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1.
J Card Surg ; 36(11): 4393-4395, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34390269

RESUMO

A serious complication of transcatheter valves is the mechanistic failure of the deployment system and prosthesis migration. We report the case of a transcatheter aortic valve implantation which failed during implantation resulting in dislodgement of the prosthesis. Emergency surgery to retrieve the deployment system and surgically replace the native valve was the only option to salvage the patient.


Assuntos
Estenose da Valva Aórtica , Calcinose , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Substituição da Valva Aórtica Transcateter , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Calcinose/diagnóstico por imagem , Calcinose/cirurgia , Humanos , Desenho de Prótese , Falha de Prótese , Substituição da Valva Aórtica Transcateter/efeitos adversos
2.
Am J Cardiol ; 152: 165-167, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34162483

RESUMO

Standard operative mitral valve replacement for mitral stenosis in the setting of severe mitral annular calcium has been associated with increased morbidity and mortality. Inability to ensure a well seated prosthesis may lead to periprosthetic leak. We present a case of severe paravalvular leak, causing significant hemolysis, after mitral valve replacement with underling severe mitral annular calcium. The leak was successfully repaired using a transseptal percutaneous approach, with subsequent resolution of hemolysis.


Assuntos
Calcinose/cirurgia , Cateterismo Cardíaco/métodos , Implante de Prótese de Valva Cardíaca , Estenose da Valva Mitral/cirurgia , Complicações Pós-Operatórias/cirurgia , Idoso , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/cirurgia , Bioprótese , Calcinose/complicações , Ecocardiografia Transesofagiana , Próteses Valvulares Cardíacas , Hemólise , Humanos , Masculino , Valva Mitral/cirurgia , Estenose da Valva Mitral/etiologia , Complicações Pós-Operatórias/diagnóstico por imagem , Falha de Prótese , Reoperação
3.
Acta Orthop Traumatol Turc ; 55(3): 281-284, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34100372

RESUMO

We, herein, presented a rare case of bilateral brachial artery infiltration by tumoral calcinosis located on both elbows. A 58-yearold man presented with a history of painless, palpable solid mass restricting the range of motion of both elbows. These masses were located on the anterior aspect of the elbows and gradually enlarged. After clinical, laboratory and radiological examinations, tumoral calcinosis was suspected, and excisional biopsy was planned for a definite diagnosis. Surgery was first performed on the left elbow. The median nerve was found to be compressed but not infiltrated by the mass. Interestingly, the brachial artery was totally infiltrated throughout the entire mass. Occlusion was observed in the brachial artery located within the mass. The tumor on the left elbow, 8.5 × 5.5 × 2.5 cm in size, was totally excised with approximately 12-cm brachial artery segment. The artery was resected until the healthy tissue was reached. The defect was reconstructed with saphenous vein graft obtained from the ipsilateral lower extremity. The same surgical procedure was performed on the right elbow after 3 months. The tumor size on the right elbow was 7 × 3.5 × 1.7 cm. Approximately 15-cm brachial artery segment was excised, and the defect was reconstructed with saphenous vein graft. Tumoral calcinosis is a rare benign condition that can be located in close relationship with neurovascular structures. In such cases, detailed neurologic and vascular examination, including imaging modalities, for arterial flow is essential to establish a more accurate surgical plan and avoid any unexpected situation during surgery.


Assuntos
Artéria Braquial , Calcinose , Descompressão Cirúrgica/métodos , Articulação do Cotovelo , Nervo Mediano , Veia Safena/transplante , Enxerto Vascular/métodos , Arteriopatias Oclusivas/diagnóstico , Arteriopatias Oclusivas/fisiopatologia , Arteriopatias Oclusivas/cirurgia , Artéria Braquial/patologia , Artéria Braquial/cirurgia , Calcinose/diagnóstico , Calcinose/fisiopatologia , Calcinose/cirurgia , Dissecação/métodos , Articulação do Cotovelo/irrigação sanguínea , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/inervação , Articulação do Cotovelo/cirurgia , Humanos , Masculino , Nervo Mediano/patologia , Nervo Mediano/cirurgia , Pessoa de Meia-Idade , Radiografia/métodos , Amplitude de Movimento Articular , Resultado do Tratamento
4.
J Clin Neurosci ; 89: 20-25, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34119267

