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BACKGROUND: Large arteriovenous malformations are often managed via endovascular embolisation followed by surgical resection. We describe the use of a new liquid embolic agent (LEA) - precipitating hydrophobic injectable liquid (PHIL) and its advantages over existing LEAs. CASE: A 60-year-old male presented with a progressively enlarging right post-auricular arteriovenous malformation. He underwent successive angioembolisation with PHIL and subsequent surgical resection on post-embolisation day 1. CONCLUSION: To our knowledge, this is the first reported case of PHIL being used in pre-operative embolization of a large extra-cranial head and neck AVM. Its excellent penetration into small calibre vessels, decreased glare artefact on imaging and decreased skin pigmentation render it a compelling alternative to existing LEAs.
Asunto(s)
Embolización Terapéutica , Procedimientos Endovasculares , Malformaciones Arteriovenosas Intracraneales , Masculino , Humanos , Persona de Mediana Edad , Malformaciones Arteriovenosas Intracraneales/terapia , Resultado del Tratamiento , Polivinilos , Procedimientos Endovasculares/métodos , Embolización Terapéutica/métodosRESUMEN
OBJECTIVES: Chondro-osseous respiratory epithelial adenomatoid hamartomas (COREAH) are extremely rare benign lesions in the sinonasal cavity. We aim to (a) report two cases of COREAH and (b) perform a literature review with a summary on previously published cases of COREAH till August 2019. METHODS: A literature review identified 16 cases, but only 12 cases from publications from 2005 to 2019 were included in analysis. In addition, we report two cases of COREAH from our tertiary academic medical center. RESULTS: COREAH is found in patients from 3 to 83 years old. It originates from various sites in the nasal cavity and sinuses but the most common location is the lateral nasal wall. Calcification on imaging is a common finding. CONCLUSION: COREAH is an uncommon entity that is important to recognize and distinguish from other sinister nasal masses. It is a slow growing benign lesion which lacks aggressive features on imaging. Future studies are needed to evaluate the possibility of an underlying genetic predisposition. LEVEL OF EVIDENCE: 4.
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Lipoid pneumonia is an entity that is not commonly thought of when faced with opacities on the chest radiograph. The radiological changes of lipoid pneumonia can mimic pneumonia or malignancy. Due to this mimicry, it is commonly missed and alternative diagnoses should always be considered and ruled out when suspecting lipoid pneumonia. Although majority of lipoid pneumonias occur due to exogenous ingestion of oil, endogenous factors such as bronchial obstruction and pulmonary alveolar proteinosis can also result in this condition. The emphasis of this case is on the approach to and treatment of lipoid pneumonia, including its association with malignancy.
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CASE PRESENTATION: A 78-year-old Chinese man presented in March 2019 with a 2-day history of small-volume hemoptysis. He did not report any associated chronic cough, sputum production, epistaxis, night sweats, unintentional weight loss, or fever. He was an ex-smoker of 10 pack years. His medical history was significant for ischemic heart disease on aspirin, as well as hospitalizations in 2016 and 2017 for hemoptysis. The patient's evaluation for hemoptysis was only notable for a right middle lobe nodule on chest CT imaging and Klebsiella pneumoniae on sputum cultures, for which he was treated with antibiotics.
Asunto(s)
Actinomicosis/complicaciones , Hemoptisis/etiología , Enfermedades Pulmonares/complicaciones , Nódulo Pulmonar Solitario/etiología , Actinomicosis/diagnóstico , Actinomicosis/tratamiento farmacológico , Actinomicosis/patología , Anciano , Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , Biopsia , Líquido del Lavado Bronquioalveolar , Broncoscopía , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/tratamiento farmacológico , Enfermedades Pulmonares/patología , Masculino , Penicilina G/uso terapéutico , Recurrencia , Nódulo Pulmonar Solitario/diagnóstico por imagen , Nódulo Pulmonar Solitario/patología , Tomografía Computarizada por Rayos XRESUMEN
Primary squamous cell carcinoma of the thyroid gland (PSCCTh) and anaplastic thyroid carcinoma with extensive squamous differentiation are rare entities which pose a diagnostic challenge in determining the primary site when presented as metastases. The difficulty in confirming a thyroid primary is further compounded by the aggressive nature of these tumours which frequently present at advanced stages. We present a case in which the patient presented with a thyroid mass and a lung mass simultaneously. The risk of misinterpreting the site of primary tumour as lung is greatly increased because squamous cell carcinoma of lung is much more common than its thyroid counterpart. This case highlights the effectiveness of PAX-8 stain in determining the primary site of tumour when squamous cell carcinoma is found in both lung and thyroid gland.