Epithelioid Angiosarcoma of the Tibia: A Case Report and Literature Review

Abstract Background：Epithelioid angiosarcoma (EA) is characterized by epithelioid-like neoplastic cells. In fact, there is little literature regarding EA of bone. Accordingly, this study presents an imaging analysis of a 66-year-old man who suffered from EA in his right tibia.Case presentation: A 66-year-old man developed right ankle pain four months prior to initial evaluation at our institute, which was progressively worsening for six days. All laboratory data were within the reference ranges. Plain radiographs and computed tomography (CT) revealed osteolytic lesions with multiple separations in the distal tibia, measuring 7.9 cm × 4.6 cm × 4.4 cm in size. The lytic lesions were ill-circumscribed and lacked marginal sclerosis. Punctate irregular calcifications and low-density areas were observed within lesion's areas. The cortical bone was irregularly thinned and was discontinuous. On magnetic resonance imaging (MRI), the lesions were heterogeneous. Immunohistochemically, the tumor cells expressed the vascular markers CD31, CD34, and factor VIII and revealed 5% positivity for Ki67. Finally, the patient was diagnosed with EA of bone.Conclusions: We reported a case of EA that occurred in the right tibia and summarized the imaging features of EA by reviewing the literature. Although pathological examination remains the gold standard for diagnosing EA, specific imaging features may assist in diagnosis.

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Neuroimaging of Children With Takayasu Arteritis

Journal of Child Neurology ◽

10.1177/0883073821991287 ◽

2021 ◽

pp. 088307382199128

Author(s):

Hafize Emine Sönmez ◽

Ferhat Demir ◽

Semanur Özdel ◽

Şerife Gül Karadağ ◽

Esra Bağlan ◽

...

Keyword(s):

Takayasu Arteritis ◽

Internal Carotid ◽

Laboratory Data ◽

Left Middle Cerebral Artery ◽

Mri Findings ◽

Cranial Mri ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

And Diffusion ◽

Left Middle

Objective: Takayasu arteritis is a rare granulomatous chronic vasculitis that affects the aorta and its main branches. Neurologic manifestations can accompany the disease; however, there is no study on neuroimaging in children with Takayasu arteritis. Therefore, we aimed to evaluate cranial magnetic resonance imaging (MRI) in pediatric Takayasu arteritis patients. Materials and Methods: Demographic, clinical, and laboratory data were obtained retrospectively. Results: The study included 15 pediatric Takayasu arteritis patients. All patients presented with constitutional symptoms. Additionally, 6 patients suffered from headache, 2 had syncope, 1 had loss of consciousness, and 1 had convulsion. All patients underwent cranial and diffusion MRI a median 12 months after diagnosis. Cranial MRI findings were normal in 12 patients, whereas 3 patients had abnormal findings, as follows: stenosis in the M1 and M2 segments of the left middle cerebral artery (n = 1); diffuse thinning of the right internal carotid, middle cerebral, and right vertebral and basilar artery (n = 1); as a sequela, areas of focal gliosis in both the lateral ventricular and posterior periventricular regions (n = 1). Among these 3 patients, 1 had no neurologic complaints. Conclusion: Abnormal MRI findings can be observed in pediatric Takayasu arteritis patients, even those that are asymptomatic; therefore, clinicians should carefully evaluate neurologic involvement in all pediatric Takayasu arteritis patients.

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Intraosseous Schwannoma of the Proximal Humarus With Pathologic Fracture

10.21203/rs.3.rs-387605/v1 ◽

2021 ◽

Author(s):

huajun jiang ◽

Wei Qu ◽

Yuxuan Wu ◽

Jingjing Yang

Keyword(s):

