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Early detection of oral cavity malignancies is essential for improving treatment outcomes and patient survival rates. Diagnostic imaging, particularly computed tomography (CT), plays a pivotal role in the early identification and detailed assessment of these malignancies. This comprehensive review explores the advancements in CT imaging and its application in diagnosing oral cavity cancers. It discusses the anatomy and physiology of the oral cavity, the clinical characteristics of common malignancies, and the principles and protocols of CT imaging. The review highlights the diagnostic features of oral malignancies on CT, including distinguishing benign from malignant lesions and staging criteria. Emerging technologies, such as higher-resolution imaging, integration with other modalities, and the potential of artificial intelligence, are examined for their role in enhancing diagnostic accuracy. The clinical implications, challenges, and future directions in the use of CT imaging for oral cavity malignancies are also discussed. This review underscores the importance of continued research and technological advancements in optimizing the use of CT for early detection and effective management of oral cavity cancers.
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Pyometra is a gynecological condition characterized by pus accumulation in the endometrial cavity. It is a rare condition, and it should be included in the differential diagnosis of abdominal pain in postmenopausal women. We present a case of a 65-year-old postmenopausal woman with complaints of foul-smelling white discharge, itching in the perineal region, lower abdominal pain, and postmenopausal bleeding for two to three months. USG of the pelvis was done outside, which revealed heterogeneous ill-defined cervical growth with endometrial fluid collection and multiple uterine fibroids. CT and MRI of the pelvis were done in our hospital, which revealed an ill-defined heterogeneously enhancing growth in the cervix with multiple uterine fibroids and heterogeneous endometrial collection showing restricted diffusion in MRI suggestive of pyometra. Cervical biopsy revealed features suggestive of moderately differentiated squamous cell carcinoma.
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Congenital facial teratomas in neonates pose diagnostic challenges, necessitating a multidisciplinary approach for accurate diagnosis and management. We present the case of a four-day-old female infant delivered via Lower Segment Cesarean Section (LSCS) with a protruding nasolabial mass noted since birth. CT brain plain revealed a soft tissue density opacification arising from the left maxilla with an underlying bony outgrowth, suggestive of a benign congenital developmental anomaly most likely teratoma. Further evaluation is warranted to delineate the exact nature and extent of the anomaly. This case underscores the importance of meticulous evaluation and interdisciplinary collaboration in managing congenital anomalies, with surgical intervention potentially required based on individual patient factors. Continued research and collaboration among medical specialities are essential to improve understanding and management strategies for congenital facial teratomas.
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Primitive neuroectodermal tumors (PNETs) are unprecedented threatening neoplasms beginning from primitive neuroectodermal cells. PNETs are reported as the predominant incidence observed in children and young adults with a high mortality rate. These neuroectodermal tumors are quite aggressive with a life expectancy of eight months on average. PNETs belong to the family of small round cell tumors majorly affecting bones and soft tissues in different body parts such as the brain, lungs, spine, and pelvic region. Computed tomography (CT) and magnetic resonance imaging (MRI) play a major role in giving the size, extent, and resectability of the tumors. A confirmed diagnosis is then made by histopathology and immunohistochemistry markers. This report depicts a case of PNET found within the right lung of a 13-year-old female, enumerating the clinical introduction, demonstrative handle, treatment modalities, and results. The case underscores the significance of precise conclusions and multidisciplinary approaches in pediatric PNET cases. Once the provisional diagnosis of pleuropulmonary blastoma or PNET was given on CT, a conformational histopathological examination was carried out. Histopathological analysis confirmed the final diagnosis of PNET, and the patient underwent neoadjuvant therapy as the tumor was non-resectable due to its massive size.
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Cerebellar hemispheric enlargement with atypical neurological symptoms poses diagnostic challenges in clinical practice. We present the case of a 57-year-old female with persistent headache, left facial paraesthesia, dysarthria, gait ataxia, and longstanding neck swelling. Imaging studies revealed enlargement of the left cerebellar hemisphere with associated mass effect and compression of adjacent structures. The underlying etiology remained uncertain despite extensive evaluation, including magnetic resonance imaging and angiography. Differential diagnoses included neoplastic, vascular, inflammatory, and metabolic etiologies, but none fully accounted for the clinical findings. Management strategies focused on symptomatic relief and close monitoring. This case underscores the complexity of diagnosing and managing patients with rare neurological manifestations and highlights the need for continued research and collaborative approaches in optimising patient care.
