Giant fibrovascular polyp of the oesophagus: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>We present a case of fibrovascular polyp, a rare submucosal tumour of the oesophagus that has been reported only sporadically in the literature. The biapproach for surgical removal of fibrovascular polyp has only been mentioned once in the literature.</p> <p>Case presentation</p> <p>A 65-year-old Greek man presented with a 9-month history of gradually progressive intermittent dysphagia. Radiologic work-up with oesophagogram and computed tomography revealed a large, sausage-shaped intraluminal polyp extending from the level of the cervical oesophagus to the level of the upper body of the stomach. The diagnosis of giant fibrovascular polyp was made radiographically and confirmed by endoscopic biopsy. The polyp was removed using a biapproach surgical technique: pharyngotomy and subsequent gastrostomy.</p> <p>Conclusion</p> <p>Fibrovascular polyp is a rare submucosal tumour. Proper treatment depends on accurate assessment of the origin, size, and vascularity of the pedicle and the size of the tumour. Choice of the appropriate surgical approach depends on the correct diagnosis, which can usually be indicated radiographically by the presence of a smooth, sausage-shaped defect with a discrete bulbous tip.</p

Littoral cell angioma, a rare cause of long standing anaemia: a case report

Littoral cell angioma is a rare primary splenic tumor that is difficult to differentiate preoperatively from other benign and malignant splenic lesions. We report a case of littoral cell angioma of the spleen in a 51-year-old woman that presented with long standing anaemia

Brucella liver abscess; imaging approach, differential diagnosis, and therapeutic management: a case report

We report a new case of a brucellar liver abscess (brucelloma) in a young woman without previous remote brucellosis who presented with pronounced systemic and mild local symptoms. Brucelloma is the result of calcification of a granoulomatous reaction induced by persistent Brucella in macrophages. It represents a rare manifestation that follows previously undetected brucellosis. We describe the findings in plain radiograph, ultrasound, computed tomography, and magnetic resonance images. Together with the positive serology, imaging yielded important elements supporting the diagnosis. Modern radiological techniques also contributed to the final therapeutic management, preventing unnecessary laparotomy. Sequencing confirmed the definite diagnosis of Brucella melitensis as the causative factor

Successful management of bulky osseous metastasis of renal cell carcinoma with selective arterial embolization and radiofrequency ablation: a case report

The case of a 64-year-old male patient who presented with a bulky osseous tumor metastasis from renal cell carcinoma is reported. The metastatic lesion extended from the acetabulum of the left iliac bone into the iliosacral joint

Magnetic resonance imaging findings in pseudo-Meigs' syndrome associated with a large uterine leiomyoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Pseudo-Meigs' syndrome is a rare pathological entity characterized by the presence of a pelvic mass other than an ovarian fibroma. The mass is associated with ascites with or without hydrothorax.</p> <p>Case presentation</p> <p>We describe the case of a 41-year-old Caucasian woman with a large uterine leiomyoma associated with massive ascites. A magnetic resonance imaging scan showed a large subserosal leiomyoma with multiple areas of cystic degeneration.</p> <p>Conclusion</p> <p>To the best of our knowledge, this is the first reported case of pseudo-Meigs' syndrome caused by a uterine leiomyoma and diagnosed using magnetic resonance imaging. The pathophysiology of this syndrome and the role of magnetic resonance imaging are emphasized in this case report.</p

Gastrointestinal stromal tumors: a pictorial review

Abstract We describe the pertinent organ-specific clinical manifestations of gastrointestinal stromal tumors (GISTs) as well as the radiological appearances that allow optimal depiction of pathology and diagnosis. Radiologic features of GISTs vary depending on tumor size and organ of origin. They most commonly have an exophytic growth pattern and manifest as dominant masses outside the organ of origin. Intramural and intraluminal masses are less common radiologic manifestations. GISTs may contain areas of hemorrhage, necrosis, or cyst formation that appear as focal areas of low attenuation on computed tomographic images. Most metastases of GISTs involve the liver and peritoneum by hematogenous spread and peritoneal seeding. CT and MRI are considered to be the imaging modality of choice for the detection, staging, surgical planning and follow-up of patients with GIST. A reduction in tumor size, extensive cystic changes, and calcification in primary and metastatic GISTs on CT and MRI indicate disease response to therapy. Radiologists and clinicians must recognize the imaging features of GISTs, detect, characterize the lesions and evaluate the tumor response during specific treatment

