Sclerochoroidal calcification as an incidental finding during oncological staging of a patient with parotid malignancy: A case report

2021 ◽  
pp. 112067212199962
Author(s):  
Nicola Vito Lassandro ◽  
Luca Danieli ◽  
Michele Nicolai ◽  
Vittorio Pirani ◽  
Paolo Pelliccioni ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Incidental Finding ◽  
Correct Diagnosis ◽  
Preoperative Staging ◽  
Malignant Lesion ◽  
Enhanced Depth Imaging ◽  
Elevated Lesion ◽  
Retinal Artery ◽  
Challenging Situation ◽  
The Right

Introduction: Incidental finding of mass lesion in the choroid represents a very challenging situation for the ophthalmologist. We describe a case of an incidental, computed tomography (CT)-hyperintense, choroidal lesion in a patient with parotid malignancy and renal failure, and how multimodal imaging helped us reaching the correct diagnosis. Case description: A 63-year-old man with parotid gland malignancy was brought to our attention because preoperative staging CT showed a hyperintense choroidal lesion of the right eye. Fundus examination showed a yellow elevated lesion near the superior temporal branch retinal artery. Enhanced depth imaging optical coherence tomography (EDI-OCT), A- and B-scan ultrasonography, and Indocyanine Green Angiography (ICGA) allowed us to exclude a malignant lesion and to diagnose a sclerochoroidal calcification. Conclusion: Multimodal imaging can guide the clinician to choose the appropriate therapeutic approach even in case of uncommon conditions like sclerochoroidal calcification.

Delayed-onset unilateral Vogt-Koyanagi-Harada syndrome: a multimodal imaging appraisal

2021 ◽  
Vol 14 (2) ◽  
pp. e238623
Author(s):  
Saurabh Verma ◽  
Himani Thakur ◽  
Shorya Vardhan Azad ◽  
Vinod Kumar
Keyword(s):  
Multimodal Imaging ◽  
Intravitreal Bevacizumab ◽  
Choroidal Neovascularisation ◽  
Enhanced Depth Imaging ◽  
Depth Imaging ◽  
Delayed Onset ◽  
First Case ◽  
Imaging Optical Coherence Tomography ◽  
The Right ◽  
Active Inflammation

A 38-year-old woman who had previously been diagnosed and treated for unilateral Vogt-Koyanagi-Harada syndrome (VKH) and had undergone multiple intravitreal bevacizumab injections to manage inflammatory choroidal neovascularisation in her right eye, presented 2 years later with visual complains in left eye. Clinical examination, fluorescein angiography, indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT) assisted evaluation confirmed active inflammation of left eye along with absence of any inflammation in the right eye. Unilateral active inflammation can be seen in the setting of VKH. To our best knowledge, ours is the first case of VKH in which unilateral active inflammation has been proven based on ICGA and EDI OCT analysis.

scholarly journals Multi Slice Computed Tomography in Assessment of Posterior Mediastinal Lesions

2021 ◽  
pp. 1-8
Author(s):  
Nora Mostafa Mohamed El Shalakany ◽  
Samah Ahmed Radwan ◽  
Abdelhady Mohamed Taha ◽  
Mohemed Fathy Dawoud
Keyword(s):  
Multidetector Ct ◽  
Incidental Finding ◽  
Correct Diagnosis ◽  
Malignant Lesion ◽  
Processing Technique ◽  
Ct Guided ◽  
Neurogenic Tumors ◽  
Characteristic Imaging ◽  
Posterior Mediastinal

