Fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) findings in an unusual case of multiple myeloma presenting with a large extra-axial intracranial mass

BACKGROUND: We aimed to present unusual cranial FDG PET/CT findings of a 56-year-old female with multiple myeloma (MM). CASE REPORT: Plain CT images revealed a lytic lesion in the right parietal bone, filled with an oval-shaped, large, extra-axial, extradural, intracranial mass which measured 75×75×40 mm and had smooth borders. The right parietal lobe was compressed by the mass. The maximum standardized uptake value (SUVmax) of the mass lesion was 8.94 on FDG PET/CT images. Multiple lytic lesions with an increased uptake were also detected in other calvarial bones, in several vertebras and in the proximal left femur. After seven months, a control FDG PET/CT following radiotherapy and chemotherapy revealed almost complete regression of the right parietal extra-axial mass lesion. The number, size and metabolism of lytic lesions in other bones also decreased. CONCLUSIONS: FDG PET/CT was useful for an initial evaluation of MM lesions and was effective in monitoring the response of these lesions to therapy

Ultrasonographic and Scintigraphic Findings of Thyroid Hemiagenesis in a Child: Report of a Rare Male Case

Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of thyroid gland fails to develop. It is much rarer in males. There is a higher incidence of associated thyroid disorders in patients with thyroid hemiagenesis; therefore early and prompt diagnosis is important for children. We present the ultrasonographic and scintigraphic findings of thyroid hemiagenesis in an eight-year-old-boy. On ultrasonography (US), left lobe of the thyroid gland could not be demonstrated and the right lobe showed minimal hyperplasia. Its echogenicity was normal and no nodule was seen. On thyroid scintigraphy, left lobe of thyroid gland or any ectopic thyroid tissue could not be demonstrated, while the right lobe showed minimal hyperplasia. Without performing any invasive procedure, we enrolled the child in a follow-up program with the guidance of US and scintigraphy, which were effective both in making the final diagnosis of thyroid hemiagenesis and in evaluating the current status of the present thyroid tissue. In conclusion, if only one thyroid lobe is detected in a pediatric case initially with US or scintigraphy, the diagnosis of thyroid hemiagenesis should be suggested and, before any unnecessary or invasive attempt, the other complementary method (scintigraphy/US) should be performed

Treatment and clinical results in cases with postoperative endophthalmitis

AMAÇ: Postoperatif endoftalmi göz cerrahisinde en çok korkulan komplikasyonların başında gelmektedir. Bu çalışmada postoperatif endoftalmi görülme sıklığı, klinik özellikler, risk faktörleri, tedavi yaklaşımları ve prognoz araştırılmıştır. GEREÇ VE YÖNTEM: Çalışmaya Ankara Eğitim ve Araştırma Hastanesi Göz Kliniği'nde postoperatif endoftalmi tanısı alan olgular dahil edildi. Postoperatif endoftalmi görülme sıklığı, hastaların oküler ve sistemik hastalıkları, başvuru semptomları, göz muayene bulguları, bakteriyel kültür sonuçları, uygulanan medikal ve cerrahi tedaviler ve prognoz incelendi. BULGULAR: Çalışmaya postoperatif endoftalmi tanısı alan 41 olgu dahil edildi. Olguların yaş ortalaması 62.8 ± 22.4 yıl idi. Endoftalmi 38 gözde (%92.8) katarakt cerrahisi ve/veya göz içi mercek implantasyonu sonrasında, 1 gözde (%2.4) trabekülektomi, 1 gözde (%2.4) penetran keratoplasti ve 1 gözde (%2.4) pars plana vitrektomi sonrası gelişmişti. Olgularda ameliyat sonrasında hastaneye başvuru süresi ortalama 15.7 ± 17.5 (2-60) gündü. Vitreus / hümör aköz kültürü olguların %46.3’ünde pozitifti. Tüm olgulara en az bir kez intravitreal antibiyotik enjeksiyonu ve 15 (%36.6) olguya pars plana vitrektomi yapıldı. Işık hissini kaybeden 7 olgudan 3’üne evisserasyon uygulandı. Olgular ortalama 11.1 ± 4.9 (6-25) ay takip edildi. Takip sonucunda 7 (%17.1) olguda ışık hissi kaybı görülürken, 12 (%29.3) olgu ışık hissi-el hareketi, 11 (%26.8) olgu 1 metreden parmak sayma - <0.1 arasında, 10 (%24.4) olgu 0.1 ve üzerinde görme keskinliği ile sonuçlandı. Bir (%2.4) olguda yaşından ötürü görme keskinliği ölçülemedi. Çalışmamızda PPV'nin sonuç görme keskinliği üzerine etkisi saptanmadı (T test, p = 0.560). SONUÇ: Postoperatif endoftalmili olgularda acilen intravitreal antibiyotik yapılması, gerektiğinde tekrarlanması ve gereken olgularda doğru zamanda uygun cerrahi tedavi ile kabul edilebilir görsel ve anatomik sonuç elde etmek mümkündür.INTRODUCTION: Postoperative endophthalmitis is one of the most frustrating complications of ophthalmic surgery. In this study we aimed to evaluate the postoperative endophthamitis incidence, clinical features, risk factors, treatment strategies and prognosis in patients with postoperative endophthalmitis. MATERIAL AND METHOD: We evaluated postoperative endophthalmitis cases in Ankara Training and Research Hospital, Department of Ophthalmology. Postoperative endophthamitis incidence, ocular and systemic illness, initial symptoms, eye examination findings, bacteriologic culture results, medical and surgical treatments and prognosis were investigated. RESULTS: Forty-one patients with postoperative endophthalmitis were included in the study. The mean age was 62.8 ± 22.4 years (range 2 months - 90 years). Endophthalmitis developed in 38 eyes (92.8%) after cataract surgery and/or intraocular lens implantation, in 1 eye (2.4%) after glaucoma surgery, in 1 eye (2.4%) after penetrating keratoplasty and in 1 eye (2.4%) after pars plana vitrectomy. The mean duration of admission to the hospital postoperatively was 15.7 ± 17.5 (2-60) days. Cultures from vitreous / aqueous humor specimens were positive in %46.3 of the patients. All the cases had at least one intravitreal antibiotic injection. Pars plana vitrectomy was performed in 15 cases (36.6%). Evisceration was performed to 3 of 7 patients who lost their sense of light. The mean follow-up was 11.1 ± 4.9 (6-25) months. Light perception was lost in 7 cases (17.1%). Visual acuity was between light perception-hand motion in 12 cases (29.3%), counting finger from a meter – <0.1 in 11 cases (26.8%), 0.1 and above in 10 cases (%24.4). We couldn’t measure visual acuity in one (2.4%) preverbal patient. Pars plana vitrectomy didn’t change functional outcome in our series (T test, p = 0.560). CONCLUSION: It is possible to obtain acceptable visual and anatomical results in postoperative endophthalmitis by performing intravitreal antibiotics immediately, repetition if necessary, and performing surgical treatment when necessar