scholarly journals Teratoma in Children: Three cases experience in Sanglah Hospital, Bali, Indonesia

2021 ◽  
Vol 6 (2) ◽  
pp. 013-019
Author(s):  
Ni Putu Indah Kusumadewi Riandra ◽  
Ketut Ariawati ◽  
Anak Agung Ngurah Ketut Putra Widnyana ◽  
Luh Putu Iin Indrayani Maker ◽  
I Gusti Ayu Ari Kusumawati
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Gold Standard ◽  
Mature Teratoma ◽  
Immature Teratoma ◽  
Cell Tumor ◽  
History Taking ◽  
Pathological Anatomy ◽  
Definitive Therapy ◽  
Surgery Resection

Teratomas are the most common germ cell tumor, and further classified into mature or immature. Immature teratoma comprise less than one percent of all teratomas and with the peak incidence at birth until four years. They were diagnosed by history taking, physical examination, laboratory, imaging, and pathological anatomy as a gold standard. This report presents our experience of diagnosed, giving treatment with or without surgery and chemotherapy in three patients with teratoma. We report three cases of teratoma, at age six months, eight months and four years old with site of cases are retroperitoneal immature teratoma, cervical teratoma and ovarian immature teratoma. History taking of these patients, they have same symptom such as enlargement of the mass. Two cases were noticed after birth and progressively getting bigger until six and eight months old. One case was noticed when the patient had abdominal pain and was suspected with appendicitis at first. The computed tomography (CT) scan of these cases showed a mass as a part of teratoma and confirmed with pathological anatomy. Two cases were immature, and one case was mature teratoma. Two patients undergone surgery resection and continue with chemotherapy (cisplatin, etoposide, and bleomycin) for 10-14 weeks showed a good result until now and showed no residual mass anymore form CT scan, but one patient did not undergo surgery and chemotherapy yet. Early diagnosis of teratomas is leading us to a definitive therapy and showed a good result.

scholarly journals Evaluation of version of acetabular component following total hip replacement on conventional radiograph and computed tomography

2020 ◽  
Vol 27 (2) ◽  
pp. 179-185
Author(s):  
Manish Raj ◽  
Ashish Jaiman ◽  
Rajesh Kumar Chopra
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Total Hip Replacement ◽  
Gold Standard ◽  
Hip Replacement ◽  
Regression Line ◽  
Patient Positioning ◽  
Acetabular Version ◽  
Total Hip ◽  
Significant Difference

Background/Purpose: Total hip replacement (THR) is considered as one of the most successful orthopedic procedures. However, improperly placed components can lead to instability and accelerated wear. Acetabular cup inclination can be very well accessed by anteroposterior pelvis X-rays; for acetabular version assessment, computed tomography (CT) scan is the gold standard. CT scan is not readily available at many centers and the surgeon has to rely on X-ray methods for evaluation of acetabular version to audit results and to predict behavior of the surgical intervention. This prospective study was undertaken to compare Woo and Morrey’s and ischiolateral methods of assessment of acetabular version on cross-table lateral radiographs with CT assessment and to assess the validity of radiographic methods with respect to CT scan method. Material and methods: A prospective follow-up study was conducted for 18 months’ duration (October 2016 to March 2018) on 30 adult patients who underwent THR surgery. Cross-table lateral radiograph was obtained at 3 and 6 weeks in the postoperative period. Two observers made each observation at two different points of time. CT scan was performed at 3 weeks. Version as measured by radiographs and CT scan was recorded. Results: The major overlap in the distribution of the values of the Woo and Morrey method suggests that there is no significant difference between the observations. Distribution of the values of the ischiolateral view and the CT scan value distributions have a very small overlap and hence suggest a strong significant difference between the two. Conclusion: In this study, Woo and Morrey’s method and ischiolateral method of assessment of acetabular version were compared with CT assessment. We found that in Woo and Morrey’s method, values were comparable to CT scan values, when put on regression line. However, in situation of change in patient positioning, namely hip stiffness in contralateral hip, measurement of component changed in series of radiography due to differences in pelvis tilt. So, in these circumstances, we can use ischiolateral method which can give consistent measurement. But it will not be in concordance with CT scan values and Woo and Morrey values, as represented in regression line. The high intra-class correlation coefficients for both intra- and inter-observer reliability indicated that the angle measured with these methods is consistent and reproducible for multiple observers. CT, however, be considered as gold standard for measurement owing to control over pelvic rotation and/or tilt/patient positioning.

