Post EVAR endovascular revision of late onset stent graft collapse due to Type 1 endoleak in a complicated case with left limb occlusion and solitary kidney

Type 1 endoleak is one of the most frequent complication usually seen at the initial phase of EVAR procedure. B alloon dilatation is mostly used to oversize the proximal or the distal part of the orifice to stabilize the attachment of the graft stent to the aortic wall. Late onset of type 1 endoleak with graft stents may cause severe lumen compression of the stent and aneurysm enlargement which might cause a serious problem especially in a patient whose graft stents left iliac branch is thrombosed and the left leg is supplied by the bypass graft from right CFA. Although operation was advised by the endovascular specialists the procedure was done in our hospital as the patient preferred the endovascular method instead of open surgery

Discrepancy between radiological and pathological size of renal masses

<p>Abstract</p> <p>Background</p> <p>Tumor size is a critical variable in staging for renal cell carcinoma. Clinicians rely on radiological estimates of pathological tumor size to guide patient counseling regarding prognosis, choice of treatment strategy and entry into clinical trials. If there is a discrepancy between radiological and pathological measurements of renal tumor size, this could have implications for clinical practice. Our study aimed to compare the radiological size of solid renal tumors on computed tomography (CT) to the pathological size in an Australian population.</p> <p>Methods</p> <p>We identified 157 patients in the Westmead Renal Tumor Database, for whom data was available for both radiological tumor size on CT and pathological tumor size. The paired Student's <it>t</it>-test was used to compare the mean radiological tumor size and the mean pathological tumor size. Statistical significance was defined as <it>P </it>< 0.05. We also identified all cases in which post-operative down-staging or up-staging occurred due to discrepancy between radiological and pathological tumor sizes. Additionally, we examined the relationship between Fuhrman grade and radiological tumor size and pathological T stage.</p> <p>Results</p> <p>Overall, the mean radiological tumor size on CT was 58.3 mm and the mean pathological size was 55.2 mm. On average, CT overestimated pathological size by 3.1 mm (<it>P </it>= 0.012). CT overestimated pathological tumor size in 92 (58.6%) patients, underestimated in 44 (28.0%) patients and equaled pathological size in 21 (31.4%) patients. Among the 122 patients with pT1 or pT2 tumors, there was a discrepancy between clinical and pathological staging in 35 (29%) patients. Of these, 21 (17%) patients were down-staged post-operatively and 14 (11.5%) were up-staged. Fuhrman grade correlated positively with radiological tumor size (<it>P </it>= 0.039) and pathological tumor stage (<it>P </it>= 0.003).</p> <p>Conclusions</p> <p>There was a statistically significant but small difference (3.1 mm) between mean radiological and mean pathological tumor size, but this is of uncertain clinical significance. For some patients, the difference leads to a discrepancy between clinical and pathological staging, which may have implications for pre-operative patient counseling regarding prognosis and management.</p

Unilateral cervical and petrosal segment agenesis of the internal carotid artery with rete mirabile

The carotid rete mirabile (RM) is a physiological network between the internal and external carotid arterial systems. In this paper, an extremely rare case is presented, in which internal–external carotid artery anastomoses and a dilated ascending pharyngeal artery, due to unilateral agenesis of the cervical and petrous segments of the internal carotid artery (ICA), is presented. © 2019 Elsevier Inc

Magnetic resonance imaging of muscular involvement in juvenile dermatomyositis: case report.

A case of 5 year old juvenile patient with dermatomyositis together with conventional and diffusion-weighted MRI images is reported. The reported case was atypical for the pattern of involvement of the accompanying oedema which was affecting distal parts of the extremities and anterior muscle groups. Electromyography was negative. The case confirmed by a pathologist demonstrates the use of diffusion weighted imaging in determining unequivocal oedema and its exact extent

Hibernoma: A benign lipomatous tumor mimicking liposarcoma

Hibernoma is a rare, benign, slow-growing soft tissue tumor. It was named after its resemblance to the brown fat found in hibernating animals. Due to its rich vascularity and magnetic resonance appearance, this tumor may mimic a liposarcoma before tissue diagnosis. Complete resection with meticulous hemostasis is enough for treatment. Malignant potential has not been demonstrated. Herein we present a case of hibernoma arising from the left groin in a young man. The clinical presentation, radiographic and histopathologic features of this rare benign soft tissue tumor are presented. This tumor is clinically important because it is indistinguishable from malignant lesions

Gorham-Stout disease of the humerus

Gorham-Stout disease is characterized by local proliferation of small vascular or lymphatic channels resulting in progressive destruction and resorption of bone. The etiology and pathogenesis of the disease remains mostly unknown, despite some 175 reported cases. A case of Gorham-Stout disease of the humerus in a 14-year-old boy is described. The patient presented with progressive pain and deformity of the right arm. Although the disease was described in different bones of the body its location in the humerus is rare. We report the natural history and clinical follow-up in a young patient. A fibular graft was performed but 10 months later, resorption and pathological fractures occurred again. This study presents the radiographic and MRI features of Gorham disease

Massive osteoradionecrosis of facial bones and soft tissues

Osteoradionecrosis (ORN) is one of the most serious and uncommon complications in head and neck irradiation for cancer It is defined as a combination of necrotic soft tissue and bone not being able to heal spontaneously, it demonstrates a general resistance to antibiotics and requires conservative surgical management. Even with modern radiation therapy, its incidence is high v unpredictable and varies between 4-30%. We report on a patient with a huge open cavitation in the cheek, communicating with the mouth and extending to contralateral periodontal gingival and temporal fossa. He had been treated with radiation therapy for naso-pharyngeal cancer 5 years ago and presented with restriction of the opening of the mouth. Osteonecrosis complicated with osteomyelitis was evident in bilateral mandible and maxillary bones and the temporal bone. The ramus of the mandible and zygomatic arc were resected, subtotal maxillectomy was performed and the defect was repaired by a free double island flap from the scapular and parascapular osteocutaneous latissimus dorsi muscle flap supplied by subscapular artery. To our knowledge, this is the most extensive bone and soft tissue destruction due to radiation reported in the literature

Doppler sonography of the normal lacrimal gland

WOS: 000227685200006PubMed: 15756661Purpose. We used Doppler sonography to determine the resistance index (RI) and pulsatility index (PI) of the normal lacrimal artery (LA) in both females and males. We also compared the values obtained at various periods of reproductive life. Methods. The study was performed in 25 prepubertal girls, 28 females of reproductive age, and 27 postmenopausal women, 23 pregnant women, and 104 healthy males. Doppler sonography was used to determine the RI and PI of the LA. Results. The mean PI for the entire patient population was 1.48 +/- 0.60 and the RI was 0.72 +/- 0.09. The RI and PI values of the LA did not differ between males and females. Similarly, the mean RI and PI values of the LA did not change significantly between the various reproductive phases. Conclusion. The PI and Rl of the lacrimal gland are similar in both sexes. Moreover, they are not altered by changes in levels of sex steroids. (c) 2005 Wiley Periodicals, Inc. J Clin Ultrasound 33:123-126, 2005; Published online in Wiley InterScience (www.interscience.wiley.com)

Radiologic diagnosis of a type-III pleuropulmonary blastoma

PubMed ID: 25786292Pleuropulmonary blastoma (PPB) is a rare and aggressive dysontogenic neoplasm, occurring in children under the age of 6 years in most cases. CT and MRI findings are well-known, a mixed solid and cystic lesion with variable contrast enhancement and a necrotic centre. We report the radiologic features of type III PPB case