RESUMO
Osteoid osteoma and simple bone cyst are readily observed in long bones, but are much less common in the short bones of the foot. The association of these two tumors in the same foot is exceptional. We report the case of a 15-year-old girl who presented an osteoid osteoma of the talus and a simple bone cyst of the calcaneus of the left foot. The patient complained of pain in the rear foot for four months which worsened at night and was of the inflammatory type. The physical examination was normal. Standard x-rays revealed a simple bone cyst in the calcaneus which could not explain the nighttime inflammatory pain. Scintigraphy and computed tomography of the left foot revealed an osteoid oseoma of the talus. Biopsy total resection of the osteoid osteoma with curettage and filling with cancellous bone of the simple bone cyst were performed. The patient has been free of recurrence at three years follow-up.
Assuntos
Cistos Ósseos/complicações , Neoplasias Ósseas/complicações , Calcâneo , Osteossarcoma/complicações , Tálus , Adolescente , Feminino , HumanosRESUMO
OBJECTIVE: A maxillofacial location of a hydatid cyst is rare, accounting 2% of cases. The purpose of this study was to review clinical and radiological features by emphasizing diagnostic difficulties. MATERIALS AND METHODS: Two observations of hydatid cyst with a maxillofacial location are presented. Two cases were investigated by panoramic dental radiography, an ultrasound and CT scan. MRI was done in one case. RESULTS: The first observation reports a 23-year-old woman who consulted for jugal tumefaction with pharyngeal extension evolving in spurts. The second observation was a 16-year-old girl, which consulted for a genian and masseter tumefaction with a tight trismus. In both cases, the imaging studies suggested the diagnosis of the hydatid cyst confirmed by the anatomopathologic exam. CONCLUSION: The hydatid cyst is an endemic parasitic pathology involving most often the lung and the liver. The maxillofacial location is exceptional. In cases of a cyst mass in an endemic zone, the diagnosis of the hydatid cyst must be entertained. CT scan and MRI provided a complete lesion workup. Treatment is surgical.
Assuntos
Equinococose/patologia , Equinococose/cirurgia , Maxila/patologia , Maxila/cirurgia , Adolescente , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Cirurgia Bucal/métodosRESUMO
Retrovesical hydatid cyst is rare, even in endemic regions. From a presentation of three cases, the authors will review the clinical findings and illustrate the imaging features of this pathology and relate diagnostic and therapeutic difficulties.
Assuntos
Equinococose/diagnóstico , Doenças Peritoneais/parasitologia , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Criança , Pré-Escolar , Escavação Retouterina/parasitologia , Equinococose/cirurgia , Feminino , Humanos , Doenças Peritoneais/cirurgia , Tomografia Computadorizada por Raios X , Bexiga UrináriaRESUMO
The authors report the case of a 48-year-old man with a history of coronary bypass graft 15 years earlier. The follow-up by routine chest radiography showed a right paracardiac opacity, which MRI conformed to be an aneurysm of the saphenous vein graft.
Assuntos
Aneurisma/etiologia , Ponte de Artéria Coronária , Complicações Pós-Operatórias , Veia Safena/patologia , Veia Safena/transplante , Aneurisma/patologia , Doença da Artéria Coronariana/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeRESUMO
Arterial involvement in Behçet's disease is rare. It represents one of the fashions of expression of this pathology. We report an observation of a 32-year-old man who was hospitalised for an intense abdominal pain. Doppler ultrasound and computed angiography showed a superior mesenteric artery aneurysm. The patient was operated in urgency and operating suites were simple. The etiologic inquiry of this aneurysm ended in the diagnosis of Behçet disease. The result underline the need to search for Behçet's disease in all cases of arterial involvement in young patient. The treatment of the aneurysm should not be delayed.
Assuntos
Aneurisma/etiologia , Síndrome de Behçet/complicações , Artéria Mesentérica Superior , Adulto , Síndrome de Behçet/diagnóstico , Humanos , MasculinoRESUMO
OBJECTIVES: To clarify the contribution of the doppler and the CT in the balance aetiology of a fever of the post-partum and to connect it with a thrombophlebitis of ovarian vein. PATIENTS AND METHODS: Five patients presented there post-partum a fever with pointed abdominal painful syndrome. A doppler and a CT were performed. RESULTS: Doppler showed a hypoechoic tubular structure located forward and laterally with regard to the psoas with a flat spectre in pulsed Doppler in every case. CT confirmed the diagnosis of a thrombophlebitis of the right ovarian vein in three cases and left in two cases. Evolution after anticoagulation and an antibiotic therapy was favourable with regression of clinical signs and doppler evaluation. CONCLUSION: In front of any fever of the post-partum, it is necessary to evoke a thrombophlebitis of the vein ovarian, although it is about a rare aetiology. In spite of the superiority of the CT-scan and RP imaging for such a diagnosis, doppler is a simple and reproducible diagnostic tool for the monitoring which must be practised in first intention.
