Predictive model of pheochromocytoma based on the imaging features of the adrenal tumours.

The purpose of our study was to develop a predictive model to rule out pheochromocytoma among adrenal tumours, based on unenhanced computed tomography (CT) and/or magnetic resonance imaging (MRI) features. We performed a retrospective multicentre study of 1131 patients presenting with adrenal lesions including 163 subjects with histological confirmation of pheochromocytoma (PHEO), and 968 patients showing no clinical suspicion of pheochromocytoma in whom plasma and/or urinary metanephrines and/or catecholamines were within reference ranges (non-PHEO). We found that tumour size was significantly larger in PHEO than non-PHEO lesions (44.3 ± 33.2 versus 20.6 ± 9.2 mm respectively; P < 0.001). Mean unenhanced CT attenuation was higher in PHEO (52.4 ± 43.1 versus 4.7 ± 17.9HU; P < 0.001). High lipid content in CT was more frequent among non-PHEO (83.6% versus 3.8% respectively; P < 0.001); and this feature alone had 83.6% sensitivity and 96.2% specificity to rule out pheochromocytoma with an area under the receiver operating characteristics curve (AUC-ROC) of 0.899. The combination of high lipid content and tumour size improved the diagnostic accuracy (AUC-ROC 0.961, sensitivity 88.1% and specificity 92.3%). The probability of having a pheochromocytoma was 0.1% for adrenal lesions smaller than 20 mm showing high lipid content in CT. Ninety percent of non-PHEO presented loss of signal in the "out of phase" MRI sequence compared to 39.0% of PHEO (P < 0.001), but the specificity of this feature for the diagnosis of non-PHEO lesions low. In conclusion, our study suggests that sparing biochemical screening for pheochromocytoma might be reasonable in patients with adrenal lesions smaller than 20 mm showing high lipid content in the CT scan, if there are no typical signs and symptoms of pheochromocytoma.

Development of Thyroid Carcinoma During Treatment With Pembrolizumab in a Lung Cancer Patient.

Pembrolizumab, a programmed death 1 inhibitor, has been shown to have clinically significant efficacy in different types of cancer, providing long-term survival benefit for patients with lung cancer. Herein, we report the development of a primary thyroid cancer in a lung cancer patient that was being treated with pembrolizumab. Primary thyroid malignancy (and not only metastatic disease or immunotherapy-induced thyroiditis) should be considered in patients with lung cancer being treated with immune checkpoint inhibitors who develop new incidental thyroid lesions on imaging studies.

Carcinoma broncogénico extensamente cavitado simulando una hernia de hiato paraesofágica / Extensive Cavitary Lung Cancer Mimicking Paraesophageal Hiatal Hernia

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Prostatic Brachytherapy Seed Embolization to the Lung / Embolización Pulmonar De Una Semilla De Braquiterapia Prostática

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Cement fragment from hip arthroplasty causing deep femoral artery pseudoaneurysm.

An 81-year-old woman who had undergone total hip arthroplasty 12 years earlier presented with a painful spontaneous hematoma in the proximal left thigh. A left hip radiograph showed a displaced cement fragment from the acetabular component of the hip prosthesis. Computed tomography confirmed an extruded cement fragment causing a large pseudoaneurysm of the deep femoral artery. The patient underwent successful percutaneous embolization of the pseudoaneurysm with coils.

Edema pulmonar por presión negativa tras cirugía de hernia de disco cervical / Negative pressure pulmonary edema following cervical disc hernia surgery

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Realce vertebral secundario a congestión venosa en paciente con trombosis de la vena innominada: una causa de falsas metástasis óseas escleróticas / Vertebral Enhancement due to Venous Congestion in a Patient with Innominate Venous Thrombosis: A Cause of False Sclerotic Bone Metastases

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Bronquiolitis constrictiva tras trasplante de progenitores hematopoyéticos: importancia de la tomografía computarizada espiratoria / Bronchiolitis obliterans following hematopoietic stem cell transplantation: Importance of expiratory computed tomography

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Hipertensión arterial pulmonar secundaria a un drenaje venoso pulmonar anómalo parcial en una paciente anciana / Arterial pulmonary hypertension secondary to partial anomalous pulmonary venous return in an elderly patient

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