Juvenile nasal angiofibroma significant locoregional involvement / [Angiofibroma nasal juvenil con importante afectación locorregional]

Juvenile nasal angiofibroma is a benign tumor characterized by abundant vascularization and a tendency to hemorrhage. Despite its benign histology, it can present locally expensive growth that usually presents bone remodeling and the mass effect of adjacent stuctures. We present the case of a 15-year-old patient who came to the emergency department of our center for recurrent epistaxis. After physical examination, it was decided to carry out imaging tests (CT an MRI) that reveal the presence of a large hypervascular mass in the right nostril and maxillary sinus. The patient undergoes surgery after embolization of the tumor.

El angiofibroma nasal juvenil es un tumor de carácter benigno, caracterizado por la vascularización abundante y tendencia a la hemorragia. A pesar de su histología benigna, puede presentar un crecimiento localmente expansivo que suele presentar una remodelación ósea y efecto masa de estructuras adyacentes. Se presenta el caso de un paciente de 15 años de edad, que acude al servicio de urgencias de nuestro centro por epistaxis de repetición. Tras la exploración física se deciden realizar pruebas de imagen (TC y RM) que ponen de manifiesto la presencia de una gran masa hipervascular en la fosa nasal derecha y seno maxilar. El paciente es intervenido quirurgícamente previa embolización del tumor.

Diagnosis of Glioblastoma by Immuno-Positron Emission Tomography.

Neuroimaging has transformed neuro-oncology and the way that glioblastoma is diagnosed and treated. Magnetic Resonance Imaging (MRI) is the most widely used non-invasive technique in the primary diagnosis of glioblastoma. Although MRI provides very powerful anatomical information, it has proven to be of limited value for diagnosing glioblastomas in some situations. The final diagnosis requires a brain biopsy that may not depict the high intratumoral heterogeneity present in this tumor type. The revolution in "cancer-omics" is transforming the molecular classification of gliomas. However, many of the clinically relevant alterations revealed by these studies have not yet been integrated into the clinical management of patients, in part due to the lack of non-invasive biomarker-based imaging tools. An innovative option for biomarker identification in vivo is termed "immunotargeted imaging". By merging the high target specificity of antibodies with the high spatial resolution, sensitivity, and quantitative capabilities of positron emission tomography (PET), "Immuno-PET" allows us to conduct the non-invasive diagnosis and monitoring of patients over time using antibody-based probes as an in vivo, integrated, quantifiable, 3D, full-body "immunohistochemistry" in patients. This review provides the state of the art of immuno-PET applications and future perspectives on this imaging approach for glioblastoma.

Neuroblastoma olfatorio. todo lo que el radiólogo debe saber / Olfactory Neuroblastoma. everything the Radiologist Should Know

Resumen El neuroblastoma olfatorio (NBO) es un tumor maligno poco frecuente que se origina de las células neuroepiteliales olfativas. Su diagnóstico precoz es difícil debido a la poca especificidad de los síntomas que presentan los pacientes. Las pruebas de imagen juegan un papel importante en su diagnóstico y en la planificación quirúrgica, por lo que es importante que los radiólogos conozcan sus hallazgos y las diferentes clasificaciones que ayudarán a elegir el tratamiento más adecuado para cada tumor.

Abstract Olfactory neuroblastoma (ONB) is a rare malignant tumor that originates from olfactory neuroepithelial cells. Its early diagnosis is difficult due to the low specificity of the symptoms. Imaging tests play an important role in its diagnosis and surgical planning so it is important that radiologists know their findings and the different classifications that will help to choose the most appropriate treatment for each tumor.

Carotid artery stenting in a single center, single operator, single type of device and 15 years of follow-up.

BACKGROUND: Revascularization with carotid stent (CAS) is considered the therapeutic alternative to endarterectomy (CEA). However, its role compared to CEA remains questioned, mainly due of the heterogeneity of long-term results. The objective of this study was to report the efficacy and durability of CAS in terms of stroke prevention in a "real world experience". METHOD: This was a single-center retrospective analysis of 344 patients treated with CAS between January 2001 and December 2015.The primary outcome of the trial was stroke, myocardial infarction, or death during a periprocedural period or any stroke event over a 15-year follow-up. The secondary aim was to identify risk factors for 30-day complications, long-term neurological complications, and intra-stent restenosis. RESULTS: The primary composite end point (any stroke, myocardial infarction, or death during the periprocedural period) was 2.3%. The use of an EPD was protective against major complications.Long-term follow-up was achieved in 294 patients (85,5%) with a median of 50 months (range 0-155 months). Fifty-six (16,3%) died within this period, most commonly of nonvascular causes (4 patients had stroke-related deaths). During the follow-up period, 8 strokes and 3 TIAs were diagnosed (3.2%).ISR determined by sequential ultrasound was assessed in 4.4% of the patients and remained asymptomatic in all but 2 patients (0.6%). All patients with restenosis underwent revascularization with balloon angioplasty. CONCLUSION: The long-term follow-up results of our study validate CAS as a safe and durable procedure with which to prevent ipsilateral stroke, with an acceptable rate of restenosis, recurrence and mortality.

