Melanocytoma of Optic Disc: Clinical Manifestations, Imaging Characteristics and Follow Up

Abstract BACKGROUND Chondromyxoid fibromas (CMFs) are benign tumors that occur rarely in the skull base. OBJECTIVE To conduct a preliminary exploration of the diagnosis and treatment of cranial CMFs. METHODS A retrospective analysis of 19 cases of CMFs in the base of the skull between 2009 and 2014 in our hospital was conducted. The clinical manifestations, imaging characteristics, pathology, treatment strategies, and outcomes were examined. RESULTS The study cohort included 7 women (36.8%) and 12 men (63.2%), and symptom duration ranged from 1 mo to 5 yr. Of the 19 intracranial CMF cases examined, 15 (78.9%) conformed with the diagnostic criteria for extracranial CMF. Resection operations yielded subtotal removal of 13 tumors (68.4%) and partial removal of 6 tumors (31.6%). Postoperative pathological analysis demonstrated that the tumors were characterized by spindle-shaped or stellate cells arranged in a myxoid matrix without mitoses or permeation. Follow-up (range 2-7.3 yr; mean, 4.4 ± 1.7 yr) revealed that symptoms improved postoperatively in 15 cases (78.9%), were maintained in 2 cases (10.5%), and worsened in 2 cases (10.5%). Imaging follow-up revealed that residual tumors were stable in 18 cases (94.7%) and enlarged in 1 case (5.3%). CONCLUSION An accurate diagnosis should involve comprehensive consideration of clinical, radiological, and pathological features. The treatment strategy for CMFs consists of maximizing tumor removal while protecting adjacent key structures. Postoperative stereotactic radiotherapy is appropriate for residual tumors.

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Cerebral Hemangioblastoma Without Von Hippel-Lindau Syndrome: A Report of 6 Cases

International Journal of Surgical Pathology ◽

10.1177/1066896920933998 ◽

2020 ◽

pp. 106689692093399

Author(s):

Limei Qu ◽

Chuanqi Lv ◽

Tiefeng Ji ◽

Yinping Wang ◽

Jinlu Yu

Keyword(s):

Parietal Lobe ◽

Clinical Manifestations ◽

Pathological Examination ◽

Cystic Tumor ◽

Mixed Tumor ◽

Wild Type ◽

Von Hippel Lindau ◽

Imaging Characteristics ◽

Von Hippel Lindau Syndrome

Background. Hemangioblastoma occurs mainly in the cerebellum and rarely in the cerebrum. Objective. The present study aimed to analyze the clinical manifestations and radiological and pathological features of cerebral hemangioblastoma, and to improve the recognition of this tumor and avoid misdiagnosis. Methods. The characteristics of 6 patients with cerebral hemangioblastoma were analyzed, and a retrospective review of cerebral hemangioblastoma reported in the literature was performed. Results. All 6 patients were female, aged from 22 to 70 years (55 years on average), and all cases were wild-type sporadic, in which 4 cases occurred in the frontal lobe and 2 cases occurred in the parietal lobe. Imaging revealed a solid tumor in 4 cases, a cystic tumor in 1 case, and a mixed tumor in 1 case. Microscopically, the morphology and immunophenotype of tumor cells were not different from those of classical hemangioblastoma. All 6 patients survived tumor free during the follow-up period. Conclusions. Cerebral hemangioblastoma often simulates the imaging characteristics of meningioma or glioma. Enough attention should be paid to differential diagnosis before the operation, and exact diagnosis relies on the pathological examination.

