Ultrasound of the adrenal gland in children

Introduction Ultrasound is the modality of choice in the evaluation of neonates and young children with suspected adrenal lesions including adrenal haemorrhage and congenital adrenal hyperplasia. It is also the initial imaging modality in children presenting with an upper abdominal mass, which may be adrenal in origin. Topic discussion: This paper shows adrenal anatomy and demonstrates how the sonographic features change with age. It reviews the imaging features of congenital adrenal lesions, as well as benign and malignant conditions affecting the adrenal gland in childhood. Discussion and Conclusion: Ultrasound is a useful primary imaging modality in the assessment of the adrenal gland in children. Knowledge of the changes of the adrenal gland with age is important when assessing the adrenal gland. Ultrasound is also useful for assessing abdominal masses. However, it cannot differentiate adrenal masses, therefore correlation with biochemical findings, multimodality imaging, and histology is usually required.

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Functioning adrenocortical carcinoma causing virilisation: a case report

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20200126 ◽

2020 ◽

Vol 7 (2) ◽

pp. 442

Author(s):

Vivek Parameswara Sarma ◽

Sunil S. Menon

Keyword(s):

Case Report ◽

Steroid Hormone ◽

Abdominal Mass ◽

Female Child ◽

Young Female ◽

Imaging Features ◽

Adrenal Hyperplasia ◽

Fourth Decade ◽

Localized Disease ◽

Uncommon Tumor

Adrenocortical carticnoma (ACC) is an uncommon tumor with an incidence of 1-2 cases/million/year. It has two peak incidences; the first one in the first decade and the second one in the fourth decade. Most patients present with features of steroid hormone excess or abdominal mass effects, but about 15% of ACC are diagnosed incidentally. It is hormonally functional in 80 - 100% patients and the predisposing lesions include congenital adrenal hyperplasia and adenoma. ACC has significant syndromic and genetic association. Surgery offers the best chance of cure, especially in localized disease. Here, we present the case of virilization in a young female child secondary to a functioning ACC. The child had classical hormonal and imaging features of functioning ACC and underwent resection of the tumor (Adrenalectomy) with good outcome.

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An Uncommon Cause of Massive Intraperitoneal Bleeding: Leiomyoblastoma of the Stomach

Tumori Journal ◽

10.1177/030089168807400322 ◽

1988 ◽

Vol 74 (3) ◽

pp. 365-367

Author(s):

Alessandro Zerbi ◽

Marco Braga ◽

Alessandro Sironi ◽

Agostino Faravelli ◽

Valerio Di Carlo

Keyword(s):

Abdominal Mass ◽

Abdominal Ultrasound ◽

Cystic Mass ◽

Emergency Laparotomy ◽

Intraperitoneal Rupture ◽

Abdominal Masses ◽

Liver And Pancreas ◽

Intraperitoneal Bleeding ◽

Upper Abdominal ◽

Diagnostic Investigations

A large exogastric leiomyoblastoma in a 48-year-old male revealed by asymptomatic upper abdominal mass is reported. Abdominal ultrasound, computerized tomography scan and magnetic resonance showed a 20 cm cystic lesion apart from liver and pancreas of undetermined origin. During hospitalization, massive intraperitoneal bleeding due to rupture of the mass was observed. An emergency laparotomy was carried out, and excision of a large, ruptured, cystic mass involving the greater gastric curvature was performed. Microscopy revealed a gastric leiomyoblastoma. Even if infrequent, massive intraperitoneal bleeding is a very serious complication of gastric leiomyoblastoma. Considering the difficulty of an accurate preoperative diagnosis and the risk of intraperitoneal rupture, the authors suggest that similar abdominal masses should be managed by quick diagnostic investigations and early surgical procedures.

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Ultrasound of Focal Salivary Gland Lesions

Ultrasound ◽

10.1179/174313409x448525 ◽

2009 ◽

Vol 17 (3) ◽

pp. 124-130

Author(s):

Rajat Chowdhury ◽

Hazel A Pratt ◽

Keith C Dewbury ◽

Elizabeth E Rutherford

Keyword(s):

Salivary Gland ◽

Imaging Modality ◽

Needle Aspiration ◽

Definitive Diagnosis ◽

Imaging Features ◽

Ultrasound Guided ◽

Fine Needle ◽

Diagnostic Uncertainty ◽

Sensitive Tool ◽

Initial Imaging

Ultrasound is a sensitive tool for assessing focal salivary gland lesions and is the initial imaging modality of choice for investigating such conditions. Whilst certain lesions have very characteristic ultrasound appearances, many hyperechoic lesions have non-specific imaging features resulting in diagnostic uncertainty based on imaging alone. Here we review the appearances of these lesions on ultrasound and highlight the importance of proceeding to ultrasound-guided fine-needle aspiration for cytology or core biopsy to reach a definitive diagnosis.