Educational Review of Predictive Value and Findings of Computed Tomography Scan in Diagnosing Bowel and Mesenteric Injuries after Blunt Trauma: Correlation with Trauma Surgery Findings in 163 Patients

2017 ◽  
Vol 68 (3) ◽  
pp. 276-285 ◽  
Author(s):  
Francesco Cinquantini ◽  
Gregorio Tugnoli ◽  
Alice Piccinini ◽  
Carlo Coniglio ◽  
Sergio Mannone ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Predictive Value ◽  
Gold Standard ◽  
Clinical Management ◽  
Trauma Surgery ◽  
Trauma Patients ◽  
Increased Risk

Background and Aims Laparotomy can detect bowel and mesenteric injuries in 1.2%–5% of patients following blunt abdominal trauma. Delayed diagnosis in such cases is strongly related to increased risk of ongoing sepsis, with subsequent higher morbidity and mortality. Computed tomography (CT) scanning is the gold standard in the evaluation of blunt abdominal trauma, being accurate in the diagnosis of bowel and mesenteric injuries in case of hemodynamically stable trauma patients. Aims of the present study are to 1) review the correlation between CT signs and intraoperative findings in case of bowel and mesenteric injuries following blunt abdominal trauma, analysing the correlation between radiological features and intraoperative findings from our experience on 25 trauma patients with small bowel and mesenteric injuries (SBMI); 2) identify the diagnostic specificity of those signs found at CT with practical considerations on the following clinical management; and 3) distinguish the bowel and mesenteric injuries requiring immediate surgical intervention from those amenable to initial nonoperative management. Materials and Methods Between January 1, 2008, and May 31, 2010, 163 patients required laparotomy following blunt abdominal trauma. Among them, 25 patients presented bowel or mesenteric injuries. Data were analysed retrospectively, correlating operative surgical reports with the preoperative CT findings. Results We are presenting a pictorial review of significant and frequent findings of bowel and mesenteric lesions at CT scan, confirmed intraoperatively at laparotomy. Moreover, the predictive value of CT scan for SBMI is assessed. Conclusions Multidetector CT scan is the gold standard in the assessment of intra-abdominal blunt abdominal trauma for not only parenchymal organs injuries but also detecting SBMI; in the presence of specific signs it provides an accurate assessment of hollow viscus injuries, helping the trauma surgeons to choose the correct initial clinical management.

scholarly journals Concurrent, Bilateral Presentation of Immature and Mature Ovarian Teratomas with Refractory Hyponatremia: A Case Report

2020 ◽  
Vol 10 ◽  
pp. 23
Author(s):  
Ali Shah Tejani ◽  
Lin He ◽  
Wenxin Zheng ◽  
Kanupriya Vijay
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Erectile Dysfunction ◽  
Mature Teratoma ◽  
Immature Teratoma ◽  
Tumor Rupture ◽  
The Past ◽  
Bilateral Presentation ◽  
Fat Stranding ◽  
Ovarian Teratomas

We present the imaging and histopathological findings in a 32-year-old female who presented to the erectile dysfunction with progressively worsening abdominal pain over the past 2 months. Computed tomography abdomen and pelvis revealed bilateral ovarian teratomas, left significantly larger than right. There was associated fat stranding, mesenteric/omental stranding, and ascites worrisome for rupture versus peritoneal carcinomatosis. Histopathology confirmed a left immature teratoma (Grade 2), right mature teratoma, and peritoneal gliomatosis from possible tumor rupture before surgery.

scholarly journals Diagnostic accuracy of renal calculi on ultrasonography taking computed tomography as gold standard

2021 ◽  
Vol 8 (7) ◽  
pp. 3269
Author(s):  
Hina Pathan ◽  
M. Kashif Shazlee ◽  
Junaid Iqbal ◽  
Ashraf A. Ali ◽  
Kamran Hameed ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Surgical Approach ◽  
Gold Standard ◽  
Ultrasound Examination ◽  
Renal Calculi ◽  
Final Diagnosis ◽  
Clinical Suspicion ◽  
Number Of Patients

Background: Ultrasonography is a useful modality to diagnose stones and to confirm the occurrence of complications of other renal pathology, so it is important to understand these characteristic findings and other diseases that mimic them. In addition, other imaging modalities such as computed tomography (CT) can be recommended if the clinical or radiological diagnosis is ambiguous.Methods: A group of 325 patients with clinical suspicion of renal calculi were included in this study. Out of these 325 patients 179 (55.0%) were male and 146 (44.9%) were female. All these patients underwent ultrasonography (USG) examination. Final diagnosis was based on CT findings which was done subsequently.Results: The total number of patients comprising the study were 325 who underwent ultrasound examination. After USG and CT scan was done to confirm the diagnosis. Out of 325 patients, 201 patients were confirmed having renal calculi on USG analysis and remaining 103 patients were true negative.Conclusions: The study proves that USG is highly accurate in diagnosing and characterizing renal calculi. USG also guides in defining exact location as well as aids in deciding the medical or surgical approach to be used.

