The aim of this case report is to demonstrate a case of primary thyroid hemangioma in a 62-year-old female who presented with a painless neck mass, treated with right hemithyroidectomy and diagnosed ...by surgical biopsy. Thyroid hemangiomas are rare, benign lesions which present a diagnostic challenge given the lack of specific imaging findings and clinical manifestations associated with them. However, accurate recognition of these lesions is important and can facilitate conservative, rather than surgical, management strategies. In this report, we discuss a case in a patient whose laboratory assessment raised concern for a thyroid paraganglioma, leading to surgical resection of what was ultimately a benign thyroid hemangioma. We also review the pathophysiology, clinical manifestations, differential diagnostic considerations, and imaging characteristics of thyroid hemangiomas across multiple modalities and discuss strategies for accurately diagnosing these lesions.
Uveal melanoma is the most common primary intraocular malignancy and can occur in the choroid, the ciliary body, or the iris. It is most often diagnosed based on clinical examination by an ...ophthalmologist. Nearly all patients present with visual symptoms. Characteristic findings on clinical examination include pigmented or pale choroidal masses with serous retinal detachments and acoustic hollowness seen with ocular ultrasonography. CT and MRI of the orbits are not traditionally utilized for the diagnosis of uveal melanoma. We present 3 cases in which uveal melanoma was an incidental finding on neuroimaging for unrelated conditions in asymptomatic patients. Radiologists should maintain a high suspicion for uveal melanoma when an intraocular mass of greater than 2 mm in thickness is seen on CT or MRI.
Long-term post-treatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, ...current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months.BACKGROUNDLong-term post-treatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months.We performed a systematic review to evaluate the impact of long-term imaging surveillance (i.e., imaging beyond 6 months following treatment completion) on survival in patients treated definitively for head and neck squamous cell carcinoma.PURPOSEWe performed a systematic review to evaluate the impact of long-term imaging surveillance (i.e., imaging beyond 6 months following treatment completion) on survival in patients treated definitively for head and neck squamous cell carcinoma.A search was conducted on PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma.DATA SOURCESA search was conducted on PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma.718 abstracts were screened and 95 underwent full-text review, with 2 articles meeting inclusion criteria. The Risk of Bias in Non-randomized Studies of Interventions assessment tool was used.STUDY SELECTION718 abstracts were screened and 95 underwent full-text review, with 2 articles meeting inclusion criteria. The Risk of Bias in Non-randomized Studies of Interventions assessment tool was used.A qualitative assessment without a pooled analysis was performed for the two studies meeting inclusion criteria.DATA ANALYSISA qualitative assessment without a pooled analysis was performed for the two studies meeting inclusion criteria.No randomized prospective controlled trials were identified. Two retrospective two-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to a different conclusion with one study reporting a survival benefit for long-term surveillance imaging with FDG PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit.DATA SYNTHESISNo randomized prospective controlled trials were identified. Two retrospective two-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to a different conclusion with one study reporting a survival benefit for long-term surveillance imaging with FDG PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit.Limited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma.LIMITATIONSLimited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma.There is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multi-center registry assessing outcomes.CONCLUSIONSThere is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multi-center registry assessing outcomes.HNSCC = Head and Neck Squamous Cell Carcinoma; RT= radiotherapy; NCCN = National Comprehensive Cancer Network; MPC = metachronous primary cancer; CR = complete response; OS = overall survival; CRT = chemoradiotherapy; HPV = human papillomavirus; PFS = progression-free survival; CFU = clinical follow up; NI-RADS = Neck Imaging Reporting and Data System.ABBREVIATIONSHNSCC = Head and Neck Squamous Cell Carcinoma; RT= radiotherapy; NCCN = National Comprehensive Cancer Network; MPC = metachronous primary cancer; CR = complete response; OS = overall survival; CRT = chemoradiotherapy; HPV = human papillomavirus; PFS = progression-free survival; CFU = clinical follow up; NI-RADS = Neck Imaging Reporting and Data System.
Utilization of brain MRI has dramatically increased in recent decades due to rapid advancement in imaging technology and improving accessibility. As a result, radiologists increasingly encounter ...findings incidentally discovered on brain MRIs which are performed for unrelated indications. Some of these findings are clinically significant, necessitating further investigation or treatment and resulting in increased costs to healthcare systems as well as increased patient anxiety. Moreover, management of these incidental findings poses a significant challenge for referring physicians. Therefore, it is important for interpreting radiologists to know the prevalence, clinical consequences, and appropriate management of these findings. There is a wide spectrum of incidental findings on brain MRI such as asymptomatic brain infarct, age-related white matter changes, microhemorrhages, intracranial tumors, intracranial cystic lesions, and anatomic variants. This article provides a narrative review of important incidental findings encountered on brain MRI in adults with a focus on prevalence, clinical implications, and recommendations on management of these findings based on current available data.
Given the ever-increasing utilization of magnetic resonance angiography, incidental vascular findings are increasingly discovered on exams performed for unconnected indications. Some incidental ...lesions represent pathology and require further intervention and surveillance, such as aneurysm, certain vascular malformations, and arterial stenoses or occlusions. Others are benign or represent normal anatomic variation, and may warrant description, but not further work-up. This review describes the most commonly encountered incidental findings on magnetic resonance angiography, their prevalence, clinical implications, and any available management recommendations.
Diagnosis of brain infections is based on a combination of clinical features, laboratory markers, and imaging findings. Imaging characterizes the extent and severity of the disease, aids in guiding ...diagnostic and therapeutic procedures, monitors response to treatment, and demonstrates complications. This review highlights the characteristic imaging manifestations of bacterial and viral infections in the brain.
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