Retroperitoneal cellular schwannoma (CS): a potential pitfall of malignancy. Report of a case and review of the literature

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Echinococcosis — Rare Locations and Uncommon Clinical Manifestations

Echinococcosis is a zoonotic infection caused by tiny tapeworms of the genus Echinocococcus. Cystic Echinococcosis, also known as hydatid disease, is caused by Echinococcus granulosus and rarely by Echinococcus multilocularis

ABDOMINAL CALCIUM SCORE: LA TOMOGRAFIA COMPUTERIZZATA NELLA VALUTAZIONE PRE-OPERATORIA DEL RISCHIO DI DEISCENZA DELLE ANASTOMOSI CHIRURGICHE DEL COLON

La deiscenza dell anastomosi chirurgica rappresenta la più temuta e la più severa complicanza in chirurgia colon-rettale. I processi che determinano l insorgenza della deiscenza anastomotica sono complessi e attualmente solo parzialmente conosciuti. L aterosclerosi potrebbe essere un fattore implicato nel processo di deiscenza, in quanto spia di un alterazione del microcircolo della parete colica che interferisce con i fisiologici processi di riparazione tissutale a livello delle anastomosi. La stima dell aterosclerosi dell aorta addominale può essere effettuata con TC attraverso il calcolo dell AAC secondo il metodo Agatston. I nostri risultati dimostrano una differenza statisticamente significativa dei valori di calcium score tra due gruppi di pazienti "deiscenza" e "no-deiscenza". In conclusione il calcium score può essere considerato in fase pre-operatoria un fattore di predizione del rischio di deiscenza

Congenital Portosystemic Shunt: Our Experience

Introduction. Congenital portosystemic venous malformations are rare abnormalities in which the portal blood drains into a systemic vein and which are characterized by extreme clinical variability. Case Presentations. The authors present two case reports of a congenital extrahepatic portosystemic shunt (Type II). In the first patient, apparently nonspecific symptoms, such as headache and fatigue, proved to be secondary to hypoglycemic episodes related to the presence of a portosystemic shunt, later confirmed on imaging. During portal vein angiography, endovascular embolization of the portocaval fistula achieved occlusion of the anomalous venous tract. In the second patient, affected by Down’s syndrome, the diagnosis of a portosystemic malformation was made by routine ultrasonography, performed to rule out concurrent congenital anomalies. Because of the absence of symptoms, we chose to observe this patient. Conclusions. These two case reports demonstrate the clinical heterogeneity of this malformation and the need for a multidisciplinary approach. As part of a proper workup, clinical evaluation must always be followed by radiographic diagnosis

The Utilization of Imaging Features in the Management of Intraductal Papillary Mucinous Neoplasms

Intraductal papillary mucinous neoplasms (IPMNs) represent a group of cystic pancreatic neoplasms with large range of clinical behaviours, ranging from low-grade dysplasia or borderline lesions to invasive carcinomas. They can be grouped into lesions originating from the main pancreatic duct, main duct IPMNs (MD-IPMNs), and lesions which arise from secondary branches of parenchyma, denominated branch-duct IPMNs (BD-IPMNs). Management of these cystic lesions is essentially based on clinical and radiological features. The latter have been very well described in the last fifteen years, with many studies published in literature showing the main radiological features of IPMNs. Currently, the goal of imaging modalities is to identify “high-risk stigmata” or “worrisome feature” in the evaluation of pancreatic cysts. Marked dilatation of the main duct (>1 cm), large size (3–5 cm), and intramural nodules have been associated with increased risk of degeneration. BD-IPMNs could be observed as microcystic or macrocystic in appearance, with or without communication with main duct. Their imaging features are frequently overlapped with cystic neoplasms. The risk of progression for secondary IPMNs is lower, and subsequently an imaging based follow-up is very often proposed for these lesions