Unusual Manifestation of Extraosseous Ewing Sarcoma: Report of 3 Cases.

Ewing sarcoma (ES), described as a diffuse endothelioma of the bone, is divided into two categories: osseous and extraosseous, which mainly affects adolescents. Extraosseous Ewing Sarcomas (EES) are rare tumors originating from soft tissues. Their clinical presentation depends mainly on the primary location of the tumor and are highly chemosensitive and radiosensitive. The purpose of this study was to describe the clinical characteristics and outcomes of 3 children with EES and uncommon presentation treated in our Unit. The diagnosis of EES was confirmed by biopsy and cytogenetic analysis with fluorescence in situ hybridization (FISH). Surgical excision was planned as primary treatment, followed by adjuvant chemotherapy according to EURO-E.W.I.N.G protocol. To date, all patients are alive, 1, 3 and 4 years after completion of treatment, with no signs of recurrence or metastasis.

Left atrial appendage pericardial fluid: contrast-enhanced transesophageal echocardiography makes it visible.

BACKGROUND: Contrast-enhanced transesophageal echocardiography (TEE) for the opacification of left atrial appendage (LAA) is not clearly suggested by the current guidelines and only scarce data are available. CASE PRESENTATION: A patient with a membrane-like structure in the LAA cavity is presented. Contrast-enhanced TEE revealed LAA pericardial effusion and this diagnosis was confirmed by cardiac magnetic resonance that offered comparable images and tissue characterization. CONCLUSION: Contrast-enhanced TEE has been demonstrated to safely and accurately enlighten LAA anatomy. Hippokratia 2016, 20(3): 235-237.

Diffusion Tensor Imaging in brain tumors: A study on gliomas and metastases.

PURPOSE: To explore the role of Diffusion Tensor Imaging in preoperative glioma grading, as well as in differentiation between gliomas and metastatic brain tumors. We measured diffusion tensor variables in enhancement and edema regions, which were compared between the different subject groups. MATERIALS AND METHODS: We performed DTI in 48 patients (11 Low Grade Gliomas, 27 High Grade Gliomas, 10 Single Metastatic brain tumors). We measured FA, λ1, λ2, λ3, ADC, Cl, Cp, Cs, RA, and VR in enhancing portions of tumors and edema regions. Additionally, ratios of enhancement to edema values were created for each variable. RESULTS: In peritumoral edema, Cl and RA were proven to be significantly different in pair-wise comparisons, in addition to ADC, Cp, Cs and VR in enhancement regions. Enhancement to edema values were significantly different as well. CONCLUSION: Diffusion tensor indices could be used for the differentiation between low and high grade gliomas, as well as for distinction between gliomas and metastases.

Idiopathic acute transverse myelitis: Complete recovery after intravenous immunoglobulin.

Idiopathic acute transverse myelitis is a focal inflammatory disorder of the spinal cord of unknown etiology diagnosed according to established criteria. As it occurs rarely in children herein we report a case of a 4 year old boy who developed clinical and radiological manifestations of myelitis, 10 days after a recent respiratory tract infection. Diagnostic workup failed to reveal a causative factor. After the administration of corticosteroids a clinical deterioration was observed and intravenous immunoglobulin was administered. Symptoms resolved within a 48-hour period, suggesting an immune-mediated pathogenetic mechanism.

False aneurysm of the proper palmar digital artery--report of a case.

A case of false aneurysm of the radial proper palmar digital artery located in the tip of the right index finger is presented. The aneurysm was the result of blunt trauma and the diagnosis was made by contrast enhanced magnetic resonance angiography. The patient was treated by ligation and resection of the aneurysm.

Perforated diverticulum of the caecum. A difficult preoperative diagnosis. Report of 2 cases and review of the literature.

BACKGROUND: Perforation of a solitary caecal diverticulum is a rare cause of acute abdomen and an uncommon differential diagnosis for acute appendicitis. Nine hundred cases have been described since Potiers' first description of perforated caecal diverticulum in 1912. METHODS: We describe 2 cases of perforated diverticulum of the caecum. The first patient was a 50-year-old man diagnosed by subsequent histology, and the second a 77-year-old woman diagnosed intra-operatively. Radiography, ultrasound and CT scan of the abdomen pointed at the diagnosis in the second case. A right hemicolectomy was performed. RESULTS: There were no complications, apart from a transient faecal fistula in the first patient managed conservatively. In both patients histology revealed a perforated caecal diverticulum. CONCLUSIONS: The surgeon must be familiar with the diagnosis and management of this rare, inflammatory benign caecal entity.