RESUMEN
Parapharyngeal space tumors are known for having a difficult approach, misleading diagnosis and for representing a treatment challenge. Hemangiopericytomas account for less than 1% of all vascular neoplasms and 3% of all soft tissue sarcomas. Only 14 cases have been reported in the worldwide literature in this location. We present a case of a 44-year-old male who was referred for evaluation. A CT scan and MRI showed a large parapharyngeal mass of a possible salivary gland origin. The patient underwent a lateral cervicotomy associated with a transparotid-transmandibular approach, obtaining a vimentin-positive immunostaining tumor defining the diagnosis. The accurate management and prognosis of this type of neoplasm are provided by the definite diagnosis obtained by a correct histopathologic assessment. A high clinical suspicion is essential.
Asunto(s)
Hemangiopericitoma/diagnóstico , Adulto , Hemangiopericitoma/metabolismo , Hemangiopericitoma/patología , Hemangiopericitoma/cirugía , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética , Masculino , Neoplasias Faríngeas/diagnóstico , Neoplasias Faríngeas/metabolismo , Neoplasias Faríngeas/patología , Neoplasias Faríngeas/cirugía , Pronóstico , Tomografía Computarizada por Rayos XRESUMEN
Pituitary neuroendocrine tumours (PitNETs) constitute a heterogeneous group of tumours with a gradually increasing incidence, partly accounted for by more sensitive imaging techniques and more extensive experience in neuroradiology in this regard. Although most PitNETs are indolent, some exhibit aggressive behaviour, and recurrence may be seen after surgical removal. The changes introduced in the WHO classification in 2017 and terminological debates in relation to neuroendocrine tumours warrant an update of the guidelines for the diagnosis, preoperative and postoperative management, and follow-up of response to treatment of PitNETs. This multidisciplinary document, an initiative of the Neuroendocrinology area of the Sociedad Española de Endocrinología y Nutrición [Spanish Society of Endocrinology and Nutrition] (SEEN), focuses on neuroimaging studies for the diagnosis, prognosis and follow-up of PitNETs. The basic requirements and elements that should be covered by magnetic resonance imaging are described, and a minimum radiology report to aid clinicians in treatment decision-making is proposed. This work supplements the consensus between the Neuroendocrinology area of the SEEN and the Sociedad Española de Anatomía Patológica [Spanish Society of Pathology] (SEAP) for the pathological study of PitNETs.
Asunto(s)
Tumores Neuroendocrinos , Neoplasias Hipofisarias , Radiología , Humanos , Tumores Neuroendocrinos/diagnóstico por imagen , Tumores Neuroendocrinos/terapia , Estudios de Seguimiento , Neoplasias Hipofisarias/diagnóstico por imagen , Neoplasias Hipofisarias/terapia , HipófisisRESUMEN
INTRODUCTION AND OBJECTIVES: Benign lesions of the external auditory canal (EAC) are an infrequent cause of temporal bone CT scan requests. We are not usually well versed in the different pathologies located in the EAC, perhaps because it is "only" a conduit and the relevant anatomical structures are located in the middle and inner ear. Our objective was to improve knowledge of this structure by reviewing the different benign conditions found in this location. METHODS: We reviewed the CT studies from 2 years (January 2010 through January 2012), selecting those containing lesions in the EAC. To complement this, due to the importance of these lesions, these medical histories were then analysed considering the presentation and otoscopic examination findings. RESULTS: The lesions were classified according to their diagnoses: exostosis, osteoma, cholesteatoma, keratosis obturans, haemangioma, non-neoplastic aural polyp, first branchial cyst and dermatologic disease (malignant external otitis). The presence of EAC occupation in the otological examination and chronic otorrhea as the symptom of presentation were the most relevant exploratory and clinical findings. CONCLUSIONS: Benign EAC lesions are an uncommon and seldom studied cause of temporal bone CT scan requests. Knowing the most relevant clinical and radiological findings is necessary for their proper diagnosis.