Abdomen agudo por aneurisma disecante del tronco celíaco / Acute abdomen caused by a dissecting celiac trunk aneurysm

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Cefalea hemicraneal secundaria a una malformación arteriovenosa gigante / Hemicranial headache secondary to a giant cerebral arteriovenous malformation

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Encefalopatía por contraste: a propósito de un caso / Contrast-induced encephalopathy: a case report

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[Giant right adrenal myelolipoma]. / Mielolipoma suprarrenal derecho gigante.

OBJECTIVE: Adrenal myelolipoma is a rare benign tumor, well limited, variable in size, composed of fatty and hematopoietic tissues, the finding of which is usually incidental. If they reach a big size they may produce the feeling of abdominal mass, pain, neighbour organs compression and acute intratumoral or retroperitoneal hemorrhage. METHODS: We report the case of a 57-year-old male admitted to the hospital with acute abdominal pain. CT scan with i.v. contrast and adrenal biopsy were performed. RESULTS: Radiological findings: 9 x 10 cm right adrenal mass, well defined, hypodense, with a small calcification in its posterior area. Pathologic findings: benign tumor, encapsulated, with a mixture of mature fatty tissue and hematopoietic cells. CONCLUSIONS: The presence of fat within an adrenal mass is essential for the diagnosis. Differential diagnosis should be done with all adrenal tumors with a fat component. When no radiological diagnosis is made, pathologic confirmation is necessary.

Mielolipoma suprarrenal derecha gigante / Giant right adrenal myelolipoma

OBJETIVOS: El mielolipoma suprarrenal es un raro tumor benigno y bien delimitado de tamaño variable, compuesto por tejido adiposo y hematopoyético y que su hallazgo suele ser incidental. Si alcanzan gran tamaño pueden producir sensación de masa abdominal, dolor, compresión de órganos vecinos y hemorragia aguda intratumoral o retroperitoneal. MÉTODOS: Describimos el caso de un varón de 57 años cuyo motivo de ingreso fue un cuadro de dolor abdominal agudo. Se realiza tomografía computarizada (TC) con contraste IV y estudio anatomopatológico tras biopsia suprarrenal. RESULTADOS: Hallazgos radiológicos: masa suprarrenal derecha de 9x10 cm, de perfil nítido, hipodensa, con pequeña calcificación en su zona posterior. Hallazgos de anatomía patológica: tumoración benigna, encapsulada, mezcla de tejido adiposo maduro y células hematopoyéticas. CONCLUSIONES: La presencia de grasa en una masa suprarrenal es imprescindible en el diagnóstico. El diagnóstico diferencial debe hacerse con aquellos tumores suprarrenales de contenido graso. En caso de no realizarse un diagnóstico radiológico, es necesaria la confirmación anatomopatológica

OBJECTIVE: Adrenal myelolipoma is a rare benign tumor, well limited, variable in size, composed of fatty and hematopoietic tissues, the finding of which is usually incidental. If they reach a big size they may produce the feeling of abdominal mass, pain, neighbour organs compression and acute intratumoral or retroperitoneal hemorrhage. METHODS: We report the case of a 57-year-old male admitted to the hospital with acute abdominal pain. CT scan with IV contrast and adrenal biopsy were performed. RESULTS: Radiological findings: 9 x 10 cm right adrenal mass, well defined, hypodense, with a small calcification in its posterior area. Pathologic findings: benign tumor, encapsulated, with a mixture of mature fatty tissue and hematopoietic cells. CONCLUSIONS: The presence of fat within an adrenal mass is essential for the diagnosis. Differential diagnosis should be done with all adrenal tumors with a fat component. When no radiological diagnosis is made, pathologic confirmation is necessary

Hematoma intramural colónico secundario a traumatismo abdominal

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