scholarly journals Radiological considerations and surgical planning in the treatment of giant parathyroid adenomas

2015 ◽  
Vol 97 (4) ◽  
pp. e64-e66 ◽  
Author(s):  
G Garas ◽  
M Poulasouchidou ◽  
A Dimoulas ◽  
P Hytiroglou ◽  
M Kita ◽  
...  
Keyword(s):  
Parathyroid Carcinoma ◽  
Surgical Planning ◽  
Rare Clinical Entity ◽  
Cross Sectional ◽  
Parathyroid Adenomas ◽  
Cross Sectional Imaging ◽  
Thoracic Approach ◽  
Severe Hypercalcaemia ◽  
Developed World ◽  
Biochemical Features

Giant parathyroid adenomas constitute a rare clinical entity, particularly in the developed world. We report the case of a 53-year-old woman where the initial ultrasonography significantly underestimated the size of the lesion. The subsequent size and weight of the adenoma (7cm diameter, 27g) combined with the severity of the hypercalcaemia raised the suspicion for the presence of a parathyroid carcinoma. This was later disproven by the surgical and histological findings. Giant parathyroid adenomas are encountered infrequently among patients with primary hyperparathyroidism, and appear to have distinct clinical and biochemical features related to specific genomic alterations. Cross-sectional imaging is mandated in the investigation of parathyroid adenomas presenting with severe hypercalcaemia as ultrasonography alone can underestimate their size and extent. This is important since it can impact on preoperative preparation and planning as well as the consent process as a thoracic approach may prove necessary for certain cases.

Radiology of acute mastoiditis and its complications: a pictorial review and interpretation checklist

2019 ◽  
Vol 133 (10) ◽  
pp. 856-861
Author(s):  
M W Mather ◽  
P D Yates ◽  
J Powell ◽  
I Zammit-Maempel
Keyword(s):  
Head And Neck ◽  
Surgical Planning ◽  
Systematic Approach ◽  
Acute Mastoiditis ◽  
Cross Sectional ◽  
Imaging Technology ◽  
Radiological Features ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

AbstractBackgroundMastoiditis is an otological emergency, and cross-sectional imaging has a role in the diagnosis of complications and surgical planning. Advances in imaging technology are becoming increasingly sophisticated and, by the same token, the ability to accurately interpret findings is essential.MethodsThis paper reviews common and rare complications of mastoiditis using case-led examples. A radiologist-derived systematic checklist is proposed, to assist the ENT surgeon with interpreting cross-sectional imaging in emergency mastoiditis cases when the opinion of a head and neck radiologist may be difficult to obtain.ResultsA 16-point checklist (the ‘mastoid 16’) was used on a case-led basis to review the radiological features of both common and rare complications of mastoiditis; this is complemented with imaging examples.ConclusionAcute mastoiditis has a range of serious complications that may be amenable to treatment, once diagnosed using appropriate imaging. The proposed checklist provides a systematic approach to identifying complications of mastoiditis.

scholarly journals 439 Managing Parathyroid Carcinoma in the Age of COVID 19

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Greene ◽  
P Truran ◽  
R Bliss ◽  
J Ramsingh
Keyword(s):  
Surgical Management ◽  
Parathyroid Carcinoma ◽  
Elective Surgery ◽  
Endocrine Surgery ◽  
Parathyroid Cancer ◽  
Tertiary Referral Centre ◽  
Cross Sectional ◽  
Operative Outcomes ◽  
Rare Malignancy ◽  
Severe Hypercalcaemia

Abstract Aim Parathyroid carcinoma is a rare malignancy accounting for 1% of cases of primary hyperparathyroidism. Pre-operative diagnosis is difficult because in the absence of metastatic disease, the presentation is similar to benign parathyroid disease. In patients with hyperparathyroidism and severe hypercalcaemia or a significantly raised parathyroid hormone (PTH) level clinicians should consider parathyroid carcinoma and expediting surgical management. During the current pandemic, a high index of suspicion should be maintained to ensure that care is not compromised. A review of the management of patients with suspected parathyroid carcinoma during the COVID-19 pandemic is presented. Method In our tertiary referral centre for Endocrine surgery, 4 presentations of parathyroid cancer were reviewed. Their investigations, surgical management and post-operative outcomes are described with a brief literature review of parathyroid cancer. Results Of the four cases of parathyroid carcinoma described, all presented with severe hypercalcaemia and significantly raised PTH levels. Pre-operative mean calcium was 3.36mmol/L and mean PTH was 80pmol/L (52-99.8). Patients were imaged with a combination of cross-sectional imaging and ultrasound. Two patients had evidence of distant disease at presentation. 1 patient was transferred as an inpatient to our centre and the other three patients were seen within 2 weeks of referral; the mean time from referral to surgery was 14days (1-23). Post-operatively, all patients achieved normocalcaemia, with PTH levels normal in all but one. Conclusions Despite limitations on face-to-face clinic consultations and reduced capacity for elective surgery during the COVID-19 pandemic, all patients were investigated and managed promptly to ensure superior outcomes.