RESUMO

PURPOSE: To quantify calcification in spinal meningiomas using Hounsfield unit (HU) values on CT, and to analyze the characteristics of cases with and without calcification and with different histologic subtypes. METHODS: The subjects were 53 patients who underwent surgical resection of spinal meningioma between January 1999 and December 2019. Clinical and surgical data were collected, and all patients were examined neurologically preoperatively and at final follow-up using the modified McCormick scale and the American Spinal Injury Association scale. Calcification was quantified on CT of the spine prior to surgery. A HU value >60 was considered to indicate calcification. RESULTS: The 53 patients (11 males, 42 females) were aged 62.4 ± 14.3 (range 19 to 91) years at surgery, and had a symptom duration of 10.8 ± 9.0 (1-36) months. The histological type was meningothelial in 35 cases, psammomatous in 13, and others in 5. The mean tumor volume was 1166 ± 350 (593-2176) mm3, and the mean HU value was 212.2 ± 192.8 (43-648). Forty cases (75%) had calcification (HU value > 60). HU values were significantly related to duration of symptoms (R = 0.590, p < 0.05) and significantly higher in psammomatous cases (p < 0.05). Cases with calcification had longer operative times and greater blood loss, and a significantly lower rate of neurological improvement. CONCLUSION: CT was effective for detecting calcification based on HU values. Detection of a HU value > 60 in spinal meningioma may be useful to narrow the differential diagnosis, evaluate the difficulty of resection, and improve intraoperative management, all of which may improve outcomes.


Assuntos
Calcinose/diagnóstico por imagem , Calcinose/cirurgia , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/cirurgia , Carga Tumoral , Adulto Jovem
5.
BMC Cardiovasc Disord ; 21(1): 315, 2021 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-34182931

RESUMO

BACKGROUND: Our goal was to determine the accuracy of 3-dimensional transesophageal echocardiography (3D-TEE) compared with that of computed tomography (CT) in the preoperative evaluation for transcatheter aortic valve replacement (TAVR) when the errors caused by inconsistent software and method have been eliminated and the representativeness of the sample has been improved. We also investigated the influence of aortic root calcification on the accuracy of 3D-TEE in aortic annulus evaluations. METHODS: Part I: 45 of 233 patients who underwent TAVR in the department of cardiovascular surgery at the Xijing hospital from January 2016 to August 2019 were studied retrospectively. Materialise Mimics software and the multiplanar reconstruction method were used for evaluation, based on 3D-TEE and CT. The annulus area-derived diameter, the annulus perimeter-derived diameter (Dp), the annulus mean diameter, the left ventricular outflow tract Dp diameter, the sinotubular junction (STJ) diameter-Dp, and the aortic sinus diameter were compared and analyzed. Part II: 31 of 233 patients whose 3D-TEE and CT data were well preserved and in the required format were included. HU450 and HU850 were used as indicators to measure the severity of calcification. The Spearman rank correlation and Linear regression were used to analyze the correlation between aortic root calcification and the accuracy of 3D-TEE in aortic annulus measurement. RESULTS: The measurement results based on 3D-TEE were significantly lower than those obtained using CT (P < 0.05), except for the STJ diameter-Dp in diastole (P = 0.11). The correlation coefficient of the two groups was 0.699-0.954 (P < 0.01), which also indicated a significant correlation between the two groups. A Bland-Altman plot showed that the ordinate values were mostly within the 95% consistency limit; the consistency of the two groups was good. By establishing the linear regression equation, the two groups can be inferred from each other. The Spearman rank correlation analysis and the Linear regression analysis showed that the influence of aortic calcification on the accuracy of the 3D-TEE annulus evaluation was limited. CONCLUSIONS: Although an evaluation based on 3D-TEE underestimated the results, we can deduce CT results from 3D-TEE because the two methods exhibit considerable correlation and consistency. TRIAL REGISTRATION: Name: Surgery and Transcatheter Intervention for Structural Heart Diseases. Number: NCT02917980. URL: https://clinicaltrials.gov/ct2/results?term=NCT02917980 .