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Large renal leiomyoma: A multidisciplinary approach to diagnosis

Journal of Radiology Case Reports ◽

10.3941/jrcr.v15i8.4125 ◽

2021 ◽

Vol 15 (8) ◽

pp. 18-26

Author(s):

Sotiris Chaniotakis ◽

Yi Yang ◽

Tulsi Patel ◽

James Banks

Keyword(s):

Differential Diagnosis ◽

Multidisciplinary Approach ◽

Abdominal Mass ◽

Unknown Origin ◽

Final Diagnosis ◽

Imaging Features ◽

Computed Tomographic ◽

Abdominal Masses ◽

Additional Testing ◽

Palpable Abdominal Mass

We report the case of a 45-year-old woman who presented with a large palpable abdominal mass. Initial sonographic and computed tomographic studies prompted a differential diagnosis of retroperitoneal or renal sarcoma, leiomyoma, and lipid-poor angiomyolipoma. A final diagnosis of renal leiomyoma was reached based on a consensus among radiology, surgery and pathology. In addition to reviewing the features of this entity, this case demonstrates the process of developing a working diagnosis, narrowing the differential as additional testing is performed and establishing a final diagnosis with interdepartmental coordination. Despite the rarity of this condition, the ability to recognize and apply imaging features to differentiate between abdominal masses of unknown origin is important for clinicians and researchers.

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Myxofibrosarcoma: clinical and prognostic value of MRI features

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616999200729152135 ◽

2020 ◽

Vol 16 ◽

Cited By ~ 1

Author(s):

Paolo Spinnato ◽

Andrea Sambri ◽

Tomohiro Fujiwara ◽

Luca Ceccarelli ◽

Roberta Clinca ◽

...

Keyword(s):

Soft Tissue ◽

Local Recurrence ◽

Contrast Enhancement ◽

Imaging Modality ◽

Soft Tissue Sarcomas ◽

The Elderly ◽

High Rate ◽

Imaging Features ◽

High Grade ◽

Mri Features

: Myxofibrosarcoma is one of the most common soft tissue sarcomas in the elderly. It is characterized by an extremely high rate of local recurrence, higher than other soft tissue tumors, and a relatively low risk of distant metastases.Magnetic resonance imaging (MRI) is the imaging modality of choice for the assessment of myxofibrosarcoma and plays a key role in the preoperative setting of these patients.MRI features associated with high risk of local recurrence are: high myxoid matrix content (water-like appearance of the lesions), high grade of contrast enhancement, presence of an infiltrative pattern (“tail sign”). On the other hand, MRI features associated with worse sarcoma specific survival are: large size of the lesion, deep location, high grade of contrast enhancement. Recognizing the above-mentioned imaging features of myxofibrosarcoma may be helpful to stratify the risk for local recurrence and disease-specific survival. Moreover, the surgical planning should be adjusted according to the MRI features

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Radiologic Findings of a Rare Subtype of Invasive Breast Cancer with Poor Prognosis: Metaplastic Carcinoma of the Breast

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405614666180813120227 ◽

2019 ◽

Vol 15 (3) ◽

pp. 338-348

Author(s):

Hale Aydin ◽

Bahar Guner ◽

Isil Esen Bostanci ◽

Nazan Ciledag ◽

Melda Boyacioglu Bulut ◽

...

Keyword(s):

Breast Carcinoma ◽

Multimodality Imaging ◽

Metaplastic Carcinoma ◽

Imaging Features ◽

Mri Findings ◽

Radiologic Findings ◽

Round Shape ◽

Malignant Feature ◽

Imaging Results ◽

Metaplastic Breast Carcinoma

Background and Objectives: The purpose of this study was to evaluate the mammographic, sonographic and MRI findings of metaplastic breast carcinoma. Methods: In this retrospective review study, we analyzed the medical files of 9600 patients who were treated for invasive breast cancers. Clinical information, histopathologic and radiologic findings of 65 patients were included in this study. All existing radiologic images and medical reports were reviewed retrospectively. Thirty-three patients had MG, 58 patients had US and 7 patients had MRI imaging results. Results: Mammographically, the most frequent presentations of MPBC were round shape, microlobulated margin and high density masses. Calcifications with or without masses were not a frequent finding. The most common sonographic findings were round shape, partially indistinct angular margin, hypoechoic and heterogeneous echo patterns and no posterior feature masses. All lesions were presented as masses rather than non-mass enhancements on magnetic resonance imaging. Features of masses had more malignant feature on MRI than other modalities in all 7 patients. Conclusion: Metaplastic breast carcinoma is one of the rarest poorly differentiated invasive breast carcinomas. Interestingly, these aggressive tumors demonstrate benign or moderately malign features on imaging methods. This appearance of MPBC can cause it to be misdiagnosed as a benign breast lesion especially in young women. MPBC should be kept in mind in the differential diagnosis of large palpable breast masses. Therefore, follow-up at short intervals and/or multimodality imaging studies which include breast MRI are important for the diagnosis of MPBC.