scholarly journals TERATOMA OF THE KIDNEY: A RARE CASE OF EXTRAGONADAL GERM CELL TUMOR

2017 ◽  
Vol 14 (3) ◽  
pp. 202-207
Author(s):  
Tamara R. Panferova ◽  
Timur T. Valiev ◽  
Oleg P. Bliznyukov ◽  
Olga A. Kapkova
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Clinical Observation ◽  
Mature Teratoma ◽  
Morphological Characteristics ◽  
Cell Tumor ◽  
X Ray ◽  
Domestic Literature ◽  
X Ray Computed ◽  
First Time

For the first time, a clinical observation of a rare case of a mature teratoma of the kidney in a child aged 5 months is presented in domestic literature. A literature review is given on this topic. The clinical picture, characteristic signs of a tumor during ultrasound and X-ray computed tomography, the results of a surgical procedure receive full coverage. Special attention is paid to the morphological characteristics of a mature teratoma.

External Validation Study On The Value of Deep Learning Algorithm For The Prediction of Hematoma Expansion From Noncontrast CT Scans

2021 ◽  
Author(s):  
Dong Chuang Guo ◽  
Jun Gu ◽  
Jian He ◽  
Hai Rui Chu ◽  
Na Dong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Deep Learning ◽  
Ct Scan ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Learning Algorithm ◽  
External Validation ◽  
Hematoma Expansion ◽  
Fast Method ◽  
Deep Learning Algorithm

Abstract Background: Hematoma expansion is an independent predictor of patient outcome and mortality. The early diagnosis of hematoma expansion is crucial for selecting clinical treatment options This study aims to explore the value of a deep learning algorithm for the prediction of hematoma expansion from noncontrast Computed tomography（NCCT） scan through external validation.Methods: 102 NCCT images of Hypertensive intracerebral hemorrhage (HICH) patients diagnosed in our hospital were retrospectively reviewed. The initial Computed tomography (CT) scan images were evaluated by a commercial Artificial intelligence (AI) software using deep learning algorithm and radiologists respectively to predict hematoma expansion and the corresponding sensitivity and specificity of the two groups were calculated and compared, Pair-wise comparisons were conducted among gold standard hematoma expansion diagnosis time, AI software diagnosis time and doctors’ reading time.Results: Among 102 HICH patients, The sensitivity, specificity and accuracy of predicting hematoma expansion in the AI group were higher than those in the doctor group（80.0% vs 66.7%,73.6% vs 58.3%,75.5% vs 60.8%）,with statistically significant difference (p<0.05).The AI diagnosis time (2.8 ± 0.3s) and the doctors’ diagnosis time (11.7 ± 0.3s) were both significantly shorter than the gold standard diagnosis time (14.5 ± 8.8h) (p <0.05), AI diagnosis time was significantly shorter than that of doctors (p<0.05).Conclusions: Deep learning algorithm could effectively predict hematoma expansion at an early stage from the initial CT scan images of HICH patients after onset with high sensitivity and specificity and greatly shortened diagnosis time, which provides a new, accurate, easy-to-use and fast method for the early prediction of hematoma expansion.

Significance of p53 Expression in Immature Teratomas

2002 ◽  
Vol 5 (5) ◽  
pp. 499-507 ◽  
Author(s):  
Pimlak Charoenkwan ◽  
Christof Senger ◽  
Sheila Weitzman ◽  
Elizabeth Sexsmith ◽  
Christopher G. Sherman ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Transcriptional Activation ◽  
Mature Teratoma ◽  
P53 Gene ◽  
Immature Teratoma ◽  
Cell Tumor ◽  
P53 Expression ◽  
P53 Target Gene ◽  
Stabilizing Factors

Twenty-nine pediatric immature teratomas were reviewed to determine the frequency and clinical significance of p53 expression. Tumors were stained for p53 expression by immunohistochemistry and results were correlated with the presence of other germ cell tumor elements and with outcome. Sequencing of p53 for mutations was performed on positive cases. Eighteen cases showed widespread positive p53 staining of the immature teratoma elements, 9 showed staining only in very occasional cells, and 2 cases showed no staining. Of the 18 positive cases, 5 recurred. All five were pure immature teratomas at diagnosis. Four recurred as immature or mature teratoma and one as a sarcoma; all except one showed frequent cells positive for p53 in the recurrent tumor. Another 5 of the 18 diffusely positive cases contained immature teratoma as well as other malignant germ cell elements at diagnosis; none of these recurred. None of the remaining eight cases with frequent positive cells, the nine cases with occasionally positive p53 staining, or the two cases with no staining recurred or demonstrated other germ cell tumor elements. We conclude that p53 expression is not unusual in immature teratoma and diffuse p53 immunopositivity is associated with recurrence or the presence of malignant elements in ~50% of cases. In only 1 of 29 cases tested was p53 immunopositivity associated with mutations in the p53 gene; hence, overexpression in the majority of cases is presumed to reflect increased half-life of the protein from undetermined stabilizing factors. Expression of p21, a p53 target gene, was only focal, suggesting impaired transcriptional activation by p53. The finding of frequent p53-positive cells in immature teratoma should prompt a search for malignant elements within the tumor and affected patients should be followed closely for evidence of recurrence.

