Tenosynovial giant cell tumor (TGCT) is a benign condition that arises from tendon sheaths, synovium, or bursae and is classified according to the site of involvement (intra-articular versus ...extra-articular) and pattern of growth (localized versus diffuse). The diffuse form tends to present as peri-articular masses and are locally aggressive. It usually presents as a mono-articular process affecting larger joints. Spinal involvement is extremely rare, particularly the cervical spine. In this case report, we present a pediatric case of spinal TGCT involving the C1-C2 joint which was incidentally detected in a 13-year-old girl undergoing surveillance for medulloblastoma recurrence. Although spinal TGCT is a benign condition, it remains a diagnostic challenge, which specific to our case can raise the concern for malignancy or metastasis. We also described a percutaneous biopsy approach using a spring-loaded blunt tip coaxial needle to avoid inadvertent vascular injury. The imaging features of spinal TGCT and biopsy approach for atlantoaxial lesion are discussed together with a comprehensive review of the literature.
This brief report aims to evaluate the treatment outcome of transarterial embolization in ruptured hepatoblastoma complicated with acute intra‐abdominal hemorrhage. Three children (mean age 6 years) ...with high‐risk hepatoblastoma presented with rupture and acute intra‐abdominal hemorrhage. In addition to aggressive fluid resuscitation and blood product support, super‐selective embolization of the arteries with active bleeding or pseudoaneurysm was performed using calibrated gelfoam particles, with a technical success rate of 100%. Hemodynamic status and hemoglobin level were normalized in all patients within 2 days postembolization. The 30‐day survival rate was 100%. No major complication was detected apart from mild elevation of alanine transaminase.
We report, to the best of our knowledge, the first case of neuropsychiatric systemic lupus erythematosus with clinical presentation of bilateral upward gaze palsy and intraoral numbness. Magnetic ...resonance imaging of the brain was able to identify the pathogenic lesion at the left side of midbrain, involving the vertical gaze center and sensory pathways for innervating the buccal and hard palate mucosa. A course of aggressive immunosuppressive treatment resulted in prompt resolution of gaze palsy and the midbrain lesion.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
5.
Case 280: Trichopoliodystrophy Kevin Fung, Kin Fen; Kwong, Yin Yee; Mak, Wing Sze ...
Radiology
296, Številka:
2
Journal Article
Recenzirano
HistoryAn 8-month-old previously healthy boy was referred to our institution by the maternal child health center for progressive truncal hypotonia and developmental delay. This infant was born after ...an uncomplicated pregnancy with no perinatal complications. He was delivered at full term via spontaneous vaginal delivery. Two of his older male siblings died around 2-3 years of age due to pneumonia. According to the parents, these siblings also displayed reduced muscle tone, and one of them developed recurrent seizure.On physical examination, the child showed marked head lag and did not reach out to objects. Visual and auditory development were normal. His head circumference was below the third percentile, and his body weight was at the 10th percentile. His hair was sparse and coarse. A mild pectus excavatum deformity was present. Skull and chest radiographs were obtained (Figs 1, 2), and the patient underwent MRI of the brain (Fig 3).
This case report illustrates the presence of intranodal thyroid tissues in ipsilateral cervical lymph nodes after hemithyroidectomy for multinodular goiter in an adolescent patient. It highlights the ...rare radiological finding of thyroid tissues within cervical lymph nodes detected by ultrasonography and computed tomography, which is a great mimicker of nodal metastasis.
Case 280 Kevin Fung, Kin Fen; Kwong, Yin Yee; Mak, Wing Sze ...
Radiology,
04/2020, Letnik:
295, Številka:
1
Journal Article
Recenzirano
Odprti dostop
HistoryAn 8-month-old previously healthy boy was referred to our institution by the maternal child health center for progressive truncal hypotonia and developmental delay. This infant was born after ...an uncomplicated pregnancy with no perinatal complications. He was delivered at full term via spontaneous vaginal delivery. Two of his older male siblings died around 2-3 years of age due to pneumonia. According to the parents, these siblings also displayed reduced muscle tone, and one of them developed recurrent seizure.
Background
A large aneurysmal renal arteriovenous fistula (AVF) can cause hypokalaemic hypertension due to activation of renin-aldosterone system due to steal effect from renal parenchyma. In ...comparison to nephrectomy, endovascular embolisation of renal AVF is minimally invasive and can be nephron sparing, thus preserving renal function. However, such embolisation is technically challenging and can be associated with high risk of embolic migration.
Case presentation
We present a case of successful embolisation of a large aneurysmal renal AVF in a 11-year-old girl. The AVF was initially treated with coil embolization via transarterial route, resulting in partial migration of coil into inferior vena cava. After removal of the migrated coil via transvenous snaring, coils were deployed simultaneously via transarterial and transvenous routes to prevent migration. AVF flow dampened but residual flow persisted at 1 month follow up. A second embolization session with additional coil deployment and N-butyl cyanoacrylate (NBCA) injection resulted in successful occlusion of the AVF. At 3 months follow up, the girl’s blood pressure and serum potassium level have normalized without need of antihypertensive agent or potassium supplements.
Conclusion
Endovascular embolisation can be an effective nephron sparing treatment for large aneurysmal renal AVF. This is particularly important in paediatric patients as most renal function can be preserved with their expected longer life span. Risk of coil migration can be controlled by simultaneous transarterial and transvenous deployment. Complete occlusion of AVF can be aided by additional use of NBCA.
This brief report demonstrates the diagnostic utility of cone-beam CT lymphangiography (CBCTL) with intranodal injection of water-soluble iodinated contrast agent for assessing lymphatic disorders in ...two infants who were contraindicated for MRI and oil-based contrast agent. Both infants had dextro-transposition of the great arteries (d-TGA) and presented with high-output chylothoraces that were recalcitrant to conservative medical therapy. Both infants were diagnosed with central lymphatic flow disorder based on the CBCTL findings.
Hepatic angiosarcoma is an extremely rare primary malignant vascular tumour in children with very poor prognosis. Radiological diagnosis of hepatic angiosarcoma is challenging due to overlapping ...imaging features with other benign vascular hepatic tumours, particularly infantile hepatic haemangioma. Consumptive hypothyroidism is a condition that is almost exclusively associated with infantile hepatic haemangioma and has never been reported in angiosarcoma. We present a case of hepatic angiosarcoma in a 20-month-old girl, associated with consumptive hypothyroidism and, as a result, initially misdiagnosed as infantile hepatic haemangioma. Radiologists should be aware that consumptive hypothyroidism is not a reliable feature to use in excluding paediatric hepatic angiosarcoma. Biopsy should be performed in patients older than 1 year of age or with atypical imaging features.
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