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Pancreatic Leiomyosarcoma With Schistosomiasis Hematobia: A Case Report and Literature Review

Frontiers in Oncology ◽

10.3389/fonc.2021.638905 ◽

2021 ◽

Vol 11 ◽

Author(s):

Qiang Li ◽

Daniel Staiculescu ◽

Yurong Zhou ◽

Jiang Chen

Keyword(s):

Case Report ◽

Tumor Resection ◽

Clinical Manifestations ◽

Malignant Neoplasm ◽

The Body ◽

Imaging Characteristics ◽

Magnetic Resonance Imaging Mri ◽

The Relationship ◽

Ct And Mri

Pancreatic leiomyosarcoma (PL) is a very rare, malignant neoplasm with a very poor prognosis. Here, we examine a novel case of PL with schistosomiasis hematobia. The patient had been initially misdiagnosed by the first magnetic resonance imaging (MRI). The second imaging examination demonstrated an enlarged heterogeneous tumor mass in the body-tail of pancreas. Following image analysis, the patient underwent a pancreatectomy, splenectomy and lymph node dissections. Sixteen months after the tumor resection, follow-up computed tomography (CT) and MRI revealed tumor metastasis in the liver and lung. PL has non-specific clinical manifestations and imaging characteristics, making early diagnosis very challenging. When it is difficult to distinguish between benign and malignant pancreatic lesions, short-term imaging follow-up is preferred. In this case report, we discuss the relationship between PL and schistosomiasis hematobia.

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Clinical Characteristics of 20 Patients with Chronic Eosinophilic Pneumonia: A 6-year Retrospective Study

10.21203/rs.3.rs-38360/v1 ◽

2020 ◽

Author(s):

Yang Xu ◽

Zhanbo Wang ◽

Zhaorui Zhang ◽

Yu Dai ◽

Qiang Zhu ◽

...

Keyword(s):

Peripheral Blood ◽

Clinical Manifestations ◽

Lavage Fluid ◽

Eosinophilic Pneumonia ◽

Imaging Features ◽

Course Of Disease ◽

Chronic Eosinophilic Pneumonia ◽

Imaging Characteristics ◽

Blood Eosinophils

Abstract Background: Chronic eosinophilic pneumonia (CEP) is a rare disease and there are few systematic studies on the disease. We summarized the clinical and pathological data of CEP to improve the understanding of the disease, as well as to reduce misdiagnosis and mistreatment. Methods: The data of patients pathologically diagnosed as CEP in PLA General Hospital between May 2013 and May 2019 were collected, and the clinical manifestations, imaging characteristics, pathological features, treatment and prognosis were retrospectively analyzed. Results: There were 20 patients with CEP, including 6 males and 14 females. The average age at the time of diagnosis was 47.0 ± 10.2 (22-83) years, and the average course of disease was 15.5 ±11.5 (2-72) months. The main clinical manifestations were cough, dyspnea, expectoration, and shortness of breath, and often accompanied by fever, weight loss, and asthenia. 19 patients had elevated peripheral blood eosinophils, with the proportion of eosinophils ranging from 5.3-64.7%, and the absolute value of eosinophils ranging from 0.72-14.43×109/L. 18 patients had increased proportion of eosinophils in bronchoalveolar lavage fluid (BALF), ranging from 12-67%, with an average of 46%. The main imaging features were patchy shadows, consolidated shadows, and ground glass shadows. The histological examination of bronchial mucosal biopsy indicated eosinophilic infiltration in submucosal tissues and the pulmonary biopsy indicated a large number of eosinophils infiltration in alveolar cavity and septum as the main pathological changes of CEP. All of 20 patients were treated with glucocorticoid, and one of them relapsed during follow-up. Conclusions: The onset of CEP is insidious and the clinical manifestations are lack of specificity. Eosinophils increase in peripheral blood and BALF in most of CEP patients. The typical image is peripheral and subpleural distribution of lung infiltrates. The diagnosis of CEP depends on pathology, and glucocorticoid therapy is effective.

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Spinal Epidural Cavernous Hemangiomas: A Clinical Series of 9 Cases and Literature Review

Frontiers in Oncology ◽

10.3389/fonc.2021.572313 ◽

2021 ◽

Vol 11 ◽

Author(s):

Liyan Zhao ◽

Yining Jiang ◽

Yubo Wang ◽

Yang Bai ◽

Ying Sun ◽

...