scholarly journals Assessment of Imaging Performance and Accuracy for the Diagnostic Evaluation of Wilms Tumor in Kids in the ERA of Contrast Based CT Scan with Histopathological Correlation: A Study in Tertiary Care Hospital

2021 ◽  
Vol 6 (10) ◽  
pp. 668-673
Author(s):  
Ashraf Amirali ◽  
Jaideep Darira ◽  
Hina Pathan ◽  
Sorath Murtaza ◽  
Munaza Irshad
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Predictive Value ◽  
Gold Standard ◽  
Wilms Tumor ◽  
Diagnostic Evaluation ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

The aim of the study is the assessment of accuracy for the diagnostic evaluation of Wilms tumor in the pediatric population in the era of contrast-enhanced CT scan using histopathology as a gold standard. Plain and contrast-enhanced abdominal Computed Tomography including pelvis and chest was performed in suspected patients with multiple axial sections with sagittal and coronal reconstructions. Patients were being followed, data was collected and recorded on proforma after histopathology. The patient's mean age for this study in years was 3.5 ± 1.2. Gender distribution showed 170 patients (54.6%) were male while the remaining 141 patients (45.33%) were female. Contrast-enhanced computed tomography showed sensitivity (90.36%), specificity (51.72%), diagnostic accuracy (72.34%), positive predictive value (68.18%), and negative predictive value (82.42%) confirmed on Histopathology as the gold standard. It is concluded from the results of this study that contrast-enhanced computed tomography proved high diagnostic accuracy positive predictive in the detection of Wilms’ tumor by taking histopathology as the gold standard.

scholarly journals Pediatric Ovarian Growing Teratoma Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Rebecca M. Rentea ◽  
Aaron Varghese ◽  
Atif Ahmed ◽  
Alexander Kats ◽  
Michelle Manalang ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Mature Teratoma ◽  
Diagnostic Algorithm ◽  
Chemotherapeutic Agents ◽  
Immature Teratoma ◽  
Cell Tumor ◽  
Growing Teratoma Syndrome ◽  
Liver Recurrence ◽  
Management Protocol

Ovarian immature teratoma is a germ cell tumor that comprises less than 1% of ovarian cancers and is treated with surgical debulking and chemotherapy depending on stage. Growing teratoma syndrome (GTS) is the phenomenon of the growth of mature teratoma elements with normal tumor markers during or following chemotherapy for treatment of a malignant germ cell tumor. These tumors are associated with significant morbidity and mortality due to invasive and compressive growth as well as potential for malignant transformation. Current treatment modality is surgical resection. We discuss a 12-year-old female who presented following resection of a pure ovarian immature teratoma (grade 3, FIGO stage IIIC). Following chemotherapy and resection of a pelvic/liver recurrence demonstrating mature teratoma, she underwent molecular genetics based chemotherapeutic treatment. No standardized management protocol has been established for the treatment of GTS. The effect of chemotherapeutic agents for decreasing the volume of and prevention of expansion is unknown. We review in detail the history, diagnostic algorithm, and previous reported pediatric cases as well as treatment options for pediatric patients with GTS.

scholarly journals Utility of Computed Tomography Scans in Predicting Need for Surgery in Nasal Injuries

2013 ◽  
Vol 6 (4) ◽  
pp. 221-223 ◽  
Author(s):  
Benjamin E. Peterson ◽  
Timothy D. Doerr
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Bone Fracture ◽  
Gold Standard ◽  
Nasal Bone ◽  
Plain Film ◽  
Ct Scans ◽  
Nasal Injury ◽  
Computed Tomography Scans ◽  
Nasal Trauma

In many centers, computed tomography (CT) scan is preferred over plain film radiographs in the setting of acute nasal injury because CT scan is thought to be more sensitive in predicting nasal bone fracture. However, the usefulness of CT scans in predicting the need for surgery in acute nasal injury has not been well-studied. We conducted a retrospective review of 232 patients with known nasal bone fracture and found very similar rates of surgery in patients with a diagnosis of nasal fracture by CT scan as by nasal radiographs (41 and 37%, respectively). This suggests that experienced clinical examination remains the gold standard for determining the need for surgery in isolated nasal trauma, regardless of CT findings.

Sign in / Sign up

Export Citation Format

Share Document