Congruence and incongruence on the radiological and functional examination of inner ear hemorrhage.

BACKGROUND: Inner ear hemorrhage (IEH) is an increasingly recognized cochlear lesion that can cause sensorineural hearing loss (SNHL). Magnetic resonance imaging (MRI) is known to be the best imaging modality for clarifying the causes of SNHL and providing images that point to those causes. AIMS: Evaluate the lesional patterns in patients with presumed Inner ear hemorrhage (IEH) from radiological and functional aspects. MATERIAL AND METHODS: We retrospectively reviewed 10 patients performed in our institution from 2014 to 2020, with suspected labyrinthine hemorrhage based on radiological and functional examination. RESULTS: We included 8 patients with IEH and sensorineural hearing loss (SNHL). The median age was 55 years (range: 3 months - 78 years). The results from the MRI and functional tests were compared for each end-organ. Only three cases (37.5%) showed a correlation between signal abnormalities and dysfunction in the labyrinthine apparatus. CONCLUSIONS: In patients with SNHL inner ear hemorrhage needs to be ruled out in the differential diagnosis, so specific MRI sequences should be requested. It represents a way to a better understanding of the disorder and the variety of findings claim for a complete auditory and vestibular testing.

Challenging Diagnosis of Invasive Sinus Aspergillosis Mimicking Gradenigo's Syndrome in an Elderly Patient with T-Cell Lymphoma.

(1) Background: Gradenigo's Syndrome (GS) is a rare complication of acute otitis media characterized by the triad of diplopia, otitis, and facial pain. The widespread use of antibiotics has significantly reduced its occurrence. (2) Case summary: We present the case of an elderly patient with T-cell lymphoma who developed neurological deficits resembling GS. The patient was ultimately diagnosed with invasive sinus aspergillosis. The diagnostic process was challenging due to the atypical clinical presentation and the lack of specific imaging findings. A biopsy was the most important test for clarifying the diagnosis. (3) Conclusions: The prognosis for this complication is extremely poor without surgery, and the patient died despite adequate antifungal coverage. Therefore, maintaining high clinical suspicion is paramount to avoid adverse outcomes in similar cases, particularly in the geriatric population, wherein this syndrome's occurrence may not be expected.

Errores frecuentes en el diagnóstico mamográfico / Frequent mistakes in mammographic diagnosis

El error forma parte de nuestro trabajo y es importante aprender sobre él para evitarlo. Uno de los datos más llamativos repetidos en la literatura es que, en el contexto del cribado, entre un 25 y un 75% de los cánceres se pueden ver en las mamografías previas informadas como normales. Sin embargo, analizando con detenimiento las cifras, descubriremos que gran parte de esos cánceres visibles no informados se presentan con apariencia inespecífica o benigna, y por tanto no representan verdaderos errores. Es importante tener presente el concepto del cáncer visible pero no reconocible, para no considerar un error lo que en realidad no lo es. Del mismo modo, no debemos confundir los hallazgos inespecíficos (que objetivamente no indican cáncer) con los hallazgos sutiles (que objetivamente sí indican cáncer, aunque son difíciles de detectar). En la segunda parte de nuestro artículo repasaremos uno a uno, aportando soluciones para evitarlos, los 9 errores más frecuentemente citados en la literatura. Estos son (o se asocian a): el hallazgo en una proyección, la mala aplicación del BI-RADS, «la satisfacción de encontrar», el cáncer de crecimiento lento, la mama densa, benignidad junto a malignidad, el error de técnica o posición, la mala correlación entre pruebas de imagen y la mala correlación con el contexto clínico (AU)

Errors form part of our work and it is important to learn about them so that they can be avoided. One of the most striking findings repeated in the literature is that, in the context of screening, between 25% and 75% of cancers can be seen on previous mammograms reported as normal. However, careful analysis of the figures reveals that a large proportion of these visible non-reported cancers appear as non-specific or benign findings, and thus do not represent true errors. It is important to keep in mind the concept of visible but not recognisable cancer, in order not to mistakenly identify something as an error. Likewise, we should not confuse non-specific findings (which objectively do not suggest cancer) with subtle findings (which objectively do suggest cancer, although they are difficult to detect). In the second part of our article, we review, one-by-one, the nine errors most frequently cited in the literature and provide strategies for their avoidance. These are (or are associated with): one-view findings, incorrect use of BI-RADS, "satisfaction of search", slow-growing cancer, dense breasts, benignancy with malignancy, technical or positioning errors, poor correlation among imaging techniques, and poor correlation with the clinical context (AU)