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Fibrous dysplasia (FD) is a rare benign skeletal disorder that replaces normal bone with fibrous tissue and immature woven bone. We present a case of a 13-year-old girl with right-sided facial swelling and craniofacial deformity since birth, accompanied by nasal obstruction and difficulty in breathing and swallowing. Computed tomography (CT) imaging revealed an expansile bony lesion with a ground-glass matrix involving multiple craniofacial bones. Histopathological examination confirmed the diagnosis of FD. Management involved regular monitoring and conservative measures, with surgical intervention reserved for symptomatic progression or cosmetic concerns. This case underscores the importance of considering FD in the differential diagnosis of craniofacial asymmetry and highlights the collaborative approach to patient care. Further research is needed to optimize management strategies and outcomes for pediatric patients with FD.
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T2-weighted hyperintensities in neuroimaging represent areas of heightened signal intensity on magnetic resonance imaging (MRI) scans, holding crucial importance in neuroimaging. This comprehensive review explores the T2-weighted hyperintensities, providing insights into their definition, characteristics, clinical relevance, and underlying causes. It highlights the significance of these hyperintensities as sensitive markers for neurological disorders, including multiple sclerosis, vascular dementia, and brain tumors. The review also delves into advanced neuroimaging techniques, such as susceptibility-weighted and diffusion tensor imaging, and the application of artificial intelligence and machine learning in hyperintensities analysis. Furthermore, it outlines the challenges and pitfalls associated with their assessment and emphasizes the importance of standardized protocols and a multidisciplinary approach. The review discusses future directions for research and clinical practice, including the development of biomarkers, personalized medicine, and enhanced imaging techniques. Ultimately, the review underscores the profound impact of T2-weighted hyperintensities in shaping the landscape of neurological diagnosis, prognosis, and treatment, contributing to a deeper understanding of complex neurological conditions and guiding more informed and effective patient care.
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Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) is a complex Mullerian and Wolffian duct anomaly, which is difficult to diagnose before puberty. We present a rare case of a congenital syndrome known as OHVIRA in a 21-year-old female who came with complaints of intermittent type of lower abdominal pain, dysmenorrhea, and oligomenorrhea with frequent visits to different hospitals without any radiological investigations done. Early magnetic resonance imaging (MRI) investigations helped her in diagnosing and managing this syndrome.
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Patients present to the orthopedic outpatient department with complaints of shoulder pain on movement or restriction of movement in the shoulder joint and are referred for magnetic resonance imaging (MRI) of the shoulder joint. Almost all the patients have similar complaints but may have a wide range of pathology affecting the joint and causing pain. Rotator cuff tears or tendinopathy are the most common causes of shoulder pain. Ultrasound (USG) and MRI are the most commonly used imaging modalities for assessing rotator cuff pathologies. There is a wide range of pathologies affecting the shoulder joint, other than rotator cuff tendinopathies or tears, for which USG is less sensitive and specific in detecting accurate pathology. MRI is the choice of imaging for shoulder joint pathologies. We present a pictorial review discussing and depicting MRI features of a wide list of pathologies of the shoulder joint complex that should be kept in mind when the patient presents with shoulder pain.
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Pigmented villonodular synovitis (PVNS) is a rare benign condition of tenosynovial proliferation that mostly affects the knee joint. In this case report, we present a 39-year-old female with a ten-year history of gradual progression in the size of painful soft tissue swelling in her left knee. Our case report emphasizes the MRI's ability to provide detailed information on tendon sheath and synovium involvement, as well as extensive extra-articular involvement and hemosiderin deposition.
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Intracranial dermoid cysts are rare, benign, congenital, and slow-growing cystic lesions. They contain mature squamous epithelium, apocrine, eccrine, sebaceous glands, and ectodermal structures. The rupture of intracranial dermoid cysts is a rare event and can cause life-threatening conditions.
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Adamantinoma, an uncommon low-grade primary malignant bone tumor, rarely causes leg pain in adolescents and typically manifests in the lower extremities, with a notable preference for the tibia, although occurrences in other bones such as the femur, fibula, and pelvis have been documented. Instances of local recurrence and regional metastasis are infrequent. This case report aims to comprehensively review the clinical presentation, imaging features, histological findings, and management of adamantinoma. The presented case involves a 17-year-old male patient with a four-year history of edema and discomfort in the right anterior leg. Radiographic examination of the proximal tibia revealed a well-defined, expansile lytic-sclerotic lesion with multiple septae and a partially sclerotic border. Subsequent magnetic resonance imaging (MRI) confirmed the nature of the lesion, and a biopsy, followed by histological analysis, confirmed the diagnosis of adamantinoma. This case highlights the significance of a multidisciplinary approach, emphasizing close collaboration among radiology, pathology, and orthopedic oncology in adamantinoma management. Long-term follow-up is imperative for monitoring recurrence and administering timely therapy. The objective of this case report is to contribute to an improved understanding of adamantinoma and offer guidance on the treatment of this uncommon bone tumor.