Assuntos
Febre/etiologia , Doenças Ovarianas/complicações , Tromboflebite/complicações , Dor Abdominal/etiologia , Adulto , Cefotaxima/uso terapêutico , Cefalosporinas/uso terapêutico , Feminino , Febre/diagnóstico por imagem , Humanos , Doenças Ovarianas/diagnóstico por imagem , Ovário/irrigação sanguínea , Ovário/diagnóstico por imagem , Período Pós-Parto , Fluxo Sanguíneo Regional/fisiologia , Tromboflebite/diagnóstico por imagem , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
PURPOSE: We present the various imaging features of pediatric pulmonary hydatidosis based upon a series of 232 cases. The importance of chest radiographs and thoraco-abdominal ultrasound is emphasized. PATIENTS AND METHODS: A retrospective study of 232 children with pulmonary hydatidosis is presented. The 232 cases (130 boys and 102 girls, age range: 18 months to 14 years) were studied between January 1982 and December 2001. Chest radiographs were available in all cases, chest ultrasound in 156 cases and abdominal ultrasound in 212 cases. CT was only performed in 40 cases. Surgery was performed for all patients. Diagnosis was confirmed with serology tests and/or pathological study of resected cysts. RESULT: The total number of pulmonary cysts detected on chest radiographs was 344. The right lung was more frequently affected than the left (208 lesions). A simple cyst was the most commonly observed lesion (220 cysts). Complicated forms were noted in 118 cases. 180 cysts were observed at ultrasound. A simple cyst presenting as an anechoic mass was noted in 140 cases. In 38 cases, the lesion was heterogeneous. In two lesions endocystic germinal membranes were detected. CT visualized 50 lesions. Thirty three lesions were complicated with endocystic floating or collapsed membranes. Bronchiectasis was observed in seven cases. CONCLUSION: Chest radiographs and thoraco-abdominal ultrasound are very useful for the diagnosis of pulmonary hydatidosis and evaluation of lesion extension. CT is useful for diagnosis of atypical or complicated lesions and to detect bronchiectasis.
Assuntos
Equinococose Pulmonar/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
Amyotrophic lateral sclerosis is the most common form of motor neuron disease. The diagnosis is based on clinical and electromyography criteria. The primary role of imaging in amyotrophic lateral sclerosis is to exclude other causes such as cervical degenerative disk disease, Chiari malformation or multiple sclerosis. Imaging is also helpful in atypical cases of the disease.
Assuntos
Esclerose Lateral Amiotrófica/patologia , Mapeamento Encefálico/métodos , Imageamento por Ressonância Magnética/métodos , Córtex Motor/patologia , Tratos Piramidais/patologia , Adulto , Esclerose Lateral Amiotrófica/fisiopatologia , Axônios/patologia , Diagnóstico Diferencial , Progressão da Doença , Humanos , Deslocamento do Disco Intervertebral/diagnóstico , Masculino , Córtex Motor/fisiopatologia , Neurônios Motores/patologia , Valor Preditivo dos Testes , Tratos Piramidais/fisiopatologia , Compressão da Medula Espinal/diagnósticoRESUMO
A case of primary hepatic leiomyosarcoma is documented with the use of intermediate filament and actin isoform antibodies. The majority of the tumour cells were positive with alpha smooth muscle actin antibody and about 20% with anti-desmin antibody indicating their smooth muscle nature. A review of the literature revealed 16 previously documented cases.
Assuntos
Actinas/análise , Proteínas de Filamentos Intermediários/análise , Leiomiossarcoma/patologia , Neoplasias Hepáticas/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Leiomiossarcoma/química , Leiomiossarcoma/ultraestrutura , Neoplasias Hepáticas/química , Neoplasias Hepáticas/ultraestrutura , Prognóstico , Sarcoma/química , Fatores SexuaisRESUMO
Thrombophlebitis of the ovarian vein is a rare post-partum complication. Its diagnosis is said to be difficult, but was greatly facilitated by the progress made in imaging. The authors report about two cases identified with computed tomography. Evolution was favorable in both cases with an anticoagulant and antibiotic treatment.
Assuntos
Ovário/irrigação sanguínea , Transtornos Puerperais/complicações , Trombose/etiologia , Dor Abdominal/etiologia , Doença Aguda , Adulto , Apendicite/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Cistos Ovarianos/diagnóstico por imagem , Gravidez , Pielonefrite/diagnóstico por imagem , Trombose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , VeiasRESUMO
The ingestion of caustic substances is a frequent accident in the child. The treatment of caustic strictures of the esophagus, which constitute the most frightening complication, varies from conservative treatment to esophageal replacement. We report the preliminary results of a prospective work established since July 1998 and aimed at evaluating the role of pneumatic dilatation in the treatment of these injuries. STUDIED POPULATION: The series included five boys with an average age of six years. Two children were neurologically handicapped. RESULTS: The caustic product was soda (three cases), a dishwasher solution (one case) and bleach (one case). Dysphagia was constant and concerned the semi-fluids in four cases. The stricture was extended over an average length of 4 cm. The total number of dilatations was 36, with an average of seven sessions/patient. No complication was noted. The result was good in four cases. The only failure was noted in a child who presented a gastroesophageal reflux secondary to the scarring phenomena. CONCLUSION: Pneumatic dilatation constitute a therapeutic mean whose results are attested. The best treatment remains, however, preventive: it is the setting out of reach of the child the dangerous products.