Assuntos
Insuficiência da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/diagnóstico por imagem , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/patologia , Calcinose/diagnóstico por imagem , Ecocardiografia Tridimensional , Ecocardiografia Transesofagiana , Substituição da Valva Aórtica Transcateter , Idoso , Valva Aórtica/fisiopatologia , Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/cirurgia , Estenose da Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/cirurgia , Calcinose/fisiopatologia , Calcinose/cirurgia , Tomada de Decisão Clínica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
6.
Kyobu Geka ; 74(2): 134-137, 2021 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-33976020

RESUMO

Calcified amorphous tumor (CAT) is a nonneoplastic cardiac tumor that can be located in any of the four cardiac chambers, but is predominantly detected on the mitral valve. We report a rare case of CAT originating from the mitral and aortic valves. A 69-year-old woman with end-stage renal disease, hypertension, and diabetes mellitus was referred to our hospital for the evaluation of cardiac masses found incidentally on screening transthoracic echocardiography. She had no symptoms, including fever and neurological deficits, and her blood cultures were negative. Echocardiography revealed mobile masses arising from the mitral and aortic valves. We performed surgical excision and histopathologically diagnosed the masses with cardiac CATs. Mobile and pedunculated CAT frequently causes systemic embolization, and thus, complete surgical excision is recommended in such a case.


Assuntos
Calcinose , Neoplasias Cardíacas , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Calcinose/diagnóstico por imagem , Calcinose/cirurgia , Ecocardiografia , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia
7.
Int Heart J ; 62(3): 682-686, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34054003

RESUMO

Usage of an optimal guide extension catheter often helps successful outcomes in complex percutaneous coronary intervention. Here, we report a case of successfully retrieving a guide extension catheter entrapped by a coronary stent in the middle RCA. The guide extension catheter was retrieved by anchoring with the stent delivery balloon. Also, our in vitro experiment demonstrated that a "deep seating method" and an "anchoring guide extension catheter method" could be effective in bailing out guide extension catheter entrapment.


Assuntos
Reestenose Coronária/cirurgia , Vasos Coronários/patologia , Intervenção Coronária Percutânea/efeitos adversos , Stents/efeitos adversos , Idoso de 80 Anos ou mais , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/métodos , Calcinose/cirurgia , Cateteres/efeitos adversos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Remoção de Dispositivo/métodos , Humanos , Masculino , Intervenção Coronária Percutânea/métodos , Resultado do Tratamento
11.
Int Heart J ; 62(2): 264-273, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33731525

