The increasing use of highly conformal radiation deliberates a higher accurate targeting. Contouring and clinical judgment are presumably the crucial point, thus positron emission tomography/magnetic resonance imaging PET/MRI with somatostatin analogs appears to be useful in radiotherapy target definition. A case report of a 43-year-old woman presented with a recurrence of a meningioma (World Health Organization group I classification) in skull base, 2 years after resection. Magnetic resonance imaging (MRI) revealed a left sided skull base mass on sphenoid wing, anterior clinoid and with a soft tissue component in the lateral portion of the orbit.
Contrast-enhanced MRI and a computed tomography (CT) dedicated were used to the radiotherapy planning. Aiming an improvement on target volume delineation, 68Ga-DOTATOC-PET/MRI was also performed due the difficult localization of the tumor in skull base. Was treated using intensity-modulated radiotherapy (IMRT) to a total dose of 54 Gy in 28 fractions. It was prescribed to the planning target volume (PTV), defined based of both imaging modalities. In our case PET/MRI helped to define the target, which volume becomes bigger than that based exclusively on MRI and CT.
Hypogastric artery aneurysms are an uncommon entity. When the diameter achieves > 30-35 mm, they should be treated. Endovascular repair may be considered as first line therapy. One therapeutic option for internal iliac artery aneurysm exclusion is its embolization with or without covering the ostium with a covered stent. They may be some complications when it is not, as a distal coil migration that may produce ischemic symptoms.
We are presenting a 73-years-old male admitted to hospital with an acute right lower limb ischemia caused by a coil migration. He recently underwent a right hypogastric artery aneurysm endovascular treatment by coil embolization without covering the hypogastric ostium with a covered stent. The patient underwent an emergency surgery to remove the coil by a transfemoral surgical approach with posterior thrombectomy of the secondary thrombus. Actually, he remains asymptomatic and with right posterior tibial pulse.
Covered stent placement at the common iliac artery and external iliac artery could be the best option to avoid the risk of aneurysm rupture caused by endotension and the risk of distal coil migration.
Acute severe Asthma is a common paediatric emergency managed according to the BTS and SIGN guidelines. They recommend that if initial β2 agonist treatment bears no response, frequent Ipratropium Bromide doses can be given every 20-30 minutes . We present a case of paradoxical bronchospasm to Ipratropium, an observed but rare side effect.
Bladder carcinomas have a great propensity for divergent differentiation with more that 90% being Transitional cell carcinoma. Several histological variants have been have described so far; they are not only morphologically unique but also have significant prognostic and therapeutic differences making their timely identification of paramount importance. Osteoclastic giant cell variant of urothelial carcinoma is very rare type with controversial management. Studies from China have documented higher incidence and severity of illness in COVID-19 positive cancer patients. We report an unusual case of Osteoclastic giant cell variant of urothelial carcinoma in a 63 yrs old male patient associated with simultaneous COVID-19 infection.
A case of oncocytic papillary cystadenoma in a 72-year old woman, a rare tumor of laryngeal seromucinous glands of unclear nature is presented. The patient had a history of chronic inflammation of laryngeal mucosa and both her age and tumor location were typical. The lesion was resected transorally without complications. Histological findings are shown in the present study. The controversial status of oncocytic papillary cystadenoma as either a true neoplasm or a combination of metaplastic and hyperplastic changes, its resemblance to Warthin’s tumor and optimal approach to treatment are discussed.
The aim of this publication is to present case reports to show what is possible with pterygoid implants for the rehabilitation of edentulous space in the jaw (maxilla) while avoiding sinus lifts and bone grafting procedures. In addition, the added value of one-piece implants for screwed retention is elucidated.
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