Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Otite Externa/diagnóstico por imagem , Nervo da Corda do Tímpano/diagnóstico por imagem , Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Neurilemoma/diagnóstico por imagem , Otite Externa/patologia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Nervo da Corda do Tímpano/patologia , Neoplasias dos Nervos Cranianos/patologia , Achados Incidentais , Neurilemoma/patologiaAssuntos
Nervo da Corda do Tímpano/diagnóstico por imagem , Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Neurilemoma/diagnóstico por imagem , Otite Externa/diagnóstico por imagem , Idoso de 80 Anos ou mais , Nervo da Corda do Tímpano/patologia , Neoplasias dos Nervos Cranianos/patologia , Humanos , Achados Incidentais , Imageamento por Ressonância Magnética , Masculino , Neurilemoma/patologia , Otite Externa/patologia , Tomografia Computadorizada por Raios XRESUMO
CONTEXT: Sinonasal paragangliomas have rarely been reported in the literature. They are often aggressive. PATIENT: We report an original case of sinonasal paragangliomas with a tumor recurrence diagnosed 13 years after resection of the primary tumor. Somatostatin receptor scintigraphy and [18F]-fluorodeoxyglucose positron emission tomography/computed tomography were the most sensitive functional imaging techniques, and they ruled out distant metastases. Interestingly, [18F]-fluorodihydroxyphenylalanine positron emission tomography/computed tomography was negative, a feature that may be considered a sign of functional dedifferentiation. Screening for germline mutations of the SDHB, SDHC, SDHD, SDHAF2, VHL, MAX, and TMEM127 was negative. CONCLUSION: The diagnosis of malignancy remains challenging at initial diagnosis, and patients should be followed during their entire lifetime.
Assuntos
Imagem Multimodal , Neoplasias Nasais/genética , Neoplasias Nasais/patologia , Paraganglioma/genética , Paraganglioma/secundário , Endoscopia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Nasais/cirurgia , Paraganglioma/cirurgia , Seios Paranasais , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: The aim of this study was to assess the feasibility of 64-slice coronary computed tomography (CT) angiography in patients treated by orthotopic liver transplantation, and to compare prognostic values of CT angiography and dobutamine stress echocardiography in the same population. METHODS: Eighty-two consecutive patients, without known coronary artery disease, who underwent orthotopic liver transplantation, were included in this study. A CT angiography was performed along with usual explorations including dobutamine stress echography. A one-year minimal follow-up was performed to seek cardiac events. RESULTS: Fifty-two (65.8%) patients underwent a CT angiography. Thirty-seven (71%) were totally normal or showed nonobstructive coronary plaque, six (12%) showed at least one obstructive coronary plaque greater than 50%. Nine (17%) of the examined patients had at least one nonassessable segment. A total of six (7.6%) major cardiac events occurred in a mean-time follow-up of 17.8 ± 12.7 months. CONCLUSION: CT angiography that is normal or with a nonobstructive coronary plaque has a negative predicting value of 95% [0.82-0.99] for major cardiac adverse events, and of 100% [0.91-1] for clinical coronary events in patients undergoing orthotopic liver transplantation. The prognostic value of CT angiography was comparable with that of dobutamine stress echography.