Keyword(s):

Surgical Intervention ◽

Vascular Malformations ◽

Clinical Manifestations ◽

Neurological Deficits ◽

Vascular Lesions ◽

Imaging Characteristics ◽

Clinical Series ◽

Cavernous Hemangiomas ◽

Spinal Epidural

ObjectiveSpinal epidural cavernous hemangiomas are very rare vascular lesions and are, therefore, seldom reported and easily misdiagnosed. Herein, we present a series of 9 cases with spinal epidural cavernous hemangiomas and discuss their pathogenesis, clinical characteristics, radiological findings, differential diagnosis, surgical interventions, pathological characteristics, and prognosis.MethodsWe retrospectively retrieved and analyzed the data of patients with pure epidural cavernous hemangiomas, who underwent spinal magnetic resonance imaging, and surgical intervention at the First Hospital of Jilin University, China, between January 2005 and December 2019. The data on patients’ clinical manifestations, imaging characteristics, surgical intervention, histopathological findings, and postoperative follow-up were also recorded and analyzed.ResultsIn all, 5 men and 4 women with the mean age of 61 years (range, 41–78 years) were recruited. All patients experienced a gradual onset of symptoms and a slowly progressive clinical course, and no patient presented an acute onset of symptoms. The clinical manifestations include myelopathic signs in 8 patients (88.9%) and radicular symptoms in 3 patients (33.3%). On T1-weighted imaging, 6 lesions appeared isointense (55.6%), and 4 lesions exhibited hypointense (44.4%) signals. On T2-weighted imaging, 8 lesions appeared hyperintense (88.9%), and 1 lesion was heterogeneously intense (11.1%). Following gadolinium administration, 5 lesions appeared homogeneous with significant enhancement (55.6%), 1 lesion was homogeneous and mild enhancement (11.1%), and 3 lesions were heterogeneous with mild enhancement (33.3%). All patients received early microsurgery assisted by intraoperative electrophysiologic monitoring and neuronavigation in the lateral position via the posterior midline approach. Five patients underwent total laminectomy (55.6%), and 4 underwent hemilaminectomy (44.4%). Total excision was achieved in all cases. The average follow-up period was 55.1 months (ranging 10–123 months). All patients exhibited significant clinical improvement of their neurological deficits and achieved a favorable outcome with no recorded recurrence at last follow-up.ConclusionsSpinal epidural cavernous hemangiomas are rare vascular malformations. Early surgical treatment with total resection is an optimum treatment, particularly for patients with an acute exacerbation onset. The prognosis is mostly good and depends predominantly on the severity of the preoperative status.

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Central Neurocytoma in the Fourth Ventricle: Case Report and Literature Review

10.21203/rs.3.rs-472481/v1 ◽

2021 ◽

Author(s):

Jiangwei Ding ◽

Yang Dong ◽

Lei Wang ◽

Baorui Guo ◽

Xinxiao Li ◽

...

Keyword(s):

Fourth Ventricle ◽

Chinese Women ◽

Clinical Manifestations ◽

Central Neurocytoma ◽

Subtotal Resection ◽

Intracranial Tumour ◽

Soap Bubble ◽

Imaging Characteristics ◽

Solid Lesions

Abstract Background: Central neurocytoma is a rare primary intracranial tumour that usually occurs in young people. Central neurocytoma is more common in the lateral ventricle, but it is rare in the fourth ventricle. Herein, we report a case of central neurocytoma in the fourth ventricle. To improve our understanding, diagnosis, and treatment of this disease, we reviewed the literature to analyse the age, gender, clinical manifestations, imaging characteristics, and surgical prognosis of CNC in the fourth ventricle.Case presentation: A 44-year-old Chinese women presented with headache and dizziness for 8 years, walking instability for 2 years, and aggravation for 1 month. MRI revealed a 3.0 cm × 3.6 cm ×3.4 cm lesion located in the fourth ventricle. The tumour was completely resected. Pathological results were consistent with central neurocytoma. The patient could not walk or speak fluently during post-operative period, and no recurrence was found during the seventh month of follow-up.Conclusions: Central neurocytoma in the fourth ventricle is a rare intracranial tumour that is difficult to diagnose preoperatively. However, it can be considered when cystic and solid lesions are present in the fourth ventricle, especially when the morphology is like a soap bubble. Surgery is the main treatment for CNC. Adjuvant radiotherapy can be considered for partial or subtotal resection cases, and the prognosis is good. No recurrence of central neurocytoma in the fourth ventricle has been reported thus far.