Assuntos
Queimaduras Químicas/terapia , Cáusticos/efeitos adversos , Dilatação/métodos , Estenose Esofágica/induzido quimicamente , Estenose Esofágica/terapia , Queimaduras Químicas/complicações , Criança , Pré-Escolar , Feminino , Refluxo Gastroesofágico/etiologia , Humanos , Masculino , Estudos Prospectivos , Resultado do TratamentoRESUMO
UNLABELLED: Esophageal duplications represent 10 to 20% of esophageal malformations and 15 to 20% of digestive duplications. METHODS: The authors report a series of seven cases observed between 1985 and 1999. RESULTS: The sex ratio was 2.5. The diagnosis was made before the age of six months in five cases. The clinical presentation included respiratory signs in six cases and digestive signs in five cases. The diagnosis was made on the association of a mediastinal mass behind vertebral malformation in five cases. The duplication was cystic in five cases and tubular in two. A perforation in the pleura occurred in one case of tubular duplication. The intervention consisted of total excision of the duplication in four cases and subtotal resection in two cases. For the seventh patient, who presented a perforation of the duplication in the pleura, the operation comprised a thoracic drainage associated to feeding gastrostomy. The histologic examination of the six operative specimens confirmed the diagnosis of esophageal duplication. Six patients survived and have favorable evolution with an average follow-up of four years. DISCUSSION: Esophageal duplications represent 15 to 20% of digestive duplications. Their clinical presentations are variable. Their diagnosis is often made before the age of two years, when a posterior mediastinal mass is associated with vertebral malformations. Apart from the tubular form, which is rare, diagnosis is confirmed by the histologic study of the operative specimen. CONCLUSION: Esophageal duplications are rare and often pose a problem of positive diagnosis. Their treatment is surgical and should be undertaken before the appearance of complications.
Assuntos
Esôfago/anormalidades , Pré-Escolar , Anormalidades Congênitas/diagnóstico , Anormalidades Congênitas/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos RetrospectivosRESUMO
Histiocytosis X is an uncommon disease. Temporal bone involvement is a frequent head and neck manifestation. Most patients are under fifteen years of age. The authors report a case of a bilateral extensive temporal involvement complicated with vertigo and peripheric facial palsy. CT plays a dominant role in the diagnosis because of the ability to identify bone destruction, soft tissue involvement and intra-cranial histiocytosis more accurately.
Assuntos
Histiocitose de Células de Langerhans/complicações , Osteólise/etiologia , Crânio , Osso Temporal , Paralisia Facial/etiologia , Feminino , Histiocitose de Células de Langerhans/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Osteólise/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The occurrence of chylothorax due to thrombosis of the subclavicular venous drainage is reported. This occurred in a young adult with previously undiagnosed Behçet's disease which had been developing over three years. Venous thromboses during the course of Behçet's disease are extremely frequent and are currently one of the diagnostic criteria. When these thromboses involve the central veins, in particularly the superior vena cava or one of its branches a chylothorax is possible due to blockage of the lymphatic circulation and may be a grave complication, given its location.
Assuntos
Síndrome de Behçet/complicações , Quilotórax/etiologia , Síndrome da Veia Cava Superior/complicações , Adulto , Quilotórax/diagnóstico por imagem , Humanos , Masculino , Radiografia , Síndrome da Veia Cava Superior/diagnóstico por imagemRESUMO
The authors report the case of a 20 year old patient in whom the clinical findings combined with the radiological signs, suggested the diagnosis of renal cancer. The histological findings after nephrectomy established the diagnosis of xanthogranulomatous pyelonephritis. This disease may rarely give the appearance of a renal tumor. This points out the importance of identifying this lesion in preoperative staging to avoid carcinologic surgery and all of its difficulties.
Assuntos
Neoplasias Renais , Pielonefrite Xantogranulomatosa , Adulto , Diagnóstico Diferencial , Humanos , Neoplasias Renais/patologia , Masculino , Pielonefrite Xantogranulomatosa/patologiaRESUMO
Intrathoracic extra-medullary hematopoiesis is a compensatory mechanism usually seen in thalassemia. The authors report a case with multiple mediastinal localisations fortuitously discovered. CT has allowed diagnosis and led percutaneous biopsy.