scholarly journals A surgical case of mediastinal hematoma caused by a minor traffic injury

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Katsuyuki Suzuki ◽  
Satoshi Shiono ◽  
Kazuki Hayasaka ◽  
Makoto Endoh
Keyword(s):  
Inferior Thyroid Artery ◽  
Case Presentation ◽  
Mediastinal Hematoma ◽  
Traffic Injury ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right ◽  
A Minor

Abstract Background Mediastinal hematoma rarely occurs after a minor traffic injury. Case presentation A woman in her forties was transferred to the emergency room by ambulance due to a traffic accident. Computed tomography (CT) revealed no abnormal findings, and she went home. Two days after the accident, the contrast-enhanced CT was repeated, which revealed cervical and mediastinal hematomas. Because it was possible that there was active bleeding from the right inferior thyroid artery, embolization of the right inferior thyroid artery was performed; however, her condition further deteriorated, so we performed emergency surgery to achieve hemostasis and remove the hematoma. Because of oozing from the right thyroid lobe, we performed right hemithyroidectomy and drainage of mediastinal space and right thoracic cavity. Since there was no bleeding site in the mediastinum, we thought that the mediastinal hematoma was due to bleeding from the thyroid gland. Her postoperative course was uneventful, and she is doing well at 9 months of follow-up after surgery. Conclusions It is possible that mediastinal hematoma might be caused by a minor traffic injury.

scholarly journals Upper Tract Transitional Carcinoma: An Array of Imaging Conundrum

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Raihanah Haroon ◽  
Siti Kamariah Che Mohamed ◽  
Khairunisa Ahmad Affandi
Keyword(s):  
Urothelial Carcinoma ◽  
Histopathological Analysis ◽  
Distinctive Features ◽  
Upper Tract ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Carcinoma Of The Bladder ◽  
The Right

Case report: We report a 38-year-old gentleman who presented with painless haematuria for 6-months duration. Contrast-enhanced CT renal revealed a large, calcified intrapelvic mass with calyceal extension confined within the right kidney with moderate pelvicalyceal dilatation but no evidence of synchronous lesion elsewhere. Histopathological analysis showed high grade urothelial carcinoma of the renal pelvis with invasion of the renal parenchyma. Upper tract urothelial carcinoma (UTUC) which was once thought similar to urothelial carcinoma of the bladder (UCB), is increasingly being recognized as a different entity. However, heterogenous array of imaging manifestations of UTUC is also increasingly being encountered and pose diagnostic challenges though UTUC is not as prevalent as UCB which is easier to diagnose. Despite distinctive features against renal cell carcinoma (RCC), UTUC may mimic numerous other renal pathology especially the benign ones hence imaging plays a pivotal role to ascertain the diagnosis. This disease is usually treated with radical nephroureterectomy with superadded neoadjuvant chemotherapy for high risk cases. Less invasive endoscopic resection is also offered in certain cases but stringent surveillance of the whole urinary tract as well as post-operative follow-up are mandatory.

scholarly journals Incremental Role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in detection of recurrence of carcinoma cervix

2016 ◽  
Author(s):  
S. Dash ◽  
A. Goel ◽  
S. Sogani
Keyword(s):  
Fdg Pet ◽  
Carcinoma Cervix ◽  
Histopathological Correlation ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Radiologic Imaging ◽  
18F Fdg

Purpose: To evaluate the role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in early detection of recurrence in follow up patients of carcinoma cervix. Methods: Patients with histopathologically proven carcinoma cervix who underwent chemotherapy, radiotherapy and/or surgery and on follow up were recruited in the study. Fifty-two patients underwent 18F-FDG PET-CECT for detection of recurrence. The median age was 51.5 (average = 53.4) years. PET-CECT studies were evaluated and analyzed separately by an experienced nuclear medicine physician and a radiologist independently. The physicians were blinded for the patient history. PET-CECT results were validated with histopathological correlation, conventional radiologic imaging/follow up PET-CECT study and clinical follow up. Results: Out of 52 patients, 34 patients were reported as positive for recurrence, 17 of these were having active local recurrence and 31 patients had regional lymph nodal metastases, 14 patients had distant metastases (out of them 6 patients had distant lymph node metastases, 6 had pulmonary metastases, 4 had skeletal metastases and two had liver metastases). Remaining 18 patients were reported as negative for recurrence. The lung was the most common site for distant metastasis. Patient were then further evaluated based on histopathological correlation, conventional radiologic imaging and follow up PET-CECT scan and five were found to be false positive and one patient was identified as false negative. The sensitivity, specificity, positive and negative predictive value were derived to be 96.7%, 77.3%, 85.3% and 94.4%, respectively. Accuracy was calculated to be 88.5%. Conclusions: 18F-FDG PET-CECT is a very useful non-invasive modality for the early detection of recurrence and metastatic workup in patients with carcinoma cervix with a very high sensitivity and negative predictive value. It is also useful in targeting biopsy sites in suspected cases of recurrence.