New MR techniques in diagnosis and grading of brain tumors

Brain tumors remain one of the major health problems worldwide. These include some of the most malignant tumors in humans and are resistant to all advanced treatments. Magnetic Resonance Imaging ( MRI ) plays an important role in the diagnosis and grading of brain tumors, and thus in determining prognosis and treatment monitoring.During the last decade as new techniques applied, neuroimaging of brain tumors has evolved from a purely anatomy-based discipline to one that incorporates morphologic abnormality with physiologic alterations in extracellular compartment kinetics, cellular metabolism, and hemodynamics.The purpose of this study is to assess the contribution of diffusion MRI, perfusion MRI and spectroscopy in grading primary Brain Tumors and the differentiation of high grade tumors from solitary metastasisThe study included 70 cases: 10 low grade gliomas , 8 high grade gliomas (grade III), 38 high-grade gliomas (grade IV) and 14 metastases. Although the sample is unbalanced largely reflect the actual proportion of clinical cases in daily practice, correlated the epidemiological data Statistical analysis demonstrated rCBV critical value of 1,625 <cv <1,735 to provide sensitivity 100 % , specificity 98.3 % and accuracy 98%. in determining high- grade gliomas Critical value of Cho/Cr metabolite ratio 1,685 <cv <1,885 resulted in accuracy 94% in determining high grade gliomasThreshold value for rCBV 2.3 leads to sensitivity 100 % , specificity 37.5 % and 89.13 % accuracy in distinguishing grade III from grade IV gliomas .Critical value of peritumoral Cho/Cr metabolite ratio 1,16 cv <1,3 leads to sensitivity 75 %, specificity 97 2% and 91% accuracy in differentiation of high grade gliomas from solitary metastases. Peritumoral rCBV value achieves lower accuracy of around 83.3 % .The advanced MR techniques contribute to the accurate separation of brain tumors preoperatively. The integration of advanced techniques should become routine in the protocol study of brain tumors Οι όγκοι του εγκεφάλου παραμένουν ένα από τα σημαντικά προβλήματα υγείας σε όλο τον κόσμο. Σε αυτούς περιλαμβάνονται ορισμένα από τα πλέον κακοήθη νεοπλάσματα που προσβάλλουν τον άνθρωπο και είναι ανθεκτικά σε όλες τις εξελιγμένες θεραπείες. Η ΜΤ παίζει σημαντικό ρόλο στη διάγνωση των όγκων του εγκεφάλου, στην διαβάθμισή τους και άρα στον καθορισμό της πρόγνωσης και στην παρακολούθηση της θεραπείας.Κατά τη διάρκεια των τελευταίων δεκαετιών καθώς νέες τεχνικές εφαρμόζονται γινόμαστε μάρτυρες μιας μετατόπισης της απεικόνισης από την απλή παροχή πληροφοριών ως προς τις ανατομικές δομές, προς την απεικόνιση που συγχρόνως παρέχει πληροφορίες για τη φυσιολογία των όγκων. Στις νεότερες εξελιγμένες τεχνικές περιλαμβάνονται η MΤ διάχυσης, η MΤ αιμάτωσης, και η φασματοσκοπία.Στην παρούσα μελέτη έγινε προσπάθεια διαβάθμισης των όγκων του εγκεφάλου και διαφορικής διάγνωσης των όγκων υψηλής κακοήθειας από τις μεταστάσεις.Στην μελέτη συμπεριλήφθηκαν 70 περιστατικά. 10 γλοιώματα χαμηλού βαθμού κακοήθειας, 8 γλοιώματα υψηλού βαθμού κακοήθειας (grade III), 38 γλοιώματα υψηλού βαθμού κακοήθειας (grade IV) και 14 μεταστάσεις. Αν και το δείγμα είναι ετεροβαρές αντιπροσωπεύει σε μεγάλο βαθμό την πραγματική αναλογία περιστατικών στην κλινική πράξη, δηλαδή αντιπροσωπεύει τα επιδημιολογικά δεδομένα.Στον διαχωρισμό των όγκων χαμηλού βαθμού κακοήθειας από τους όγκους υψηλού βαθμού κακοήθειας (υψηλού βαθμού κακοήθειας γλοιώματα και μεταστάσεις) η μεταβλητή rCBV στο εμβαδό του όγκου θέτοντας ως κρίσιμη τιμή 1.625<cv<1.735 οδηγεί σε ευαισθησία 100%, εξειδίκευση 98.3% και ακρίβεια ταξινόμησης 98%. Αν χρησιμοποιήσουμε όλες τις μεταβλητές για την ταξινόμηση δεν καταφέρνουμε να πετύχουμε καλύτερα αποτελέσματα.Ωστόσο και η χρησιμοποίηση της μεταβλητής Cho/Cr στον όγκο με κρίσιμη τιμή 1.685<cv<1.885 οδηγεί σε υψηλή ακρίβεια ταξινόμησης άνω του 94%.Στον διαχωρισμό των όγκων βαθμού ΙΙΙ από τους όγκους βαθμού IV με βάση την μεταβλητή rCBV και με κατώφλι 2.3 οδηγούμαστε σε ευαισθησία 100%, εξειδίκευση 37.5% και ακρίβεια ταξινόμησης 89.13%.Στον διαχωρισμό των όγκων υψηλού βαθμού κακοήθειας από τις μεταστάσεις αν χρησιμοποιήσουμε την μεταβλητή Cho/Cr στο οίδημα και με κριτική τιμή, 1.16<cv<1.3 κάτω από την οποία ο όγκος κατατάσσεται ως μετάσταση οδηγούμαστε σε ευαισθησία 75%, εξειδίκευση 97.2% και ακρίβεια ταξινόμησης 91%.Η χρησιμοποίηση της μεταβλητής rCBV στο οίδημα πετυχαίνει χαμηλότερη ακρίβεια ταξινόμησης της τάξης του 83.3%.Οι εξελιγμένες τεχνικές συμβάλλουν στον ακριβή διαχωρισμό των όγκων του εγκεφάλου προεγχειρητικά.Η ενσωμάτωση των ως άνω προηγμένων τεχνικών θα πρέπει να γίνει ρουτίνα στο πρωτόκολλο μελέτης των όγκων του εγκεφάλου