RESUMO

Drug-eluting stent (DES) is well known to be effective in severely calcified lesion after rotational atherectomy (ROTA). However, there are still some situations when stents should be avoided and plain old balloon angioplasty (POBA) should be the preferred option. The present study aims to explore whether POBA is comparably effective to DES in large and calcified coronary pretreated by ROTA in clinical outcomes.Consecutive patients treated for severely calcified lesions in the large (≥ 3 mm) coronary using ROTA + DES or ROTA + POBA were retrospectively analyzed. The major adverse cardiac events (MACE), including all-cause/cardiac death and target lesion revascularization (TLR) at 1 year and 2 years posttreatment, were compared between groups using the Cox regression analysis to identify independent predictors of TLR and MACE.The analysis included 285 cases in the ROTA + DES group and 47 cases in the ROTA + POBA group, without relevant differences in clinical baseline characteristics. Of note, lesion length was greater in the ROTA + DES group (37.2 versus 19.3 mm, P < 0.001); the ROTA + DES group had a higher rate of chronic total occlusion (CTO) lesions, with 8.4%, and the ROTA + POBA group had none. The inhospital/30-day mortality rate (5.3%, ROTA + DES; 6.4%, ROTA + POBA) and the 12- and 24-month all-cause/cardiac mortality rate (9.3%, ROTA + DES; 7.7%, ROTA + POBA) were not significantly different between the two groups. TLR rates were not significantly different between the two groups at 12 (4.6%, ROTA + DES; 4.3%, ROTA + POBA) and 24 (5.3%, ROTA + DES; 6.4%, ROTA + POBA) months.Outcomes were comparable for ROTA + DES and ROTA + POBA in severely calcified large coronary artery intervention with respect to midterm death or TLR rate, especially for short lesion of < 20 mm.


Assuntos
Angioplastia Coronária com Balão/métodos , Aterectomia Coronária/métodos , Calcinose/cirurgia , Doença da Artéria Coronariana/cirurgia , Stents Farmacológicos , Idoso , Calcinose/diagnóstico , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Desenho de Prótese , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
12.
Artigo em Inglês | MEDLINE | ID: mdl-33691046

RESUMO

Mitral valve surgery can be especially difficult in patients with mitral annular calcification. Not only is it associated with higher morbidity and mortality, but there is no consensus strategy for the treatment of mitral annular calcification, which may render some patients inoperable. We describe a case of severe mitral annular calcification successfully treated with the cavitron ultrasonic surgical aspirator.   We demonstrate the proper technique for and the efficacy of using this instrument for decalcification of the mitral annulus. The video tutorial includes the patient presentation, preoperative and postoperative imaging, and the proper surgical technique for cavitron ultrasonic surgical aspirator-assisted mitral annular decalcification. With the proper technique, the cavitron ultrasonic surgical aspirator may mitigate the risk of surgical complications associated with severe calcification of the mitral annulus.


Assuntos
Calcinose/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Doenças das Valvas Cardíacas/cirurgia , Valva Mitral/cirurgia , Procedimentos Cirúrgicos Ultrassônicos/métodos , Idoso , Feminino , Humanos , Período Pós-Operatório , Resultado do Tratamento
13.
Clin Podiatr Med Surg ; 38(2): 165-181, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33745649

RESUMO

Calcification of the posterior portion of the calcaneus has numerous terms that refer to this pathology. Given the number of names, there can be confusion when discussing the different pathologies involving calcification at the insertion of the Achilles tendon at the calcaneus. Two of the diagnosis that can be confused with each other are Haglund's deformity and Achilles insertional calcific tendinosis. This article discusses how these 2 entities are differentiated clinically and how their surgical management is different.


Assuntos
Tendão do Calcâneo , Calcâneo , Calcinose/diagnóstico , Tendinopatia/diagnóstico , Tendão do Calcâneo/diagnóstico por imagem , Tendão do Calcâneo/cirurgia , Bursite/diagnóstico , Bursite/cirurgia , Calcâneo/diagnóstico por imagem , Calcâneo/cirurgia , Calcinose/cirurgia , Diagnóstico Diferencial , Calcanhar/diagnóstico por imagem , Humanos , Tendinopatia/cirurgia
14.
Vet Ophthalmol ; 24(2): 203-208, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33544454

RESUMO

This report describes the clinical features, histopathology, and surgical treatment of a case of conjunctival calcification in a 5-month-old female English Setter, referred with a history of recurrent conjunctivitis in the right eye (OD). The ophthalmic findings were limited to multifocal white plaques embedded in a markedly inflamed conjunctiva of the eyelids and the anterior nictitating membrane OD. Calcification was suspected. The blood cell count, blood chemical profile, and urinalysis were within normal limits, and long-bone radiographs appeared normal. After removal of the affected area by means of a large conjunctivectomy, cryopreserved canine amniotic membrane (AM) was transplanted to fill in the defect. Multifocal ectopic calcium deposits in the conjunctival lamina propria were confirmed histopathologically. The postoperative healing was uneventful, and no recurrence was observed during a follow-up period of five years. Conjunctival mineralization is uncommon in canine ophthalmology, and the cause remained undetermined in the present case, for which AM transplantation was able to promote conjunctival healing after a large surgical excision.