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Clinical Manifestations and Radiological Characteristics on Rosai-Dorfman Disease: A Retrospective Observational Study

Medical & Clinical Research ◽

10.33140/mcr.05.05.005 ◽

2020 ◽

Vol 5 (5) ◽

Keyword(s):

Blood Vessels ◽

Abdominal Cavity ◽

Clinical Manifestations ◽

Ct Images ◽

High Signal ◽

Radiological Features ◽

Imaging Characteristics ◽

Rosai Dorfman Disease ◽

Heterogeneous Enhancement ◽

The Masses

Background and Objective: Rosai-Dorfman disease (RDD) are usually misdiagnosed because of rarity and nonspecific clinical and radiological features. The aim of our study is to explore the clinical and imaging characteristics of RDD to improve diagnostic accuracy. Methods: Clinical and imaging data in 10 patients with RDD were retrospectively analyzed. 7 patients were underwent CT scanning and 3 patients were underwent MR examination. Results: 8 (8/10) patients presented with painless enlarged lymph nodes (LNs) or mass. 3 cases were involved with LNs, 5 cases were involved with extra-nodal tissues, and the remaining 2 cases were involved with LNs and extra-nodal tissue simultaneously. In enhanced CT images, enlarged LNs displayed mild or moderate enhancement, and 2 cases showed heterogeneous ring-enhancement. MR features of 3 patients with extra-nodal RDD, 2 cases showed a mass located in the subcutaneous and anterior abdominal wall respectively, and 1 case showed an intracranial mass. Besides, all lesions showed high signal foci on DWI images, and were characterized by marked heterogeneous enhancement with blurred edge. The dural/fascia tail sign and dilated blood vessels could be seen around all the lesions on enhanced MRI. Radiological features of 2 cases with LN and extranodal tissue involved, one case presented with the swelling and thickening of pharyngeal lymphoid ring and nasopharynx, meanwhile with enlarged LNs in bilateral submandibular area, neck and abdominal cavity, and also companied with osteolytic lesion in right proximal humerus. All these LNs displayed mild and moderate enhancement on CT images. Another case showed enlarged LNs in bilateral neck accompanied with soft tissue mass in the sinuses. Conclusions: RDD occurred commonly in young and middle-aged men and presented with painless enlarged LNs or mass.RDD had a huge diversity of imaging findings, which varied with different location. The radiological features, such as small patches of high signal foci in the masses on DWI images, heterogeneous enhancement and blood vessels around the masses, are helpful in diagnosis of extranodal RDD.

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Monogenic Diabetes: Genetics and Relevance on Diabetes Mellitus Personalized Medicine

Current Diabetes Reviews ◽

10.2174/1573399816666191230114352 ◽

2020 ◽

Vol 16 (8) ◽

pp. 807-819 ◽

Cited By ~ 1

Author(s):

Madalena Sousa ◽

Jácome Bruges-Armas

Keyword(s):

