of 100 consecutive patients who underwent magnetic resonance imaging for the primary complaint of olfactory dysfunction was performed. Patients with a diagnosis of chronic rhinosinusitis, with or without nasal polyps, were excluded.Results:Magnetic resonance imaging abnormalities that were considered clinically relevant to the presentation of olfactory dysfunction were found in only seven patients (7 per cent). Of these, only one patient (1 per cent) had an abnormality found that altered their clinical management. A comparison of the findings for children (less than 16 years old,n = 5) with those for adults (equal to or more than 16 years old,n = 95) revealed that 4 per cent of adults scanned had olfactory-related pathology diagnosed, as opposed to 60 per cent of children.Conclusion:Cross-sectional imaging may not be necessary in most patients with olfactory dysfunction. Imaging adds little to the patient history and clinical examination findings.


2005 ◽  
Vol 24 (4) ◽  
pp. 284-290 ◽  
Author(s):  
David F. Abbott ◽  
Helen I. Opdam ◽  
Regula S. Briellmann ◽  
Graeme D. Jackson

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