Background: Posterior Mediastinal lesions are relatively common and represent 23-30% of all mediastinal lesions; 40% of these lesions are an incidental finding. Multidetector CT (MDCT) has shorter imaging time and better spatial resolution than MRI, especially in mediastinum; it is more widely available & less expensive. The additional role of CT is in performing CT guided biopsies if needed. This study aimed to evaluate the role of MSCT in the diagnosis of mediastinal lesions based on the characteristic imaging appearances, which can lead to a correct diagnosis and optimal management. The post-processing technique further improves the diagnosis and surgical planning. Patients and Methods: This study included 30 patients with posterior mediastinal lesions evaluated according to clinical data, diagnostic imaging procedure (MSCT), and histopathological evaluation. Most of the cases in this study had a lesion raised from the LN and vessels by 23.3%. Results: Metastatic lymphadenopathy was the commonest lesion in our study, 13.3%, followed by lymphoma 10.3% and neurogenic tumors 10%. Benign lesions were 60%, while the malignant lesion represents 40% of all cases. Multiple CT features of each posterior mediastinal lesion were used to predict the nearest histological diagnosis. The accuracy of MSCT in our study was 93.3%. Conclusion: MSCT has a practical and significant role in the assessment & evaluation of the posterior mediastinal lesions according to the anatomical origin, the CT feature of the lesion (solid or cystic), density, the effect on the surroundings, the distribution pattern, and extent of the lesion.

scholarly journals Incidental finding of malignant renal cystic tumour diagnosed sonographically

2008 ◽  
Vol 136 (3-4) ◽  
pp. 166-169
Author(s):  
Milan Stojanovic ◽  
Branislav Goldner
Keyword(s):  
Ct Scan ◽  
Cystic Lesion ◽  
Incidental Finding ◽  
Malignant Lesion ◽  
Histological Finding ◽  
Cystic Neoplasm ◽  
Simple Cyst ◽  
Cystic Tumour ◽  
The Right ◽  
Contrast Ct

Introduction Malignant cystic renal tumor is a rare variant of renal malignancy. Cystic neoplasm results from haemorrhage, necrosis and colliquation of a solid tumour or tumour occurring within the wall of a cyst. That pathoanatomic substratum reflects characteristic sonographic features indicating its malignant nature. It is important to distinguish a simple cyst (not requiring surgery) from intracystic malignant lesion because it requires surgery. Case Outline The authors present a 59-year-old woman with a sonographic finding of a simple cyst in the upper pole of the right kidney revealed during gynaecological ultrasonography. Immediately afterwards, the radiologist performed renal sonography and its finding was a cystic lesion suggestive of malignancy. Further evaluation by CT scan showed that the lesion was clearly malignant. After surgery, the histological finding verified cystic renal cancer. Conclusion Ultrasonography may reveal a complex cyst and solid mass but requires an experienced sonographer. Contrast CT scan would be performed to examine the "suspicious" lesion because it clearly shows if a cystic lesion is benign or malignant. .

Multimodal imaging in IRVAN syndrome presenting with Branch Retinal Artery Occlusion

2020 ◽  
pp. 112067212096549
Author(s):  
Sourour Zina ◽  
Imen Ksiaa ◽  
Chiraz Abdelhedi ◽  
Hager Ben Amor ◽  
Sonia Attia ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Disc ◽  
Multimodal Imaging ◽  
Fundus Autofluorescence ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Hard Exudates ◽  
Retinal Artery ◽  
The Right

Purpose: To describe multimodal imaging findings in a patient with idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome presenting with branch retinal artery occlusion (BRAO). Case description: A 33-year-old woman presented with acute BRAO in the right eye. A diagnosis of underlying IRVAN syndrome was made based on the presence of arteriolar aneurysms on the optic disc and along major arterioles and faint retinal hard exudates in both eyes. Eight months later, best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. The hard exudates had increased, and there were extensive areas of peripheral retinal capillary nonperfusion without new vessels. Optical coherence tomography (OCT) showed a localized retinal thinning corresponding to the prior BRAO. Fundus autofluorescence showed nodulo-linear periarterial hypoautofluorescence. OCT angiography (OCTA) showed localized ischemic changes, mainly involving the deep capillary plexus, corresponding to the area of resolved BRAO. It also clearly delineated the optic disc aneurysms. The patient received bilateral scatter laser photocoagulation directed to areas of peripheral capillary nonperfusion. Over a 6-month follow-up period, visual acuity remained unchanged, and there was no evidence of disease progression. Conclusion: Multimodal imaging, including fundus autofluorescence, OCT, and OCTA can provide additional valuable information in the evaluation of IRVAN syndrome complicated with BRAO.