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Sinus histiocytosis with massive lymphadenopathy (SHML), an alternative term for Rosai-Dorfman disease (RDD), is a rare benign idiopathic immune-related lymphoproliferative condition. The central nervous system (CNS) has been documented to be involved in RDD, although lymph nodes are the organs that are most frequently and primarily associated with the disease manifestation. Nonetheless, CNS involvement in RDD is rare and poorly understood. As a result, there is a lack of a solid basis for therapeutic approaches for CNS involvement in RDD. Here, we present a case of RDD with cerebral involvement, a rare presentation of RDD with atypical symptoms. A brief assessment of the radiographic appearance, histological findings, and the peculiar manifestations of the disease is provided.
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INTRODUCTION: Atherosclerosis (i.e. hardening and thickening of arteries) causes vascular remodeling, obstruction of lumen, abnormalities of blood flow and reduced oxygenation of target tissues. Manifestation of atherosclerosis in the form of either Myocardial Infarction or Stroke is the major cause of morbidity and mortality. This study evaluated extracranial carotid arteries of patients (>60 years) who presented with risk factors of atherosclerosis and determined the association of risk factors with carotid abnormalities. AIM: To evaluate the prevalence of atherosclerosis, haemodynamic and morphological changes that take place in extra cranial portion of carotid arteries in patients with risk factors of atherosclerosis (Diabetes Mellitus, Hypertension, Smoking, Stroke, Coronary Artery Disease, Hypercholesterolaemia) and determine the association of risk factors with carotid abnormalities. MATERIALS AND METHODS: The prospective cross-sectional analytical study included the examination of Extracranial carotid arteries of 1043 patients over a period of 2 years (2013-2015) using duplex ultrasound. Assessment of CCA-IMT, ICA-IMT and percent stenosis was done using a linear probe of 8-12 MHz. STATISTICAL ANALYSIS: Correlation between risk factors of atherosclerosis, wall thickness of common carotid (CCA-IMT), internal carotid arteries (ICA-IMT) and stenosis was studied using statistical tools like multiple logistic regression analysis and analysis of variance (p<0.05) using SPSS 17.0. RESULTS: Maximum percent stenosis increased with increase in age. Prevalence of severe stenosis (>70%) was low while the prevalence of mild stenosis (<50%) was quite high. In all age groups, stenosis was more prevalent and more severe in men as compared to women. Hypertension showed the strongest positive correlation with all three measures of interest CCA-IMT, ICA-IMT and maximum percent stenosis. Stroke history showed strong positive correlation with CCA-IMT and stenosis. Smoking, Diabetes Mellitus, Hypercholesterolaemia, Heart disease showed strong association with all three measures as well. Atherosclerotic plaques were mostly found at the site of carotid bifurcation. CONCLUSION: CCA-IMT was strongly associated with hypertension, smoking and diabetes mellitus. ICA-IMT was strongly associated with hypertension and history of heart disease. Percent stenosis was strongly associated with smoking and history of heart disease.
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An adolescent presented with headache and projectile vomiting and showed ataxia, dysarthia and nystagmus with normal cognition. A diagnosis of acute cerebellitis was made on the basis of computed tomography and magnetic resonance imaging findings. He developed seizures and had a rapid downhill course with death at 48 hours after admission. Clinically, patients of acute cerebellitis present with fever, nausea, headache and altered sensorium with cerebellar symptoms. Inflammation of the cerebellum compresses the brain stem and induces mental alterations. It is a rare pathology developing due to an infectitious cause, post-infectitious or post vaccination etiology. Many times it is not possible to identify the causative agent. Cerebellitis can be mild where recovery occurs in few weeks and no abnormalities are seen on diagnostic imaging studies. On the other end, severe cases have focal neurological deficits, altered consciousness, raised intracranial pressure and abnormal neuroimaging. Treatment should be tailored to individual needs according to presentation, severity, and etiology. We discuss clinical features, diagnosis and management of acute cerebellitis which is an important cause of acute cerebellar functional disorder in childhood.