Assuntos
Âmnio/transplante , Calcinose/veterinária , Doenças da Túnica Conjuntiva/veterinária , Doenças do Cão/cirurgia , Animais , Calcinose/cirurgia , Terapia Combinada , Doenças da Túnica Conjuntiva/cirurgia , Cães , Feminino
15.
J Stroke Cerebrovasc Dis ; 30(5): 105665, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33631476

RESUMO

OBJECTIVES: Neurological complications associated with transcatheter aortic valve implantation (TAVI) are important due to its morbidity and mortality risks. The purpose of this study was to investigate the importance of the features of the aortic valve and ascending aorta to predict the neurological complications associated with TAVI. METHODS: The patients for whom the heart team decided to perform TAVI were included in the study. In order to assess possible neurological complications, cerebral diffusionweighted magnetic resonance imaging(MRI) was performed pre- and post-operatively. The diameter of the patients' aortic root and ascending aorta, aortic valve scores, intima media thickness of the ascending aorta were measured from their transesophageal echocardiography records. RESULTS: A total of 108 patients constituted the study population. 31 patients were found to develop a new lesion (MR+) detected on MRI after TAVI, while 76 patients did not have any new lesions (MR-). The groups did not have any significant differences in their aortic valve features and scores. However, AA-IMT was found to be higher in the MR+ group (1.8mm [1.6-2.3] vs 1.4mm [1.2-1.8] interquartile range). The multivariate logistic regression analysis conducted to detect new lesions revealed that AA-IMT led to a significantly increased risk. CONCLUSION: The features of the ascending are more important than the demographic characteristics of patients and features of the native valve in predicting new lesions on MRI scans and thus neurological events after TAVI.


Assuntos
Aorta/diagnóstico por imagem , Doenças da Aorta/complicações , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/patologia , Valva Aórtica/cirurgia , Calcinose/cirurgia , Transtornos Cerebrovasculares/etiologia , Ecocardiografia Transesofagiana , Substituição da Valva Aórtica Transcateter/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Doenças da Aorta/diagnóstico por imagem , Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/diagnóstico por imagem , Calcinose/complicações , Calcinose/diagnóstico por imagem , Transtornos Cerebrovasculares/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Resultado do Tratamento
16.
Medicine (Baltimore) ; 100(7): e24801, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607842

RESUMO

RATIONALE: Orbital schwannoma is a relatively rare orbital tumor, and calcification of the lesion is rarely found in the orbit. We report a case of orbital schwannoma which was characterized by calcification in the orbital muscle cone, and was cured by intracapsular excision. PATIENT CONCERNS: A 54-year-old female with a complaint of a mass in the left orbit during a magnetic resonance imaging examination and symptom of dizziness 6 months before, presented with painless exophthalmos and vision decline in the left eye. DIAGNOSES: According to clinical manifestations, imaging examinations and postoperative immunohistochemical examinations, the diagnosis was orbital schwannoma, with calcification in the muscle cone. INTERVENTIONS: The patient was treated by intracapsular excision of the left orbit. We removed the intracapsular mass and most part of the cyst wall in order to prevent orbital apex syndrome. OUTCOMES: The diagnosis of schwannoma with calcification was confirmed finally through histological and immunohistochemical exam. The patient was followed up for 28 months and the orbital CT scan showed that there were no significant lesions found in the orbital muscle cone. LESSONS: Understanding clinical, imaging diagnostic, and histopathological features of rare orbital schwannoma with calcification will facilitate timely diagnosis and treatment of this condition. The intracapsular excision can help in avoiding complications.