Incidental finding of regressed solitary unilateral choroidal metastasis from lung adenocarcinoma with EGFR exon-19 deletion treated with erlotinib

2021 ◽  
Vol 14 (1) ◽  
pp. e238131
Author(s):  
Srikanta Kumar Padhy ◽  
Swathi Kaliki
Keyword(s):  
Lung Adenocarcinoma ◽  
Incidental Finding ◽  
Previous History ◽  
Stage Iv ◽  
Choroidal Metastasis ◽  
Elevated Lesion ◽  
Exon 19 Deletion ◽  
History Of ◽  
Surrounding Areas ◽  
The Right

A 49-year-old Asian Indian woman, with a previous history of biopsy proven stage IV primary lung adenocarcinoma with metastasis to liver, bones and central nervous system, presented with 1-month history of photopsia in right eye. She was on oral erlotinib since 6 months. Dilated fundus examination of right eye revealed a solitary dome-shaped brownish elevated lesion of approximately 1-disc diameter along the inferotemporal midperiphery with surrounding areas of hypopigmentation. Based on multimodal imaging, a diagnosis of resolved solitary unilateral choroidal metastasis from lung carcinoma in the right eye was made. In view of inactive and regressed choroidal metastasis, no intervention was mandated.

scholarly journals Choroidal macrovessels: multimodal imaging findings and review of the literature

2021 ◽  
pp. bjophthalmol-2020-318095
Author(s):  
Beatrice Gallo ◽  
Samantha R de Silva ◽  
Omar A Mahroo ◽  
Zubin Saihan ◽  
Praveen J Patel ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Fundus Autofluorescence ◽  
Correct Diagnosis ◽  
Subretinal Fluid ◽  
Enhanced Depth Imaging ◽  
Fundus Photography ◽  
Imaging Features ◽  
En Face Oct ◽  
En Face ◽  
Vessel Orientation

Background/aimsTo describe clinical and multimodal imaging features in a cohort of choroidal macrovessels.MethodsDemographics and multimodal imaging features of 16 eyes of 13 patients with choroidal macrovessels were reviewed. The multimodal imaging included colour fundus photography, fundus autofluorescence (FAF), spectral domain enhanced depth imaging optical coherence tomography (OCT), en face OCT, OCT-angiography (OCT-A), B-scan ultrasonography (US), fluorescein angiography (FFA) and indocyanine green angiography (ICGA).ResultsThree patients had bilateral involvement. On colour fundus photography, three patterns were evident (a clearly visible orange-red vessel; a track of pigmentary changes; spots of mild pigmentary changes). Vessel orientation was horizontal (11 eyes), oblique (4 eyes) or vertical (1 eye). In 2 eyes, the vessel was extra-macular. OCT in all cases showed a hyporeflective choroidal area with posterior shadowing and elevation of the overlying retina. Subretinal fluid was present in 4 eyes. FAF (12 eyes) was normal (7 eyes) or showed a hypofluorescent/hyperfluorescent track (4 eyes) or linear hyperautofluorescence (1 eye). En-face OCT (2 eyes) revealed the course of the macrovessel at the level of choroid and choriocapillaris. On OCT-A (2 eyes) the vessel had a reflectivity similar to surrounding vessels but larger diameter. B-scan US (8 eyes) showed a nodular hypoechogenic lesion. FFA (5 eyes) showed early focal hyperfluorescence (4 eyes) not increasing in later phases, or was normal (1 eye). ICGA (6 eyes) showed early hyperfluorescence of the vessel.ConclusionsChoroidal macrovessels can mimic other entities, leading to underdiagnosis. Appreciating relevant features on different imaging modalities will aid a correct diagnosis.

