When should MRI be recommended for the accurate clinical staging of base of tongue carcinoma?

BACKGROUND AND PURPOSE: According to the American Joint Committee on Cancer (AJCC) cancer staging criteria (6th edition), cross-sectional imaging for base of tongue carcinoma is recommended when the deep tissue extent of a primary tumor is in question. The aim of this study was to establish which group of patients MRI might most benefit from accurate clinical staging of base of tongue carcinomas. PATIENTS AND METHODS: The clinical stagings of 33 patients with pathologically proven squamous cell carcinomas of the base of tongue were performed by two otorhinolaryngologic surgeons. Their results were compared with the results from MRI interpreted by a neuroradiologist and the numbers of patients being upstaged, downstaged or with an unchanged stage were recorded and analyzed. RESULTS: The tumor stages were changed in 13 of 33 patients (39.4%, 95% CI: 23.9-57.87%) and the overall stage groupings were changed in 10 (30.3 %, 95%CI: 15.6-48.7%) after performing MRI. Mis-staging by clinical examination in the overall stage grouping was as high as 83.3% (95%CI: 35.9-99.6%) in stages II and III and 85.7% (95% CI: 42.1-99.6%) in T3. CONCLUSION: MRI should be recommended in base of tongue carcinoma whenever clinical examination suggests overall stage groupings II, III or tumor stage T3.

Meningioma of the internal auditory canal: a case report.

Meningioma of the internal auditory canal is very rare. There are only 15 previous reports of intracanalicular meningioma. The authors add a case report of a patient with meningioma of the internal auditory canal. A 31-year-old woman presented with a one-year history of headache, dizziness, hearing loss and left facial paralysis. An MRI of the temporal bone demonstrated a tiny isointense intracanalicular tumor with inhomogeneous enhancement. In the operative field carried out by translabyrinthine approach, the tumor was found in the IAC without intracranial involvement. Pathology revealed a meningioma. The patient was followed up for 2 years without recurrence.

Accuracy of the mammographic report category according to BIRADS.

OBJECTIVE: To determine the accuracy and predictive value of the mammographic report according to the BIRADS categories in Songklanagarind University Hospital. MATERIAL AND METHOD: Mammograms of 1000 women who came to Songklanagarind University Hospital from June 1998 to September 1999 were reported and placed in category 1 for negative results, category 2 for benign lesions, category 3 for probably benign lesions, category 4 for suspicious lesions and category 5 for highly suspicious lesions. Accuracy was determined by either histology or by unchanged follow-up mammography within 24 months. RESULTS: The total accuracy was 97.8%, sensitivity 62.5% and specificity 98.1%.