MRI Finding of Prostatic Ductal Adenocarcinoma

Ductal adenocarcinoma is a variant of prostatic adenocarcinoma, originating from the epithelial lining of the primary and secondary ducts of the prostate. We report a 63-year-old male with prostatic ductal adenocarcinoma, presenting as urinary retention and a prostate-specific antigen (PSA) level of 11.71 ng/mL and biopsy-proven prostate cancer (Gleason score 3 + 3). MRI showed 2 hemorrhagic, multilocular cysts projecting into the bladder side from the prostatic inner gland and between the prostate and the right seminal vesicle. The prostate inner gland showed high signal intensity on the T2-weighted image and included tiny hyperintense spots on the fat-suppression T1-weighted image. In the part of the border of the hemorrhagic, multilocular cyst, a solid portion showing slight low intensity on T1-weigthed imaging and markedly restricted diffusion was observed, suggesting prostate cancer. He underwent total prostatectomy, and ductal adenocarcinoma (Gleason score 4 + 4) in the prostate inner gland and multilocular cysts was pathologically diagnosed. After the operation, his PSA level gradually increased, and MRI 8 months after the operation showed a vesical multilocular cyst, suggesting local recurrence. After he underwent radiation therapy and hormonal therapy, PSA level decreased, and no re-recurrence was observed during 8 years. We suggest its inclusion in the differential diagnosis of cases of prostatic ductal adenocarcinoma’s multiloculated cystic formation around the prostate and the bladder.

Management of Complications Related to Hydatid Cysts: Case Report

This paper presents the case of a 13-year-old female patient, operated in 2015 for left temporoparietal hydatid cyst and reoperated in 2016 for recurrence of the cerebral hydatid cyst. At admission, his GCS scores were E3V4M5. Neurological examination revealed a hemilatéral motor deficit estimated at 3/5 on right side without sensitive trouble. The CT scan showed a large left temporal cystic formation with an infected appearance associated with 4 cystic formations with calcified walls exerting a mass effect on the adjacent parechyma and the homolateral lateral ventricle responsible for a triventricular hydrocephalus. No primary focus was found in the lungs, liver, or other organs. In this article, we will discuss the management of complications related to hydatid cysts. Cerebral hydatid cyst is a rare condition, affecting mainly children. The diagnosis of cerebral hydatid cyst must be evoked in endemic countries in front of a symptomatology of intra-cranial hypertension.

Huge mediastinal bronchogenic cyst revealed by hemoptysis and resected by uniportal VATS: A case report

Bronchogenic cysts are rare unusual congenital cysts, resulting from abnormal budding of the primary tracheobronchial tube and can be located either in the mediastinum or in the pulmonary parenchyma. They remain asymptomatic in most adults unless they are large to compress adjacent structures or infected. We report a case of a 43-year-old woman, who presented recurrent episodes of hemoptysis low abundance 4 months ago revealing a huge mediastinal cystic formation, initially taken as a hydatid cyst, the chest CT showed a voluminous cystic formation of 11,4x10, 9x8, 8 cm exerting a mass effect on the posterior mediastinal structures: the superior vena cava, the azygos vein, and the trachea. The diagnosis as a bronchogenic cyst is done after resected by uniportal video-assisted surgery (VATS), and histological confirmation. The patient does not present any complications or reoffending during the follow-up. The rarity of this entity and even more a rare association of this lesion with symptoms of hemoptysis led to the report of this case. This case illustrates the interest of uniportal VATS for the extirpation of the bronchogenic cyst. We recommend a complete exeresis in most cases to confirm the diagnosis, relieve symptoms, and prevent complications.