scholarly journals A large retroperitoneal lipoblastoma as an incidental finding: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elena Gerhard-Hartmann ◽  
Verena Wiegering ◽  
Clemens Benoit ◽  
Thomas Meyer ◽  
Andreas Rosenwald ◽  
...  
Keyword(s):  
Incidental Finding ◽  
Correct Diagnosis ◽  
Clear Cell Sarcoma ◽  
Final Diagnosis ◽  
The Body ◽  
Differential Diagnoses ◽  
Molecular Diagnostic ◽  
Mesenchymal Neoplasm ◽  
Retroperitoneal Tumors ◽  
The Right

Abstract Background Lipoblastoma is a rare benign mesenchymal neoplasm of infancy that most commonly occurs on the extremities and trunk but can arise at variable sites of the body. Retroperitoneal lipoblastomas are particularly rare but can grow to enormous size, and preoperative diagnosis is difficult with diverse, mostly malignant differential diagnoses that would lead to aggressive therapy. Since lipoblastoma is a benign tumor that has an excellent prognosis after resection, correct diagnosis is crucial. Case presentation A case of a large retroperitoneal tumor of a 24-month old infant that was clinically suspicious of a malignant tumor is presented. Due to proximity to the right kidney, clinically most probably a nephroblastoma or clear cell sarcoma of the kidney was suspected. Radiological findings were ambiguous. Therefore, the mass was biopsied, and histology revealed an adipocytic lesion. Although mostly composed of mature adipocytes, in view of the age of the patient, the differential diagnosis of a (maturing) lipoblastoma was raised, which was supported by molecular analysis demonstrating a HAS2-PLAG1 fusion. The tumor was completely resected, and further histopathological workup led to the final diagnosis of a 13 cm large retroperitoneal maturing lipoblastoma. The child recovered promptly from surgery and showed no evidence of recurrence so far. Conclusion Although rare, lipoblastoma should be included in the differential diagnoses of retroperitoneal tumors in infants and children, and molecular diagnostic approaches could be a helpful diagnostic adjunct in challenging cases.

scholarly journals An incidental finding of testicular seminoma in the context of acute pulmonary embolism: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Kaitlin J. Mayne ◽  
Emma Lewis ◽  
Lewis Vickers
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Clinical Guidelines ◽  
Acute Pulmonary Embolism ◽  
Incidental Finding ◽  
White Male ◽  
Vena Cava ◽  
Testicular Seminoma ◽  
Computed Tomography Scanning ◽  
The Right

Abstract Background Clinical guidelines do not recommend further investigation for occult malignancy in the scenario of unprovoked venous thromboembolism in the absence of additional clinical features suggestive of malignancy. We present the case of a young gentleman with pulmonary embolism who was diagnosed with testicular seminoma despite lack of symptoms or signs suggestive of malignancy. This is a unique case describing a scenario not well documented in existing literature where contravention of clinical guidelines had a potentially advantageous outcome for the patient. Case presentation A 37-year-old white male presented with seemingly unprovoked acute pulmonary embolism with right heart strain. He did not have any predisposing factors for venous thromboembolism and did not have any symptoms or signs suggestive of malignancy. Clinical guidelines do not recommend further investigation to screen for malignancy in this scenario. Despite this, our young, otherwise healthy patient proceeded to computed tomography scanning, resulting in the diagnosis of localized testicular seminoma. Testicular ultrasound described normal-sized testes (despite a discrete lesion in the right testis), suggesting this was not detectable by the patient or clinician on routine examination. The patient was anticoagulated and had an inferior vena cava filter inserted to facilitate orchidectomy followed by adjuvant radiotherapy. Conclusions This case highlights the importance of considering malignancy in seemingly unprovoked venous thromboembolism and the availability of guidelines to direct further investigation. Our patient’s treatment was not in line with clinical guidelines and was considered a “lucky find.”

