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1.
Arch Soc Esp Oftalmol (Engl Ed) ; 99(10): 455-458, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38768848

RESUMEN

We present the case of a 68-year-old female who presented with a substantial cyclodialysis after phacoemulsification identified by anterior segment optical coherence tomography and ultrasound biomicroscopy. Gonioscopy is challenging because of its shallow anterior chamber. Due to lack of response to topical steroids and refusal by the patient for surgical treatment, topical steroids were tapered, and cycloplegic was initiated. After two weeks, the cyclodialysis cleft was closed on optical coherence tomography persisting residual subchoroidal fluid, topical treatment was mantained. Despite of this, visual acuity and hypotony were restored. Finally at 2 months visit subchoroidal fluid was reabsorbed and patient was discharged. Clinics should consider the possibility of cyclodialysis in cases of unjustified hypotony during postoperative period. In addition, we recommend performing anterior segment imaging which includes ultrasound biomicroscopy and optical coherence tomography, when the evaluation of angular structures is unfeasible. Finally, we propose medical management for severe cyclodialysis as the first option considering anti-inflammatory drugs could perpetrate the separation between scleral spur and ciliary muscle.


Asunto(s)
Facoemulsificación , Complicaciones Posoperatorias , Tomografía de Coherencia Óptica , Humanos , Femenino , Anciano , Complicaciones Posoperatorias/etiología , Microscopía Acústica , Hendiduras de Ciclodiálisis/etiología , Hipotensión Ocular/etiología , Midriáticos/uso terapéutico
2.
Rev Esp Med Nucl Imagen Mol ; 35(1): 22-8, 2016.
Artículo en Inglés, Español | MEDLINE | ID: mdl-26150109

RESUMEN

OBJECTIVE: Assess the role of SPECT-CT in sentinel lymph node (SLN) biopsy in the accurate anatomical location of the SNL in patients with cutaneous head and neck melanoma. MATERIAL AND METHODS: A retrospective study was conducted from February 2010 to June 2013 on 22 consecutive patients with a diagnosis of cutaneous head and neck melanoma (9 female, 13 male), with a mean age of 55 years old and who met the inclusion criteria for SLN biopsy. Patients underwent preoperative scanning after peri-scar injection of (99m)Tc-labeled-nanocolloid. Planar images of the injection-site, whole-body, and SPECT-CT scanning were acquired. RESULTS: Detection rate of SLN reached up to 91% (20/22 patients) by planar lymphoscintigraphy and 95.4% (21/22 patients) by SPECT-CT. SPECT-CT provided an accurate location of SLN in 14/22 patients, enabling to improve the surgical approach (clinical impact: 63.6%). SLN was positive for metastatic cells in 9.1% patients. CONCLUSION: SPECT-CT provides detailed anatomical SLN location and allows detecting a higher number of SLN than planar lymphoscintigraphy. Routine use of SPECT-CT is recommended in order to optimise the SLN detection and location in patients with head and neck melanoma.


Asunto(s)
Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Metástasis Linfática/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Melanoma/secundario , Biopsia del Ganglio Linfático Centinela/métodos , Tomografía Computarizada por Tomografía Computarizada de Emisión de Fotón Único , Neoplasias Cutáneas/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , Cuidados Intraoperatorios , Linfocintigrafia/métodos , Masculino , Melanoma/patología , Persona de Mediana Edad , Cuidados Preoperatorios , Radiofármacos/análisis , Estudios Retrospectivos , Sensibilidad y Especificidad , Neoplasias Cutáneas/patología , Agregado de Albúmina Marcado con Tecnecio Tc 99m/análisis , Adulto Joven
3.
Eur J Radiol ; 84(8): 1586-1592, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25975897

RESUMEN

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different presentations of the disease were observed in our casuistic: most indolent form was a cutaneous confined disease, presented in only one patient. Multifocal involvement with central nervous system (CNS) preservation was observed in two patients. Most aggressive form consisted in a systemic involvement with CNS infiltration, presented in three patients. In our experience neurological involvement, among one case with isolate pituitary infiltration, was associated with mortality in all cases. 18FDG-PET/CT and BS were particularly useful in despite systemic involvement; locate the site for biopsy and the treatment response evaluation. By our knowledge, 18FDOPA-PET/CT not seems useful in the initial staging of ECD. A baseline 18FDG-PET/CT and BS may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically 18FDG-PET/CT must be performed in the follow up to evaluate treatment response.


Asunto(s)
Dihidroxifenilalanina/análogos & derivados , Enfermedad de Erdheim-Chester/diagnóstico , Fluorodesoxiglucosa F18 , Imagen Multimodal , Tecnecio , Tomografía Computarizada por Rayos X , Adulto , Anciano , Huesos/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cintigrafía , Radiofármacos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/efectos adversos
4.
Rev Esp Med Nucl Imagen Mol ; 33(3): 129-35, 2014.
Artículo en Español | MEDLINE | ID: mdl-24094375

RESUMEN

OBJECTIVE: To assess the contribution of SPECT-CT lymphoscintigraphy in selective sentinel lymph node biopsy (SLNB) in patients with newly diagnosed malignant melanoma. MATERIAL AND METHODS: A prospective study was made between July 2009 and October 2010. It included 63 patients diagnosed with melanoma (32 men and 31 women) with mean age of 55 years (range: 25-88) and inclusion criteria for SLNB. The melanomas were located as follows: 28 in trunk, 5 in head and neck, 16 in upper limbs and 17 in lower limbs. Three patients had two melanomas. Preoperative lymphoscintigraphy was performed after pericicatricial/perilesional injection of 74MBq of (99m)Tc-labeled nanocolloid human serum albumin, obtaining early planar images, late whole body study and sectorial images and SPECT-CT in the area of interest. Planar scintigraphy findings were compared with SPECT-CT. RESULTS: The sentinel node (SN) was localized by planar imaging in 62/63 (98%) of patients. SPECT-CT study located the SN in all the patients with a detection rate of 100%. The number of SNs detected with SPECT-CT was higher than with the planar study in 27 patients. The SPECT-CT provided additional information (change in location and/or in its accuracy in the localization of location uncertain SN) in 14/63 (22.2%) patients, involving changes in the surgical approach and lymph node staging. CONCLUSION: SPECT-CT detects a higher number of SN than planar lymphoscintigraphy in patients with melanoma. Its contribution is more relevant in the melanomas located on the trunk, head and neck. SPECT-CT modified the SN location by 22% compared to planar scan findings, facilitating a correct surgical approach.


Asunto(s)
Linfocintigrafia , Melanoma/diagnóstico por imagen , Melanoma/patología , Biopsia del Ganglio Linfático Centinela/métodos , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Tomografía Computarizada de Emisión de Fotón Único , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
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