Gastric Ewing Sarcoma identified on a Meckel's scan.

Ewing Sarcoma is a malignant small round blue cell tumor most commonly found in bones and soft tissues of the axial skeleton and extremities. The Ewing family of tumors, including peripheral neuroectodermal tumor, represent the second most common malignancy in the pediatric population and second most common primary bone tumor after osteosarcoma. In a majority of Ewing Sarcoma cases, there is a translocation between chromosomes 11 and 22. Extraskeletal Ewing Sarcoma of the stomach is exceptionally rare, with only a handful of case reports. Here we report a case of primary Ewing Sarcoma of the stomach found initially as a filling defect in the stomach on technetium-99m pertechnetate scintigraphy to evaluate for gastrointestinal bleeding.

Exposure to, understanding of, and interest in interventional radiology in American medical students.

RATIONALE AND OBJECTIVES: The purposes of this study were to determine the degree to which medical students are exposed to interventional radiology (IR) in medical school, to assess their knowledge of the field, and to gauge their interest in IR as a career choice. MATERIALS AND METHODS: An institutional review board-approved survey was generated using the website www.surveymonkey.com. Medical student participation nationwide was elicited by sending e-mails to administrators of medical schools and radiology residency program directors and asking them to distribute the survey link to their students. RESULTS: Seven hundred twenty-nine medical students from 21 states responded to the survey. Although 58% of students said they were interested in a hands-on career, only 5.5% of students said they had participated in an IR rotation and only 12.7% were interested in IR. Less than half of the IR domain-related questions used to assess understanding of IR were answered correctly, with greater understanding found among the students who had participated in an IR rotation. CONCLUSIONS: Exposure to IR in accredited US medical education programs is inconsistent, although interest in the field is moderate among medical students compared with interest in other hands-on specialties. Understanding of IR is limited among the study population. Improved understanding of the field and recruitment could result from greater exposure.

Spindle-cell sarcoma of the popliteal fossa mimicking a benign vascular lesion.

Spindle-cell sarcomas are a group of aggressive malignant soft-tissue tumors with diverse clinical presentations. While some of these tumors may represent de novo malignant transformation of benign entities, others may present with a long indolent course before their invasive nature is apparent. We report the case of a previously healthy 73-year-old female with spindle-cell sarcoma of the left popliteal fossa who initially presented with a painless mass of several months' duration. Magnetic resonance imaging (MRI) suggested a benign vascular lesion/venous angioma, but after the patient's clinical course changed, repeat MRI 18 months later was consistent with an infiltrative soft-tissue malignancy/sarcoma. Excisional biopsy revealed a stage II spindle-cell sarcoma. The patient then underwent radiotherapy and subsequent above-the-knee amputation. Three years following the amputation, the patient is free of local tumor recurrence or metastatic disease.

Three dimensional active contours for the reconstruction of abdominal aortic aneurysms.

An aneurysm is a gradual and progressive ballooning of a blood vessel due to wall degeneration. Rupture of abdominal aortic aneurysm (AAA) constitutes a significant portion of deaths in the US. In this study, we describe a technique to reconstruct AAA geometry from CT images in an inexpensive and streamlined fashion. A 3D reconstruction technique was implemented with a GUI interface in MATLAB using the active contours technique. The lumen and the thrombus of the AAA were segmented individually in two separate protocols and were then joined together into a hybrid surface. This surface was then used to obtain the aortic wall. This method can deal with very poor contrast images where the aortic wall is indistinguishable from the surrounding features. Data obtained from the segmentation of image sets were smoothed in 3D using a Support Vector Machine technique. The segmentation method presented in this paper is inexpensive and has minimal user-dependency in reconstructing AAA geometry (lumen and wall) from patient image sets. The AAA model generated using this segmentation algorithm can be used to study a variety of biomechanical issues remaining in AAA biomechanics including stress estimation, endovascular stent-graft performance, and local drug delivery studies.

An unusual complication of an infiltrated intravenous catheter: heterotopic ossification in a newborn.

Heterotopic ossification refers to formation of lamellar bone in soft tissues. The etiology is diverse and includes genetic, post-traumatic, and metabolic causes. Elicitation of bone morphogenic proteins are thought to play a key role in the pathogenic process. Initially, heterotopic ossification presents a clinical and radiographic challenge in that it can be mistaken for other more worrisome entities which present with calcified soft tissue masses. However, a spontaneous clinical resolution, temporal relationship to an inciting agent, and radiographic evolution to a peripherally-calcified lesion are all clues to the diagnosis. Here we present the clinical and radiographic features of heterotopic ossification as a result of an infiltrated peripheral IV.