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Multimodality imaging review of focal renal lesions

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00391-z ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Jonathan Lyske ◽

Rishi Philip Mathew ◽

Christopher Hutchinson ◽

Vimal Patel ◽

Gavin Low

Keyword(s):

Malignant Tumors ◽

Multimodality Imaging ◽

Lymphoproliferative Disease ◽

Benign Tumors ◽

Main Body ◽

Imaging Features ◽

Focal Lesions ◽

Renal Lesions ◽

Positron Emission ◽

Neoplastic Lesions

Abstract Background Focal lesions of the kidney comprise a spectrum of entities that can be broadly classified as malignant tumors, benign tumors, and non-neoplastic lesions. Malignant tumors include renal cell carcinoma subtypes, urothelial carcinoma, lymphoma, post-transplant lymphoproliferative disease, metastases to the kidney, and rare malignant lesions. Benign tumors include angiomyolipoma (fat-rich and fat-poor) and oncocytoma. Non-neoplastic lesions include infective, inflammatory, and vascular entities. Anatomical variants can also mimic focal masses. Main body of the abstract A range of imaging modalities are available to facilitate characterization; ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), each with their own strengths and limitations. Renal lesions are being detected with increasing frequency due to escalating imaging volumes. Accurate diagnosis is central to guiding clinical management and determining prognosis. Certain lesions require intervention, whereas others may be managed conservatively or deemed clinically insignificant. Challenging cases often benefit from a multimodality imaging approach combining the morphology, enhancement and metabolic features. Short conclusion Knowledge of the relevant clinical details and key imaging features is crucial for accurate characterization and differentiation of renal lesions.

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Extraosseous Ewing’s Sarcoma: Pictorial Review of Imaging Findings, Differential Diagnosis, and Pathologic Correlation

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1729770 ◽

2021 ◽

Author(s):

Alan Alexander ◽

Kyle Hunter ◽

Michael Rubin ◽

Ambarish P. Bhat

Keyword(s):

Differential Diagnosis ◽

Ewing’S Sarcoma ◽

Ewing's Sarcoma ◽

Multimodality Imaging ◽

Imaging Features ◽

Older Children ◽

Radiologic Findings ◽

Pictorial Review ◽

Malignant Mesenchymal Tumor ◽

Extraosseous Ewing’S Sarcoma

AbstractExtraosseous Ewing’s sarcoma (EES), first described in 1969, is a malignant mesenchymal tumor just like its intraosseous counterpart. Although Ewing’s sarcomas are common bone tumors in young children, EESs are rarer and more commonly found in older children/adults, often carrying a poorer prognosis. We discuss the multimodality imaging features of EES and the differential diagnosis of an aggressive appearing mass in proximity to skeletal structures, with pathologic correlates. This review highlights the need to recognize the variability of radiologic findings in EES such as the presence of hemorrhage, rich vascularity, and cystic or necrotic regions and its imaging similarity to other neoplasms that are closely related pathologically.

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Subtle signs of breast cancer as an important pitfall in mammographic interpretation. Establishing an accurate diagnosis in an equivocal case

Breast Disease ◽

10.3233/bd-201075 ◽

2021 ◽

pp. 1-6

Author(s):

Nikolaos S. Salemis ◽

Eleni Mourtzoukou ◽

Michail Angelopoulos

Keyword(s):

Breast Cancer ◽

Imaging Modality ◽

Benign Lesion ◽

Imaging Features ◽

Breast Cancers ◽

Breast Clinic ◽

Delay In Diagnosis ◽

Delay Of Treatment ◽

Equivocal Case ◽

Related Mortality

Mammogram is the standard imaging modality for the early detection of breast cancer, and it has been shown to reduce disease-related mortality by up to 30%. Mammogram, however, has its limitations. It is reported that 10–30% of breast cancers may be missed on a mammogram. Delay in the diagnosis and treatment may adversely affect the prognosis of patients with breast cancer. We present a case of multifocal invasive early breast carcinoma, which was misinterpreted twice as intramammary lymph nodes, thus resulting in a delay in diagnosis for eighteen months. The tumors were detected incidentally after the patient presented to our Breast clinic for symptoms related to a concomitant benign lesion involving the same breast. We describe the tumors’ imaging features and discuss the possible reasons that likely led to repeated misinterpretation. Awareness of possible causes for missed breast cancer is necessary to avoid delay of treatment initiation that may adversely affect prognosis.

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