Assuntos
Calcinose/cirurgia , Neurilemoma/cirurgia , Neoplasias Orbitárias/cirurgia , Calcinose/complicações , Calcinose/diagnóstico por imagem , Calcinose/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neurilemoma/complicações , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/patologia , Neoplasias Orbitárias/complicações , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/patologia
19.
Sci Rep ; 11(1): 129, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33420200

RESUMO

This study aims to evaluate the diagnostic accuracy of digital breast tomosynthesis-guided vacuum assisted breast biopsy (DBT-VABB) of screening detected suspicious mammographic abnormalities comprising of calcifications, asymmetric densities, architectural distortions and spiculated masses. In this institutionally approved study, a total of 170 (n = 170) DBT-VABB were performed, 153 (90%) were for calcifications, 8 (4.7%) for spiculated mass, 5 (2.9%) for asymmetric density and 4 (2.4%) for architectural distortion. All these lesions were not detected on the corresponding ultrasound. Histopathology results revealed 140 (82.4%) benign, 9 (5.3%) borderline and 21 (12.4%) malignant lesions. The total upgrade rate at surgery was 40% for atypical ductal hyperplasia and 5.9% for ductal carcinoma in-situ. 3.6% discordant benign lesions showed no upgrade. DBT-VABB showed 100% specificity, 91.3% sensitivity and 100% positive predictive value (PPV) for detecting malignant lesions. The negative predictive value (NPV) was 80%. 2 (1.2%) patients had mild complications and 1 (0.6%) had severe pain. Our study showed that DBT-VABB was a safe and reliable method, with high sensitivity, specificity, PPV and NPV in the diagnosis of non-palpable benign and malignant breast lesions. Our data also confirmed the accuracy of DBT-VABB in detecting malignant lesions and we suggest further surgical excision in borderline lesions for a more accurate diagnostic evaluation.


Assuntos
Biópsia/métodos , Mama/diagnóstico por imagem , Detecção Precoce de Câncer/métodos , Mamografia/métodos , Adulto , Idoso , Biópsia/instrumentação , Mama/patologia , Mama/cirurgia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Calcinose/diagnóstico por imagem , Calcinose/patologia , Calcinose/cirurgia , Estudos Transversais , Detecção Precoce de Câncer/instrumentação , Feminino , Humanos , Mamografia/instrumentação , Pessoa de Meia-Idade , Estudos Retrospectivos , Ultrassonografia/métodos
20.
World Neurosurg ; 148: 165-176, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33508489

RESUMO

Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare tumefactive lesion that can develop anywhere within the neuraxis. The incidence is likely underreported, given its nonspecific imaging features and because CAPNON has often been overwhelmed by the presence of comorbid disease. CAPNON is typically diagnosed by the histopathological examination findings. However, the histopathological diagnosis is often challenging owing to the existence of similar calcifying pathological entities. Although the pathogenesis of CAPNON has remained elusive, emerging evidence supports a reactive proliferative and immune-mediated process involving the aggregation of neurofilament light chain protein and the infiltration of immune cells. The management of CAPNON is largely dependent on the symptoms, which are mainly related to the location and associated mass effects. Maximal surgical resection will result in excellent patient outcomes with rare recurrence, especially in patients presenting with epilepsy. The discovery of neurofilament light chain protein within CAPNON suggests that neurofilament might be implicated in the pathogenesis of CAPNON, serve as an immunohistochemical marker to improve the diagnostic accuracy of CAPNON, and hold therapeutic potential for the treatment of CAPNON.


Assuntos
Encefalopatias/cirurgia , Calcinose/cirurgia , Procedimentos Neurocirúrgicos/métodos , Encefalopatias/diagnóstico , Encefalopatias/patologia , Calcinose/diagnóstico , Calcinose/patologia , Humanos , Imuno-Histoquímica , Neoplasias , Síndrome
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