scholarly journals Bilateral giant parathyroid adenoma in the absence of multiple endocrine neoplasia type 1

2020 ◽  
Vol 102 (6) ◽  
pp. e111-e114
Author(s):  
P Liu ◽  
N Vakharia ◽  
A Zacharia ◽  
M Rogers ◽  
F Tanweer
Keyword(s):  
Parathyroid Adenoma ◽  
Multiple Endocrine Neoplasia ◽  
Kidney Injury ◽  
Test Results ◽  
Normal Range ◽  
Cross Sectional ◽  
Endocrine Neoplasia ◽  
Parathyroid Adenomas ◽  
Cross Sectional Imaging

Introduction Bilateral giant parathyroid adenoma in the absence of multiple endocrine neoplasia (MEN) type 1 is extremely rare and literature on this subject is limited. Case history A 79-year-old man presented with acute kidney injury secondary to hypercalcaemia. Blood test results indicated primary hyperparathyroidism. Ultrasonography revealed bilateral parathyroid adenomas measuring 19.4mm x 19.5mm x 18.8mm (left) and 15.2mm x 18.3mm x 19.6mm (left) whereas on computed tomography, the measurements were 31mm x 20mm (left) and 30mm x 14mm (right). Intraoperatively, giant adenomas measuring 50mm x 25mm x 12mm (left, weighing 8.101g) and 48mm x 22mm x 10mm (right, weighing 7.339g) were identified and excised. Parathyroid hormone level dropped from 44.6pmol/l preoperatively to 8.9pmol/l postoperatively (normal range 1.3–7.6pmol/l). The patient was discharged with no complications. Conclusions We report a rare phenomenon where bilateral giant parathyroid adenoma occurred in the absence of MEN type 1. It highlights the importance of cross-sectional imaging in delineating the anatomy of adenomas as their size can be grossly underestimated by ultrasonography alone.

scholarly journals The benefits of computed tomography imaging in the diagnosis, prognosis and treatment planning of equine orthopedic patients illustrated by six cases

2021 ◽  
Vol 90 (6) ◽  
pp. 299-312
Author(s):  
L M. J. Vandekerckhove ◽  
E. V. Raes ◽  
M. Dumoulin ◽  
A. Martens ◽  
K. Vanderperren
Keyword(s):  
Computed Tomography ◽  
Surgical Planning ◽  
Soft Tissues ◽  
Fracture Repair ◽  
Accurate Diagnosis ◽  
Computed Tomography Imaging ◽  
Cross Sectional ◽  
Tomography Imaging ◽  
Cross Sectional Imaging ◽  
Orthopedic Patients

Radiography and/or ultrasonography are the first imaging modalities for diagnosing orthopedic pathology in equine patients. However, in some cases, cross-sectional imaging is necessary to reach a more accurate diagnosis. Six cases were retrospectively selected from the imaging database of the Faculty of Veterinary Medicine (Ghent University) to illustrate the benefits of computed tomography (CT) in orthopedic patients. In two cases, CT demonstrated osteomyelitis lesions in two young foals, which could not be detected with radiography and ultrasonography. In three cases, CT was performed for surgical planning of fracture repair, and in one case CT demonstrated multiple lesions at the soft tissues and ligamentous insertions in the stifle. In all cases, CT revealed additional findings, which were important for the treatment and prognosis of the patient.

scholarly journals 671 Fetus-In-Fetu Found at Excision of An Antenatally Diagnosed Abdominal Mass: Multi-Disciplinary Approach

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Smith ◽  
A Moore ◽  
S Popov ◽  
M Adams ◽  
E Folaranmi ◽  
...  
Keyword(s):  
Current Literature ◽  
Surgical Planning ◽  
Abdominal Mass ◽  
Female Infant ◽  
Cross Sectional ◽  
Treatment Pathways ◽  
Fetus In Fetu ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Multi Disciplinary Team