scholarly journals The use of multimodal imaging in the evaluation of a patient with central retinal artery occlusion in the setting of asteroid hyalosis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Timothy M. Janetos ◽  
Olga German ◽  
Rukhsana Mirza
Keyword(s):  
Multimodal Imaging ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Timely Diagnosis ◽  
Cardiovascular Morbidity And Mortality ◽  
Asteroid Hyalosis ◽  
Retinal Artery

Abstract Background A central retinal artery occlusion (CRAO) is an ophthalmic emergency due to its strong association with cerebrovascular and cardiovascular morbidity and mortality. A timely diagnosis is necessary but difficult in the setting of dense asteroid hyalosis, as typical fundoscopic findings can be obscured. We present a case where multimodal imaging in an eye with an obscured fundus could lead to timely diagnosis and management of CRAO in a patient with acute vision loss. Case presentation A 94-year-old Caucasian woman with a history of exudative macular degeneration presented to the retina clinic with acute vision loss in one eye over the course of an afternoon. The patient had dense asteroid hyalosis, and a direct retinal exam was not possible. Multimodal imaging suggested a CRAO diagnosis. The patient received digital ocular massage directly prior to undergoing fluorescein angiography (FANG), which confirmed the diagnosis. The patient was transported from clinic to the emergency room for an emergency stroke workup, which revealed a spontaneous echo in the left atrial appendage, and the patient was started on antiplatelet therapy. When she presented for follow-up within a week, the patient noted that her vision had improved at the time of digital ocular massage and continued to improve thereafter. Her FANG showed marked reperfusion of the retina, and she subsequently has completely regained her baseline visual acuity. Conclusions Multimodal imaging is useful in evaluating visual loss in patients with acute vision loss. In addition, ocular massage is a simple, low-risk intervention that may have benefit in the treatment of acute CRAO. Patients who present to ophthalmologists with an acute CRAO need an emergency referral for evaluation of cerebrovascular and cardiovascular comorbidities.

scholarly journals 109 Game Changing Magnetic Experience in Rural and Urban Wirral Peninsula - Our Experience with Magseed Localisation of Impalpable Breast Tumours and Axillary Nodes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Arif ◽  
R Vinayagam ◽  
J M Lund ◽  
S Poonawala
Keyword(s):  
Incidental Finding ◽  
Breast Tumour ◽  
Axillary Node ◽  
Reliable Technique ◽  
Breast Tumours ◽  
Rural And Urban ◽  
Mean Size ◽  
The Right ◽  
A Prospective Study ◽  
Mean Time

Abstract Introduction Magseed is a novel localization technology in which a tiny seed is inserted to accurately mark the site of breast tumour. These can be detected intra-operatively by sentimag localization system. It aids localization of impalpable breast lesions improving margin clearance rates. Method A prospective study of first fifty Magseed localised breast tumour and axillary node excisions in Clatterbridge General Hospital. Results A total of 50 patients had 52 Magseed inserted. n = 14 was symptomatic, n = 35 was screen detected and n = 1 was an incidental finding on surveillance mammogram for a B3 lesion. 30 seeds were inserted on the right and 22 were inserted on the left (two were bilateral). 44 seeds were inserted under ultrasound guidance and the rest were targeted under stereo guidance (n = 8). Deployment of two resulted in malposition requiring wire localization. Mean age of subjects was 59.76 (range 31-81) years. Mean time to surgery after magseed insertion was 8.04 (range 1-27) days. Mean weight of the specimen was 48.57(range 10-264) gm. Mean size of the lesions was 20.32 (range 8-65) mm. Redo surgery for margin clearance was performed bringing the re-excision rate to 15.38% (n = 8). Conclusions We conclude that Magseed localization of breast tumours is a safe and reliable technique

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