scholarly journals False diagnosis of and needless therapy for presumed gestational trophoblastic disease in women with an unusual site of residual pregnancy

2018 ◽  
Vol 47 (2) ◽  
pp. 673-681 ◽  
Author(s):  
Tong Gao ◽  
Mingming Sun ◽  
Liangqing Yao ◽  
Wei Jiang

Objective This study aimed to determine the diagnostic value of magnetic resonance imaging (MRI), hysteroscopy, and laparoscopy to avoid unnecessary treatment when patients present with clinical manifestations that are close to those of gestational trophoblastic neoplasia (GTN). Methods Three patients who were falsely diagnosed with presumed GTN and received needless chemotherapy in our hospital from July 2011 to March 2012 were studied. We also reviewed data of patients with similar clinical features who were diagnosed as having residual pregnancy in recent years. Clinical manifestations were evaluated. Results All three patients had persistently high serum β-human chorionic gonadotrophin levels and a mass with abundant blood supply in the uterus after termination of pregnancy. The patients were diagnosed with GTN and underwent chemotherapy. They responded poorly to chemotherapy and underwent surgery. The pathological diagnosis in all patients was residual pregnancy. In recent years, no patients were misdiagnosed because pelvic MRI, hysteroscopy, or laparoscopy was used when residual pregnancy could not be excluded. Conclusion Gynecologists should diagnose carefully when patients present with clinical manifestations that are close to those of GTN to avoid unnecessary treatment. MRI, hysteroscopy, and laparoscopy could be important examinations for excluding residual pregnancy.

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1348
Author(s):  
Ying-Ying Chen ◽  
Sheng-Mao Wu ◽  
Russell Oliver Kosik ◽  
Yi-Chien Hsieh ◽  
Tzu-I Wu ◽  
...  

Acute abdominal pain during pregnancy is challenging, both from a diagnostic and management perspective. A non-localized, persistent pain out of proportion to physical examination is a sign that advanced imaging may be necessary. Mesenteric venous thrombosis in a pregnant patient is extremely rare, but if diagnosis is delayed, can be potentially fatal to both the mother and the fetus. We present here a pregnant patient in the tenth week of gestation with classic clinical manifestations of mesenteric vein thrombosis and the corresponding findings on magnetic resonance imaging (MRI) and computed tomography (CT).


1994 ◽  
Vol 19 (1) ◽  
pp. 55-59 ◽  
Author(s):  
M. OCHI ◽  
Y. IKUTA ◽  
M. WATANABE ◽  
K. KIMOR ◽  
K. ITOH

Findings in 34 patients with traumatic brachial plexus injury documented by surgical exploration and intra-operative somatosensory-evoked potentials were correlated with findings on myelography and magnetic resonance imaging (MRI) to determine whether MRI can identify nerve root avulsion. The coronal and sagittal planes were not able to demonstrate avulsion of the individual nerve roots. The axial and axial oblique planes did provide useful information to determine which nerve root was avulsed in the upper plexus, although it was difficult to clearly delineate the lower cervical rootlets. The accuracy of MRI was 73% for C5 and 64% for C6 and that of myelograpby 63% for C5 and 64% for C6. Thus, the diagnostic accuracy of MRI for upper nerve roots was slightly superior to myelography. Although its primary diagnostic value is limited to the upper nerve roots whose avulsion is relatively difficult to diagnose by myelography, MRI can provide useful guidance in the waiting period prior to surgical exploration after brachial plexus injury.


2016 ◽  
Vol 29 (6) ◽  
pp. 436-439 ◽  
Author(s):  
Pierre-Luc Gamache ◽  
Maude-Marie Gagnon ◽  
Martin Savard ◽  
François Émond

This article reports the case of a 68-year-old patient with anti-HU antibodies paraneoplastic encephalitis. The clinical manifestations were atypical and the paraclinical work-up, notably the magnetic resonance imaging (MRI) showing bilateral posterior thalamic hyperintensities (pulvinar sign), misleadingly pointed towards a variant Creutzfeld–Jakob disease. After presenting the case, the differential diagnosis of the pulvinar sign is discussed along with other important diagnostic considerations.


2017 ◽  
Vol 11 (1-2) ◽  
pp. 8 ◽  
Author(s):  
Fikret Balyemez ◽  
Ahmet Aslan ◽  
Ibrahim Inan ◽  
Ercan Ayaz ◽  
Vildan Karagöz ◽  
...  