Proximal Humerus ◽

Pathologic Fracture ◽

Bone Allograft ◽

Excisional Biopsy ◽

Pathological Examination ◽

Ki 67 ◽

Benign Schwannoma ◽

S 100 ◽

Magnetic Resonance Imaging Mri ◽

The Right

Abstract Purpose Intraosseous schwannomas are extremely rare in the humerus, and less than 5 cases have been reported previously in the literature. This is the first report of its origin in the proximal humerus with pathologic fracture. we herein present this case for discussing the reason for its rarity and sharing our experience of management.Case presentation A 55-year-old female patient who presented with pain in the right shoulder, which caused by tripping and falling over a board. Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) showed considerable tumor in proximal humerus, which connected with a fracture. For this suspected tumor, we performed two operations. Pathological examination demonstrated typical picture of a schwannoma, showing whorls and interlacing fascicles of schwannoma spindle cells. Immunohistochemistry, The tumor cells were diffusely positive for S-100 protein, SOX-10 and CD68, while they were completely negative for desmin, DOG-1, AE1/AE3 and P63. The ki-67 index was about 10%. No mitoses or features of malignancy were identified. Finally, a diagnosis of benign schwannoma with focal of actively proliferated cells was made.Methods The treatment for intraosseous neurilemmomais with pathologic fracture include excisional biopsy, curettage, bone allograft, and fracture fixation. Results The patient recovered well. After the surgery, the patient gradually regained mobility and pain subsided. There was no recurrence after 6 months follow-up by X-ray.Conclusion In our case, the tumor with higher CD68 staining were likely to demonstrate that the tumor volume increase is not only based on cell proliferation, but also intratumoral hemorrhage, vascularization, and inflammation, which may be produce rarefaction of the bone and lead to bone fracture after a trivial trauma.

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Intraosseous schwannoma of the proximal humarus with pathologic fracture

10.21203/rs.3.rs-387605/v2 ◽

2021 ◽

Author(s):

Huajun Jiang ◽

Wei Qu ◽

Yuxuan Wu ◽

Jingjing Yang

Keyword(s):

Proximal Humerus ◽

Pathologic Fracture ◽

Bone Allograft ◽

Excisional Biopsy ◽

Pathological Examination ◽

Ki 67 ◽

Benign Schwannoma ◽

S 100 ◽

Magnetic Resonance Imaging Mri ◽

The Right

Abstract Purpose: Intraosseous schwannomas are extremely rare in the humerus, and less than 5 cases have been reported previously in the literature. This is the first report of its origin in the proximal humerus with pathologic fracture. we herein present this case for discussing the reason for its rarity and sharing our experience of management.Case presentation: A 55-year-old female patient who presented with pain in the right shoulder, which caused by tripping and falling over a board. Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) showed considerable tumor in proximal humerus, which connected with a fracture. For this suspected tumor, we performed two operations. Pathological examination demonstrated typical picture of a schwannoma, showing whorls and interlacing fascicles of schwannoma spindle cells. Immunohistochemistry, The tumor cells were diffusely positive for S-100 protein, SOX-10 and CD68, while they were completely negative for desmin, DOG-1, AE1/AE3 and P63. The ki-67 index was about 10%. No mitoses or features of malignancy were identified. Finally, a diagnosis of benign schwannoma with focal of actively proliferated cells was made.Methods: The treatment for intraosseous neurilemmomais with pathologic fracture include excisional biopsy, curettage, bone allograft, and fracture fixation.Results: The patient recovered well. After the surgery, the patient gradually regained mobility and pain subsided. There was no recurrence after 6 months follow-up by X-ray.Conclusion: In our case, the tumor with higher CD68 staining were likely to demonstrate that the tumor volume increase is not only based on cell proliferation, but also intratumoral hemorrhage, vascularization, and inflammation, which may be produce rarefaction of the bone and lead to bone fracture after a trivial trauma.

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Medical Imaging in the Diagnosis of Schistosomiasis: A Review

Pathogens ◽

10.3390/pathogens10081058 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1058

Author(s):

Andrea Cimini ◽

Maria Ricci ◽

Paola Elda Gigliotti ◽

Luca Pugliese ◽

Agostino Chiaravalloti ◽

...

Keyword(s):

Computed Tomography ◽

Diagnostic Imaging ◽

Imaging Techniques ◽

Laboratory Data ◽

Daily Practice ◽

Imaging Features ◽

X Rays ◽

Positron Emission ◽

Diagnostic Imaging Techniques ◽

Magnetic Resonance Imaging Mri

Schistosomiasis is one of the most important parasitic diseases and it is endemic in tropical and subtropical areas. Clinical and laboratory data are fundamental for the diagnosis of schistosomiasis, but diagnostic imaging techniques such as x-rays, ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) may be helpful in the evaluation of disease severity and complications. In this context, the aim of this review is to explore the actual role of diagnostic imaging in the diagnosis of schistosomiasis, underlining advantages and drawbacks providing information about the utilization of diagnostic imaging techniques in this context. Furthermore, we aim to provide a useful guide regarding imaging features of schistosomiasis for radiology and nuclear medicine physicians of non-endemic countries: in fact, in the last years non-endemic countries have experienced important flows of migrants from endemic areas, therefore it is not uncommon to face cases of this disease in daily practice.