Asunto(s)
Conducto Auditivo Externo , Enfermedades del Oído/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Humanos , Estudios RetrospectivosAsunto(s)
Acenocumarol/efectos adversos , Anticoagulantes/efectos adversos , Pérdida Auditiva Unilateral/etiología , Hemorragia/inducido químicamente , Enfermedades del Laberinto/inducido químicamente , Acenocumarol/uso terapéutico , Administración Oral , Anticoagulantes/uso terapéutico , Femenino , Implantación de Prótesis de Válvulas Cardíacas , Hemorragia/complicaciones , Hemorragia/diagnóstico por imagen , Humanos , Enfermedades del Laberinto/complicaciones , Enfermedades del Laberinto/diagnóstico por imagen , Imagen por Resonancia Magnética , Persona de Mediana Edad , Válvula Mitral/cirugía , Trombofilia/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Vértigo/etiologíaRESUMEN
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Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Hemorragia/complicaciones , Hemorragia/diagnóstico , Hemorragia/prevención & control , Laberintitis/diagnóstico , Laberintitis/prevención & control , Acenocumarol/administración & dosificación , Pérdida Auditiva , Acúfeno , Vértigo , Audiometría/métodos , Espectroscopía de Resonancia Magnética/métodosRESUMEN
Introducción y objetivos: Las lesiones benignas del conducto auditivo externo son una causa infrecuente de estudio en la TC de peñascos. Tal vez porque es «solo» un conducto, y las estructuras anatómicas relevantes se encuentran en el oído medio e interno, generalmente no están bien valoradas las diferentes afecciones que asientan en el conducto auditivo externo. Con el objetivo de mejorar el conocimiento de esta estructura se llevó a cabo una revisión de las lesiones benignas que podemos encontrar en esta localización. Métodos: Se trata de un estudio retrospectivo en el que se revisaron las imágenes de la TC de peñascos realizados en 2 años (enero de 2010 a enero de 2012). De ellos, se seleccionaron aquellos en los que el informe radiológico reportaba lesiones del conducto auditivo externo. Posteriormente, y también de forma retrospectiva se realizó un análisis de las historias médicas de los pacientes, valorando los hallazgos clínicos y la exploración otoscópica. Resultados: Las lesiones fueron clasificadas según su diagnóstico en: osteoma, colesteatoma, queratosis obturans, hemangioma, pólipo aural no neoplásico, quiste de primer arco branquial y enfermedades dermatológicas (otitis externa maligna). Los hallazgos clínicos más frecuentemente encontrados fueron la otorrea crónica como síntoma de presentación y la ocupación del conducto en la exploración otoscópica. Conclusiones: Las lesiones que afectan al canal auditivo externo son estudiadas de forma infrecuente en la TC de peñascos. Es necesario conocer los hallazgos clínicos y radiológicos más relevantes para poder realizar su correcto diagnóstico y estudio (AU)
Introduction and objectives: Benign lesions of the external auditory canal (EAC) are an infrequent cause of temporal bone CT scan requests. We are not usually well versed in the different pathologies located in the EAC, perhaps because it is only a conduit and the relevant anatomical structures are located in the middle and inner ear. Our objective was to improve knowledge of this structure by reviewing the different benign conditions found in this location. Methods: We reviewed the CT studies from 2 years (January 2010 through January 2012), selecting those containing lesions in the EAC. To complement this, due to the importance of these lesions, these medical histories were then analysed considering the presentation and otoscopic examination findings. Results: The lesions were classified according to their diagnoses: exostosis, osteoma, cholesteatoma, keratosis obturans, haemangioma, non-neoplastic aural polyp, first branchial cyst and dermatologic disease (malignant external otitis). The presence of EAC occupation in the otological examination and chronic otorrhea as the symptom of presentation were the most relevant exploratory and clinical findings. Conclusions: Benign EAC lesions are an uncommon and seldom studied cause of temporal bone CT scan requests. Knowing the most relevant clinical and radiological findings is necessary for their proper diagnosis (AU)