Abstract We present a case of antenatally detected abdominal mass and an alternative diagnostic course for suspected neonatal neuroblastoma as a result of investigative findings. A female infant presented antenatally with a left upper quadrant mass initially managed as a suspected neonatal neuroblastoma; further cross-sectional imaging suggested a wider differential including teratoma and aided surgical planning. The multi-disciplinary team (MDT) decision was for an early excision at 31 days and post-operative histology identified a diagnosis of fetus-in-fetu (FIF). We describe this case as a compliment to the current literature and an example of a necessary variation to recognised diagnostic and treatment pathways as a result of investigative findings.

scholarly journals 469 Novel Applications of Cross-Sectional Imaging in Oncoplastic Surgical Planning for Breast Cancer Following Neoadjuvant Chemotherapy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Begaj ◽  
R McLean ◽  
P Bhaskar
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Surgical Planning ◽  
Skin Flap ◽  
Breast Mri ◽  
Observer Agreement ◽  
Arterial Supply ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Abstract Background Cross-sectional imaging using MRI is most commonly used to evaluate the response to neoadjuvant chemotherapy. Furthermore, CT scan of chest, abdomen, and pelvis (CAP) is used in staging the breast cancer. This study seeks to evaluate the feasibility of using preoperative cross-sectional imaging in oncoplastic surgical planning for patients undergoing neoadjuvant chemotherapy for breast cancer. Method All female patients who underwent neoadjuvant chemotherapy for breast cancer between January 2019 and January 2020 and underwent breast MRI pre- and post-neoadjuvant chemotherapy and staging CTCAP were included. All images were independently reviewed and analysed by two consultant breast radiologists. Chest wall symmetry, breast volume differences, skin flap thickness, arterial supply to nipple, intercostal perforators and LD pedicle were assessed on both CT and MRI. Results Nineteen women were included in this study. Breast measurements were best made by MRI due to difficulty interpreting the CT images when supine. The majority of the patients had a dual arterial supply. There was substantial inter–observer agreement in visualisation of MICAP and AICAP. The inter–observer reliability reduced when the radiologists were asked to visualize the LICAP and the thoracodorsal artery with moderate inter–observer agreement, as the MRI images were difficult to interpret laterally. Conclusions This study shows that MRI is suitable to detect most intercostal perforators and is the first study to highlight cross-sectional modalities for assessment of intercostal perforators and may aid preoperative surgical planning and choice of perforator. We have suggested potential addition of CT angiography in cases where the surgeon plans oncoplastic surgery.

scholarly journals Ribbing disease- radiograph to the rescue in an overlooked cause of painful shin

2021 ◽  
Vol 3 ◽  
pp. 111-116
Author(s):  
Suvinay Saxena ◽  
Taruna Yadav ◽  
Satya Jha ◽  
Pushpinder Singh Khera
Keyword(s):  
Case Report ◽  
Clinical Management ◽  
Accurate Diagnosis ◽  
Rare Clinical Entity ◽  
Imaging Findings ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Ribbing Disease

Ribbing disease or multiple diaphyseal sclerosis is a rare clinical entity, which is often confused with many other differential diagnoses when it primarily involves the tibia and fibula. An accurate diagnosis alleviates the need for tissue diagnosis and aids in better clinical management and outcome of the patient. The case report highlights the classical imaging findings, appearance on cross-sectional imaging, and the admirable role of radiographs in diagnosing the entity.

State-of-the-art pulmonary arterial imaging – Part 2

VASA ◽  
2018 ◽  
Vol 47 (5) ◽  
pp. 361-375 ◽  
Author(s):  
Harold Goerne ◽  
Abhishek Chaturvedi ◽  
Sasan Partovi ◽  
Prabhakar Rajiah
Keyword(s):  
Pulmonary Artery ◽  
State Of The Art ◽  
Therapy Monitoring ◽  
Pulmonary Arteries ◽  
Imaging Modalities ◽  
Cross Sectional ◽  
Multiple Imaging ◽  
Cross Sectional Imaging ◽  
Pulmonary Arterial ◽  
Arterial Imaging

Abstract. Although pulmonary embolism is the most common abnormality of the pulmonary artery, there is a broad spectrum of other congenital and acquired pulmonary arterial abnormalities. Multiple imaging modalities are now available to evaluate these abnormalities of the pulmonary arteries. CT and MRI are the most commonly used cross-sectional imaging modalities that provide comprehensive information on several aspects of these abnormalities, including morphology, function, risk-stratification and therapy-monitoring. In this article, we review the role of state-of-the-art pulmonary arterial imaging in the evaluation of non-thromboembolic disorders of pulmonary artery.

Sign in / Sign up

Export Citation Format

Share Document