Diabetes Mellitus ◽

Complex Disease ◽

Clinical Manifestations ◽

Neonatal Diabetes ◽

Monogenic Diabetes ◽

Diabetes Genetics ◽

Individualize Treatment

Background: Diabetes mellitus (DM) is a complex disease with significant impression in today's world. Aside from the most common types recognized over the years, such as type 1 diabetes (T1DM) and type 2 diabetes (T2DM), recent studies have emphasized the crucial role of genetics in DM, allowing the distinction of monogenic diabetes. Methods: Authors did a literature search with the purpose of highlighting and clarifying the subtypes of monogenic diabetes, as well as the accredited genetic entities responsible for such phenotypes. Results: The following subtypes were included in this literature review: maturity-onset diabetes of the young (MODY), neonatal diabetes mellitus (NDM) and maternally inherited diabetes and deafness (MIDD). So far, 14 subtypes of MODY have been identified, while three subtypes have been identified in NDM - transient, permanent, and syndromic. Discussion: Despite being estimated to affect approximately 2% of all the T2DM patients in Europe, the exact prevalence of MODY is still unknown, accentuating the need for research focused on biomarkers. Consequently, due to its impact in the course of treatment, follow-up of associated complications, and genetic implications for siblings and offspring of affected individuals, it is imperative to diagnose the monogenic forms of DM accurately. Conclusion: Currently, advances in the genetics field allowed the recognition of new DM subtypes, which until now, were considered slight variations of the typical forms. Thus, it is imperative to act in the close interaction between genetics and clinical manifestations, to facilitate diagnosis and individualize treatment.

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Deep Cerebral Venous Thrombosis—A Clinicoradiological Study

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1730109 ◽

2021 ◽

Author(s):

Sujana Gogineni ◽

Dhananjay Gupta ◽

R. Pradeep ◽

Anish Mehta ◽

Mahendra Javali ◽

...

Keyword(s):

Venous Thrombosis ◽

Care Center ◽

Tertiary Care ◽

Clinical Manifestations ◽

Arterial Occlusion ◽

Venous System ◽

Common Risk Factor ◽

Imaging Characteristics ◽

Deep Cerebral Venous Thrombosis ◽

High Index Of Suspicion

AbstractStroke is a common neurological emergency. Almost 80% of strokes are due to arterial occlusion. Venous thrombosis comprises less than 1–2% of all strokes. Involvement of the deep cerebral venous system is still rare and accounts for about 10.9% of all cerebral venous thromboses (CVT). CVT diagnosis is often delayed or missed, because of its variable clinical manifestations. We retrospectively (2015–18) and prospectively (2018–20) reviewed all the cases of CVT in a tertiary care center in south India. Out of a total of 52 CVT cases, 12 were due to the involvement of deep cerebral venous system. Their clinical presentation, imaging characteristics, and outcomes were assessed. The most frequent presentation was headache followed by seizures. Hyperhomocysteinemia was the most common risk factor noted. Imaging characteristics were variable, and a high index of suspicion was required for early diagnosis. All patients had favorable outcome in our study, and except one, all were treated conservatively.

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A New Multiplatform Model for Outpatient Prenatal and Postpartum Care in a Cohort of COVID-19-Affected Obstetric Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105144 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5144

Author(s):

Mar Muñoz-Chápuli Gutiérrez ◽

Ana Durán-Vila ◽

Javier Ruiz-Labarta ◽

Pilar Payá-Martínez ◽

Pilar Pintado Recarte ◽

...

Keyword(s):

Clinical Manifestations ◽

Specific Treatment ◽

Rt Pcr ◽

Good Adherence ◽

Major Morbidity ◽

Reference Hospital ◽

The Mean ◽

Discharge From Hospital ◽

Over Time

Spain was one of the epicenters of the first wave of the COVID-19 pandemic. We describe in this article the design and results of a new telephone-and-telematic multiplatform model of systematic prenatal and postpartum follow-up for COVID-19-affected women implemented in a tertiary reference hospital in Madrid. We included patients with RT-PCR-confirmed COVID-19 during pregnancy or delivery from 10 March 2020 to 15 December 2020. We had a total of 211 obstetric patients: 148 (70.1%) were tested at the onset of suspicious clinical manifestations and 62 (29.4%) were tested in the context of routine screening. Of all the patients, 60 women (28.4%) were asymptomatic and 97 (46%) presented mild symptoms. Fifty-one women (24.2%) were admitted to our hospital for specific treatment because of moderate or severe symptoms. We had no missed cases and a good adherence. The mean number of calls per patient was 2.3. We performed 55 in-person visits. We analyzed the complexity of our program over time, showing a two-wave-like pattern. One patient was identified as needing hospitalization and we did not record major morbidity. Telemedicine programs are a strong and reproducible tool to reach to pregnant population affected by COVID-19, to assess its symptoms and severity, and to record for pregnancy-related symptoms both in an outpatient regime and after discharge from hospital.

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