Introduction: We aimed to introduce the diagnostic value of diffusion-weighted (DWI) magnetic resonance imaging (MRI) for distinguishing benign and malignant renal cystic masses.Methods: Abdominal DWI-MRIs of patients with Bosniak categories 2F, 3, and 4 cystic renal masses were evaluated retrospectively. Cystic masses were assigned as benign or malignant according to histopathological or followup MRI findings and compared with apparent diffusion coefficient (ADC) values.Results: There were 30 patients (18 males and 12 females, mean age was 59.23 ± 12.08 years [range 38‒83 years]) with cystic renal masses (eight Bosniak category 2F, 12 Bosniak category 3, 10 Bosniak category 4). Among them, 14 cysts were diagnosed as benign and 16 as malignant by followup imaging or histopathological findings. For the malignant lesions, the mean ADC values were lower than for benign lesions (p=0.001). An ADC value of ≤2.28 x10-6 mm2/s or less had a sensitivity of 75% and a specificity of 92.86% for detecting malignancy.Conclusions: ADC can improve the diagnostic performance of MRI in the evaluation of complex renal cysts when used together with conventional MRI sequences.


2009 ◽  
Vol 56 (3) ◽  
pp. 39-44
Author(s):  
R.M. Maksimovic ◽  
B.A. Banko ◽  
J.P. Milovanovic

Computed tomography (CT) and magnetic resonance imaging (MRI) are enabling more precise diagnosis and treatment planning in patients with diseases of the larynx. The aim of this article is to describe the role of these methods in assessment of the laringeal diseases and key local anatomic characteristics important for spread of the disease. CT and MRI have a valuable contribution to the staging of the tumors due to the possibility to show the relationship to the ventricular complex, involvement of the subumucosal spaces, defining craniocaudal and anterposterior extension, laringeal cartilage invasion, as well as regional lymph node metastases.


2019 ◽  
Vol 22 (3) ◽  
pp. 425-431
Author(s):  
Neiandro Santos Galvão ◽  
Antonione Santos Bezerra Pinto ◽  
Alan Leandro Carvalho Farias ◽  
André Luiz Ferreira Costa ◽  
Sérgio Lúcio Pereira de Castro Lopes ◽  
...  

Ameloblastoma is an odontogenic tumor that shares clinical and imaging characteristics with other lesions of the jaws, such as odontogenic keratocyst, which makes the diagnosis difficult. However, in addition to radiographic and tomographic examinations, Magnetic Resonance Imaging (MRI) has been increasingly used, contributing with relevant additional information about the differentiation between solid and liquid components of the lesion. This case report was conducted to present two variations of ameloblastoma and discuss the radiographic, tomographic and MRI contribution in the differential diagnosis between ameloblastoma and odontogenic keratocyst.The signal intensity in T1-weighted MRI revealed internal fluid content in both cases, which was important in the differential diagnosis with other intraosseous lesions such as odontogenic keratocysts. This is probably due to the presence of keratin that increases the viscosity of the content and also for an intermediate signal intensity signal in T2-weighted MRI. Therefore, MRI revealed important internal characteristics of the reported lesions, which was very useful in the establishment of the differential diagnosis with other lesions.


2007 ◽  
Vol 65 (3b) ◽  
pp. 841-844 ◽  
Author(s):  
Henrique Barbosa Ribeiro ◽  
Tadeu Ferreira de Paiva Jr ◽  
Gustavo Pignatari Rosas Mamprin ◽  
Milton Luiz Gorzoni ◽  
Antônio José da Rocha ◽  
...  

Carcinomatous encephalitis is a rare entity, originally described by Madow and Alpers in 1951, which is characterized by tumoral spreading perivascular, without mass effect. Clinical manifestations such as hemiparesis, seizures, ataxia, speech difficulties, cerebrospinal fluid findings as well as computed tomography are nonspecific. This leads the physician to pursue more frequent diseases that could explain those manifestations - toxic, metabolic, and/or infectious encephalopathy. A magnetic resonance imaging (MRI) with gadolinium, the method of choice, presumes the diagnosis. Previous reports of this unusual form of metastatic disease have described patients with prior diagnosis of pulmonary adenocarcinoma. We present the case of carcinomatous encephalitis in a 76-years-old woman as the primary manifestation of occult pulmonary adenocarcinoma with its clinical, imaging, and anatomopathological findings.


Author(s):  
Isabelle Hebert MD FRCPC ◽  
Isabelle Fortin MD

The spondyloarthritides encompass various clinical manifestations. The hallmark of the spondyloarthropathies is inflammatory axial and sacroiliac (buttock) pain. Associated findings include peripheral arthritis, uveitis, conjunctivitis, enthesitis, and psoriasis. Human leukocyte antigen (HLA) B27 is positive in a majority of patients. Radiographic abnormalities appear first on vertebral column/sacroiliac magnetic resonance imaging (MRI) and many years later on radiography, which makes the diagnosis challenging. Of course, rheumatoid factor is negative – hence the term seronegative arthritis. Other clinical clues that help identify this disease’s spectrum are a family history of ankylosing spondylitis (AS), psoriasis, or inflammatory bowel disease (IBD); intestinal or genitourinary symptoms; or the presence of psoriasis. All this heterogeneity makes an early diagnosis difficult.


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