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Synchronous cystic teratomas of the craniofacial region

The Journal of Laryngology & Otology ◽

10.1258/002221503770716296 ◽

2003 ◽

Vol 117 (10) ◽

pp. 824-826

Author(s):

Neena Chaudhary ◽

Krishna Pal Singh Malik ◽

Alok Gupta ◽

Anil Kumar Rai ◽

Pankaj Gupta ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Pathological Examination ◽

Resonance Imaging ◽

Mri Scan ◽

Temporal Fossa ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Slow Growing

A case of synchronous cystic teratomas presented with the complaints of a slow-growing facial mass and forward protrusion of the right eye since birth. The patient was examined thoroughly and subjected to magnetic resonance imaging (MRI) scan. The MRI scan revealed the presence of two separate cysts in the right orbit and right temporal fossa. The patient was operated by a combined effort of ophthalmologists and otorhinolaryngologists. The cysts were excised and subjected to pathological examination. The histopathological survey revealed both the cysts to be mature cystic teratomas similar to each other. This coexistence of a primary temporal fossa teratoma with an orbital teratoma is the first of its kind and to the best of our knowledge has not been reported before.

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Imaging Findings of Esophageal Sarcomatoid Carcinoma: Case Report

Clinical Medicine Insights Case Reports ◽

10.1177/1179547620959066 ◽

2020 ◽

Vol 13 ◽

pp. 117954762095906

Author(s):

Yue Zhao ◽

Jing Xu ◽

Jian Zhong ◽

Wei Du ◽

Bin Yang

Keyword(s):

Sarcomatoid Carcinoma ◽

Posterior Wall ◽

Filling Defect ◽

Pathological Examination ◽

Thoracic Esophagus ◽

Imaging Features ◽

Imaging Findings ◽

Back Wall ◽

The Right ◽

Peripheral Enhancement

Objective: To investigate the imaging findings and pathological features, differential diagnosis of esophageal sarcomatoid carcinoma. Methods: Three cases of esophageal sarcomatoid carcinoma (ESC) proved by histology was retrospectively analyzed, and related literature were reviewed. Results: Two cases of barium in the digestive tract showed an irregular filling defect in the thoracic esophagus. The edges are clear, the surface of the tumor is irregular, and the niche is visible. The long axis of the tumor is the same as the esophagus, esophageal expansion, and the mucosa of the lesion area is destroyed. CT scan of 1 case showed a ellipse-like pedicle solid mass in the lower esophagus, the pedicle, and back wall is linked together, the back wall is slight thick, and esophageal eccentric stenosis, homogeneous density, lesions showed moderate enhancement, and the peripheral enhancement was relatively obvious in the central region, and the pedicle was not clear with the right posterior wall of esophagus. Intraoperative observation showed that the tumor was solid, rubbery, and the pedicle was closely related to the right posterior wall of esophagus. All 3 cases were pathologically diagnosed as esophageal sarcomatoid carcinoma. Conclusion: ESC is uncommon, the imaging features have some characteristics, accurate diagnosis depends on the pathological examination.

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Multifocal Epithelioid Hemangioma with Reactive Bone Formation

ISRN Pathology ◽

10.5402/2011/378940 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Jessica M. Sin ◽

Andrew H. Beck ◽

Reetesh K. Pai ◽

Kathryn J. Stevens

Keyword(s):