scholarly journals Clinical application of contrast-enhanced ultrasound after percutaneous renal tumor ablation

2019 ◽  
Vol 92 (1103) ◽  
pp. 20190183 ◽  
Author(s):  
Fang Guo ◽  
Bing Hu ◽  
Lei Chen ◽  
Jia Li
Keyword(s):  
Local Recurrence ◽  
Tumor Ablation ◽  
Renal Tumors ◽  
Ablation Zone ◽  
Recurrent Tumors ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Complete Tumor

Objective: To evaluate the effectiveness of contrast-enhanced ultrasound (CEUS) in detecting incomplete ablation and local recurrence of renal tumors after percutaneous radiofrequency ablation (RFA). Methods: 31 patients were included for RFA treatment and underwent CEUS examination after RFA, ablation zone and contrast distribution in the ablation area were observed, CEUS images were compared with enhanced CT/MRI images to determine the residual tumors and local recurrence of renal tumors. Results: The average maximum diameters of the tumor and the ablation zone after the first RFA were 32.3 ± 14.7 mm and 35.9 ± 12.2 mm, respectively. A higher rate of complete tumor ablation was achieved if the ablation zone was larger than the primary tumor (p = 0.026). Within 1 month after RFA, contrast-enhanced CT/MRI examinations demonstrated incomplete ablation in 9 of 31 patients (29.0%), while CEUS revealed incomplete ablation in 8 of 31 patients (25.8%). The sensitivity, specificity, positive predictive value and negative predictive value of CEUS in evaluating complete ablation of renal tumors were 88.9%, 100%, 100%, 95.7%, respectively. During the follow-up period, local recurrence was reported in 2 (7.4%) of the 27 patients with complete tumor ablation. Tumor recurrence signs in the two patients were identified by both CEUS and contrast-enhanced CT/MRI. Therefore, both the sensitivity and specificity of CEUS for the evaluation of tumor recurrence were 100%. Conclusion: After percutaneous RFA of renal tumors, the effectiveness of CEUS in the follow-up assessment of residual and recurrent tumors is basically the same as that of contrast-enhanced CT/MRI. Advances in knowledge: In this study, we evaluated the effectiveness of CEUS in the follow-up assessment of residual and recurrent tumors after RFA is basically the same as that of contrast-enhanced CT/MRI. Combining multiple follow-up methods may improve the detection rate of residual or recurrent tumors.

scholarly journals Misdiagnosis of Rectus Abdominis Abscess Owing to Delayed Contrast-Enhanced Computed Tomography

2021 ◽  
Author(s):  
Yuichiro Nagase ◽  
Yukinori Harada
Keyword(s):  
Computed Tomography ◽  
Laboratory Tests ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

A 77-year-old man, who was on anticoagulation, presented with a painful lump on the right abdominal wall. Laboratory tests showed slight anaemia and elevated inflammatory markers. Abdominal plain computed tomography (CT) revealed a mass in the right rectus abdominis muscle. He was admitted with a diagnosis of primary rectus abdominis haematoma. However, on the next day, the diagnosis was corrected to primary rectus abdominis abscess, following contrast-enhanced CT of the abdomen. This case illustrates the importance of considering primary rectus abdominis abscess in patients with suspected primary rectus abdominis haematoma, and contrast should be used when performing CT.

scholarly journals Bony cystic lesion with associated submandibular lymphadenopathy on a background of breast carcinoma: an unexpected case of cervicofacial actinomycosis

2020 ◽  
Vol 13 (4) ◽  
pp. e232850
Author(s):  
Lwazi Sibanda ◽  
Emma Wates ◽  
James Higginson
Keyword(s):  
Breast Carcinoma ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Incision And Drainage ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Bony Metastases ◽  
The Right

Actinomycosis is an uncommon, chronic suppurative granulomatous infection and needs to be considered as a differential diagnosis. A 56-year-old woman with a background of type 2 diabetes mellitus and breast carcinoma was referred to the Oral and Maxillofacial Surgery 2-week wait clinic, regarding a tender sublingual mass and firm erythematous swelling in the right submandibular and submental region. This was slowly progressive and had not responded to oral co-amoxiclav. An orthopantomogram showed a well-defined radiolucency and smaller radiolucent lesions throughout the edentulous right body of the mandible. A contrast-enhanced CT confirmed a right submandibular abscess communicating with cavitating lesions. The differentials included osteomyelitis, bony metastases, multiple myeloma or other cystic lesions. The patient underwent incision and drainage of the abscess, alongside biopsies, and intravenous co-amoxiclav was given. Microbiology cultures confirmed the presence of Actinomyces israelii and a diagnosis of cervicofacial actinomycosis with mandibular osteomyelitis. The patient was successfully treated with prolonged antibiotics.

Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) of pancreas: a rare entity—worth to note

2020 ◽  
Vol 13 (4) ◽  
pp. e234855 ◽  
Author(s):  
Bharti Varshney ◽  
Jyotsna Naresh Bharti ◽  
Vaibhav Kumar Varshney ◽  
Taruna Yadav
Keyword(s):  
Histopathological Examination ◽  
Neuroendocrine Tumour ◽  
Pancreatic Head ◽  
Ductal Adenocarcinoma ◽  
Neuroendocrine Neoplasms ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Rare Malignancy

Mixed adenocarcinoma with neuroendocrine tumour of pancreas has been reported infrequently and consists of both epithelial and neuroendocrine component. We encountered an 81-year-old male patient who presented with clinical features of painful progressive jaundice for 1 month. Contrast-enhanced CT abdomen reported a mass in the pancreatic head with dilated common bile duct and pancreatic duct. He underwent pancreatoduodenectomy and histopathological examination revealed two different tumours: ductal adenocarcinoma admixed with neuroendocrine tumour of pancreas. He received adjuvant chemotherapy, and at the end of 1-year follow-up, he has no recurrence. Here, we reported this rare malignancy of pancreas for which pancreatoduodenectomy was done and diagnosed on histopathology with immunohistochemistry.

Müllerianosis of the urinary bladder with unilateral complete renal agenesis: a rare coincidental finding causing delayed presentation

2020 ◽  
Vol 13 (7) ◽  
pp. e235217
Author(s):  
Shanmugasundaram Rajaian ◽  
Lakshman Murugasen ◽  
Deepti Jain ◽  
Srinivas Chakravarthy Narasimhachar
Keyword(s):  
Urinary Bladder ◽  
Benign Lesion ◽  
Left Kidney ◽  
Scar Tissue ◽  
Delayed Presentation ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Ureteric Orifice

Müllerianosis is a rare benign lesion of the urinary bladder, which is constituted by two or more of the Müllerian-duct-derived tissues. We report a 45-year-old perimenopausal multiparous woman presenting with occasional episodes of dysuria and lower abdominal discomfort of recent duration. Ultrasound examination revealed a well-defined lesion in urinary bladder and the absence of left kidney. Contrast-enhanced CT of the abdomen confirmed the findings. During diagnostic cystoscopy, haemorrhagic polypoidal lesions were noted in the left side of the posterolateral wall and dome of urinary bladder along with the absence of left ureteric orifice. Transurethral resection of the bladder lesions was done and histology examination confirmed the diagnosis of Müllerianosis. She was administered Luteinizing hormone-releasing hormone (LHRH) agonist monthly. At 1 year of follow-up, cystoscopy showed only scar tissue. The case was reported for the rarity of Müllerianosis noted in a patient with unilateral agenesis of kidney, a possible cause of delayed presentation.

scholarly journals Resolution of grade IV hypertensive retinopathy in an adult with pheochromocytoma: post-tumor resection

2020 ◽  
Vol 13 (2) ◽  
pp. e231245
Author(s):  
Aparajita Banerjee ◽  
Bhagabat Nayak ◽  
Gargi Verma ◽  
Sucheta Parija
Keyword(s):  
Blood Pressure ◽  
Tumor Resection ◽  
Hypertensive Retinopathy ◽  
Corrected Visual Acuity ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Hypertensive Woman ◽  
Systemic Examination ◽  
The Right

A 64-year-old hypertensive woman presented with complaints of a painless, progressive decrease in vision, headache, dizziness for the last month. She was a known case of diabetes mellitus on insulin therapy. On examination, best-corrected visual acuity was 6/12 in the right eye and 6/18 in the left eye. The fundus examination in both eyes revealed features of grade IV hypertensive retinopathy. Systemic examination revealed the raised blood pressure of 200/110 mm Hg. Diagnosis of pheochromocytoma was made on the basis of increased urinary norepinephrine (892.8 mg/dL) and mass in the left adrenal gland (measuring 31×28 mm) at contrast-enhanced CT. Medical management to control hypertension was done and ultimately, she underwent left laparoscopic adrenalectomy. After 10 months of surgery, the patient was asymptomatic, blood pressure was within normal limit and her vision improved to 6/6 in both the eyes. The retinal features of hypertensive retinopathy had completely disappeared.

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