Exploring MRI Characteristics of Brain Diffuse Midline Gliomas With the H3 K27M Mutation Using Radiomics

ObjectivesTo explore the magnetic resonance imaging (MRI) characteristics of brain diffuse midline gliomas with the H3 K27M mutation (DMG-M) using radiomics.Materials and MethodsThirty patients with diffuse midline gliomas, including 16 with the H3 K27M mutant and 14 with wild type tumors, were retrospectively included in this study. A total of 272 radiomic features were initially extracted from MR images of each tumor. Principal component analysis, univariate analysis, and three other feature selection methods, including variance thresholding, recursive feature elimination, and the elastic net, were used to analyze the radiomic features. Based on the results, related visually accessible features of the tumors were further evaluated.ResultsPatients with DMG-M were younger than those with diffuse midline gliomas with H3 K27M wild (DMG-W) (median, 25.5 and 48 years old, respectively; p=0.005). Principal component analysis showed that there were obvious overlaps in the first two principal components for both DMG-M and DMG-W tumors. The feature selection results showed that few features from T2-weighted images (T2WI) were useful for differentiating DMG-M and DMG-W tumors. Thereafter, four visually accessible features related to T2WI were further extracted and analyzed. Among these features, only cystic formation showed a significant difference between the two types of tumors (OR=7.800, 95% CI 1.476–41.214, p=0.024).ConclusionsDMGs with and without the H3 K27M mutation shared similar MRI characteristics. T2W sequences may be valuable, and cystic formation a useful MRI biomarker, for diagnosing brain DMG-M.

Maxillary Sinus Mucopyocele: About an Endoscopic Management

Introduction: Mucocele is a benign but expansive cystic formation, lined by a respiratory epithelium. When its content is infected, it is called a mucopyocele. It usually develops in the frontal-ethmoid complex. The maxillary sinus location is exceptional. Case report: a 43 year old man, presented with chronic unilateral nasal obstruction, purulent rhinorrhea and anosmia. Rhinoscopy showed a bulge in the middle meatus. The computed tomography (CT) showed complete filling of the left maxillary with low-density mass. Magnetic resonance imaging (MRI) confirmed the diagnosis of mucpyeocele of the left maxillary sinus. Patient underwent endoscopic endonasal marsupialization with complete recovery. Conclusion: Mucopyocele of the maxillary sinus is a benign rare lesion, however destructive. A radiological assessment is essential to guide the choice of surgical treatment. The endonasal route remains the reference treatment for this pathology.

AMELOBLASTOMA ASSOCIATED WITH DENTIGEROUS CYST

Ameloblastoma is a benign, locally aggressive tumour, with an unicystic variant that is very difficult to be differentiated from odontogenic cysts, because of their similarity in the clinical manifestation and X-ray examination. The morphological similarities between these processes make for a more difficult histological diagnosis. We present a case of a 32-year old male, admitted in the Maxillofacial surgery clinic in a University hospital for surgical treatment, because of a swelling in the left mandibular vestibule. A cystic formation, histologically diagnosed as an epithelial one, is removed. Eight months later, the patient is admitted once again, with the same symptoms. The biopsy result from the second operation is a plexiform unicystic ameloblastoma. What is being discussed is the connection between the two pathological processes and the difficulties with giving the correct morphological diagnosis.

Paraovarian cyst as the cause of uterine prolapse

Paraovarian cysts originate from the mesothelium and are presumed to be remnants of M?llerian or Wolffian ducts. In majority of cases they are found to be 10-80 mm in diameter and do not cause any symptoms. Paraovarian cysts can be found unexpectedly during an operation or on ultrasound examination performed for other reasons. They are most freequently discovered on ultrasound examination. However, due to the proximity of the ovary for which cystic formations are not rare, the diagnosis of these lesions can be a challenge. They are mostly asymptomatic and only large lesions (?20 cm in diameter) become symptomatic. Although these are mostly benign tumors, in rare cases they can become borderline or true malignancies. Most paraovarian cysts are found in the third and fourth decade of life. Paraovarian cyst complications include: compression of the surrounding structures of the pelvis minor and abdomen, pelvic pain, cyst torsion and rupture. Except for the already mensioned complications available literature has so far failed to show cases of uterine prolapse caused by an increase of intra-abdominal pressure due to the expansive growth of giant paraovarian cystic formation.