Bone Formation ◽

Weight Bearing ◽

Distal Tibia ◽

Final Diagnosis ◽

Epithelioid Hemangioma ◽

Woven Bone ◽

Lytic Lesions ◽

Sporting Activities ◽

The Right ◽

Multifocal Disease

A healthy 16-year-old male patient presented with several weeks of right ankle pain on weight-bearing, worsened with sporting activities, and relieved with rest. Radiographs demonstrated multiple well-marginated lytic lesions in the right distal tibia, and talar head and neck, with a further small intracortical lesion in the mid-to-distal anterior tibia. MRI showed multiple rounded low T1 and high T2 signal intensity lesions within the distal tibia and talus, with marked associated bone marrow edema. The radiologic diagnoses included multifocal hemangioendothelioma, multifocal hemangioma, angiosarcoma, atypical infection, Langerhans cell histiocytosis, or osteoblastomatosis. Histology showed sheets of epithelioid cells lining vascular structures in a hobnailed “tombstone-like” arrangement, with additional areas containing trabeculae of osteoid and woven bone, with prominent osteoblastic rimming. The differential diagnosis at this point was either multifocal epithelioid hemangioma of bone or osteoblastomatosis. Immunohistochemistry showed strong expression of the vascular marker CD31, supporting a vascular neoplasm. The final diagnosis was multifocal epithelioid hemangioma with prominent reactive bone formation, an extremely unusual tumor with only one other similar case of multifocal disease reported in the literature. The patient was treated with curettage, cryosurgery, and bioceramic replacement and is currently doing well.

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Synchronous presentation of Gaucher disease and solitary plasmacytoma with progression to multiple myeloma

Scottish Medical Journal ◽

10.1258/smj.2011.011178 ◽

2011 ◽

Vol 56 (4) ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

M P H Hawkesford ◽

A J Bowey ◽

J Rao ◽

N J Meara

Keyword(s):

Multiple Myeloma ◽

Bone Marrow ◽

Bone Marrow Biopsy ◽

Gaucher Disease ◽

Weight Bearing ◽

Lytic Lesion ◽

Solitary Plasmacytoma ◽

Lytic Lesions ◽

Magnetic Resonance Imaging Mri ◽

The Right

A 37-year-old Polish immigrant presented with unilateral hip pain and difficulty weight-bearing. Plain radiography and magnetic resonance imaging (MRI) revealed a lytic lesion in the acetabulum, with abnormal serum electrophoresis and bone marrow biopsy. The patient was diagnosed with two rare conditions presenting synchronously – Gaucher disease and plasmacytoma. He was treated with enzyme therapy and radiotherapy, but subsequently developed a recurrence of plasmacytoma in the right femur, confirmed with bone marrow biopsy. This was also treated with radiotherapy, followed by a retrograde femoral nail to reduce the risk of pathological fracture. The patient went on to develop multiple lytic lesions in the ribs and vertebra, seen on MRI. Further bone marrow biopsy confirmed dissemination of the plasmacytoma into multiple myeloma, for which he was treated with systemic chemotherapy. In patients presenting with refractory bone or joint pain, haematological and histological investigations should be considered to exclude less common diagnoses.

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A case review of the MRI features in alternating Tolosa–Hunt syndrome

Cephalalgia ◽

10.1111/j.1468-2982.2009.02018.x ◽

2010 ◽

Vol 30 (9) ◽

pp. 1133-1136 ◽

Cited By ~ 8

Author(s):

BVS Guedes ◽

AJ da Rocha ◽

HB Zuppani ◽

CJ da Silva ◽

WL Sanvito

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Laboratory Data ◽

Imaging Features ◽

Case Review ◽

Resonance Imaging ◽

Hunt Syndrome ◽

Mri Features ◽

Magnetic Resonance Imaging Mri ◽

Mri Study

Tolosa–Hunt syndrome (THS) consists of a painful ophthalmoplegia with typical features in magnetic resonance imaging (MRI). The recurring nature of this affliction has been known since its first description. However, compromise of the contralateral cavernous sinus, known as alternating THS, is very rare and has never been examined using MRI. We report clinical data, laboratory data and imaging features of a patient with alternating THS. According to our literature review, this is the first MRI study of THS.

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Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

Journal of International Medical Research ◽

10.1177/0300060520966484 ◽

2020 ◽

Vol 48 (10) ◽

pp. 030006052096648

Author(s):

Yu Wang ◽

Jie Liu

Keyword(s):

Case Report ◽

Primary Hyperparathyroidism ◽

Bone Disease ◽

Distal Humerus ◽

Left Lobe ◽

Pathological Examination ◽

Hypoechoic Mass ◽

Brown Tumors ◽

Restricted Mobility ◽

The Right

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

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