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Postembolization syndrome in a patient with a giant renal angiomyolipoma: A case report 巨型肾血管瘤患者的栓塞后综合征:病例报告
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.08.163
Angiomyolipomas are benign mesenchymal lesions often diagnosed incidentally, composed of adipose tissue, dysmorphic blood vessels, and smooth muscle. They are usually unilateral and symptomatic only when larger than 4 centimeters, posing a risk of spontaneous rupture and severe retroperitoneal hemorrhage. Treatment varies from conservative management to selective embolization or nephrectomy, depending on tumor size and patient condition. This case report describes a 26-year-old female with a giant renal angiomyolipoma treated with angioembolization, who subsequently developed postembolization syndrome.
血管肌脂肪瘤是一种良性间质病变,通常是偶然诊断出来的,由脂肪组织、畸形血管和平滑肌组成。它们通常是单侧的,只有大于 4 厘米时才会出现症状,有自发破裂和严重腹膜后出血的风险。治疗方法多种多样,从保守治疗到选择性栓塞或肾切除术,视肿瘤大小和患者情况而定。本病例报告描述了一名患有巨大肾血管肌脂肪瘤的 26 岁女性,她接受了血管栓塞治疗,但随后出现了栓塞后综合征。
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引用次数: 0
Chewing betel quid induced a critical metastatic squamous cell carcinoma of the lower lip: A case report 咀嚼槟榔诱发下唇临界转移性鳞状细胞癌:病例报告
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.09.002
Betel quid chewing is a common practice in many cultures and has been associated with various health risks, including an increased likelihood of developing squamous cell carcinoma (SCC). This case study presents a critical instance of metastatic SCC of the lower lip induced by betel quid chewing. A 45-year-old male with a history of betel quid chewing presented with a persistent and enlarging sore on his lower lip. A biopsy revealed SCC, and subsequent imaging confirmed metastasis to the lungs. This case highlights the potential for betel quid chewing to induce metastatic SCC and emphasizes the need for awareness and cessation of this habit to prevent such severe health outcomes. The aggressive nature of metastatic SCC warrants immediate and effective treatment strategies.
嚼食槟榔是许多文化中的一种常见习俗,与各种健康风险有关,包括增加患鳞状细胞癌(SCC)的可能性。本病例研究介绍了一个因咀嚼槟榔而诱发下唇转移性 SCC 的重要病例。一名有咀嚼槟榔史的 45 岁男性出现下唇持续肿大的溃疡。活组织检查发现了 SCC,随后的影像学检查证实转移到了肺部。本病例突出了咀嚼槟榔有可能诱发转移性 SCC,并强调了认识和戒除这种习惯的必要性,以防止这种严重的健康后果。转移性 SCC 具有侵袭性,需要立即采取有效的治疗策略。
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引用次数: 0
Curative intent treatment for pancreatic duct adenocarcinoma invade superior mesenteric vein 对侵犯肠系膜上静脉的胰管腺癌进行治愈性治疗
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.09.033
Pancreatic duct adenocarcinoma (PDAC) accounts for about 85-90% of all solid pancreatic tumors, which is well-known for poor prognosis and high morbidity. Despite the massive advent of chemotherapy and radiotherapy in recent years, surgical removal is still considered the cornerstone management option in this situation. Pancreaticoduodenectomy or Whipple procedure is generally contraindicated in metastasis or tumors that encase more than 50% of vessels. Vascular reconstruction is a state-of-the-art technique which requires the remarkable involvement of vascular experts in the setting of PDAC-invading vessels. In this article, we present an exceptional case of a 38-year-old male patient who underwent radical resection for advanced pancreatic cancer with superior mesenteric vein reconstruction by a great saphenous vein.
胰管腺癌(PDAC)约占所有胰腺实体瘤的 85-90%,以预后差、发病率高而闻名。尽管近年来出现了大量化疗和放疗,但手术切除仍被认为是这种情况下的基础治疗方案。胰十二指肠切除术或Whipple手术一般禁用于转移瘤或包裹50%以上血管的肿瘤。血管重建是一项最先进的技术,在 PDAC 侵犯血管的情况下,需要血管专家的大力参与。本文介绍了一例特殊病例,患者是一名 38 岁的男性,因晚期胰腺癌接受了根治性切除术,并用大隐静脉重建了肠系膜上静脉。
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引用次数: 0
Radiological diagnosis and management of postlaparoscopic cholecystectomy right hepatic arterial pseudoaneurysm: A case report 腹腔镜胆囊切除术后右肝动脉假性动脉瘤的放射学诊断和处理:病例报告
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.09.005
Injuries to blood vessels occur in 0.8% of the cases following laparoscopic cholecystectomy. They may result from direct penetration while insertion of trocar or by thermal injury (electrocautery). Pseudoaneurysm of hepatic artery is a rare occurrence. It is a serious complication following acute or chronic injuries to hepatic artery, with only 0.06% to 0.6% of the cases being reported. Endovascular embolization is usually the first line treatment in the management of pseudoaneurysm of hepatic artery with high success rate. Surgical intervention should be considered if the embolization fails, pseudoaneurysm are infected or other vascular structures are compressed. Our case highlights a 48-year-old male presenting with complaints of pain abdomen and jaundice later diagnosed to be a case of pseudoaneurysm of right hepatic artery and was successfully managed with angiographic embolization, which is the first line of management.
腹腔镜胆囊切除术后有 0.8% 的病例会造成血管损伤。这可能是由于插入套管时直接穿透或热损伤(电灼)造成的。肝动脉假性动脉瘤很少发生。它是肝动脉急性或慢性损伤后的严重并发症,仅有 0.06% 到 0.6% 的病例报告。血管内栓塞通常是治疗肝动脉假性动脉瘤的一线疗法,成功率很高。如果栓塞失败、假性动脉瘤受到感染或其他血管结构受到压迫,则应考虑手术干预。我们的病例重点介绍了一名 48 岁男性,主诉腹部疼痛和黄疸,后被诊断为右肝动脉假性动脉瘤,并通过血管造影栓塞术成功治愈。
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引用次数: 0
Spontaneous angiomyolipoma rupture: A case of hemorrhagic shock and urgent embolization 自发性血管肌脂肪瘤破裂:一例失血性休克和紧急栓塞手术
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.09.034
This case report discusses a 64-year-old male with tuberous sclerosis complex (TSC), a genetic disorder characterized by benign tumor formation across multiple organ systems. The patient presented with a spontaneous hemorrhage from a right renal angiomyolipoma, a common and potentially life-threatening manifestation of TSC, particularly in patients with TSC2 mutations. The patient's significant comorbidities, including hypertension and dyslipidemia, further complicated his clinical course. Initial management involved aggressive fluid resuscitation and blood product transfusion, followed by urgent embolization to control active bleeding. Despite developing complications such as transfusion-associated circulatory overload (TACO), the patient was successfully stabilized. This case highlights the necessity for careful monitoring and prompt intervention in patients with TSC, given the high risk of hemorrhage from angiomyolipomas, especially those larger than 3 cm. We also emphasize the importance of differentiating TSC-associated angiomyolipomas from other renal masses, considering the variability in clinical presentation and the potential for late-onset symptoms. Additionally, it highlights the critical role of a multidisciplinary approach in managing TSC patients, addressing both acute complications and long-term surveillance to prevent recurrence and other systemic manifestations of the disease.
本病例报告讨论了一名 64 岁男性结节性硬化症复合体(TSC)患者的病例,TSC 是一种遗传性疾病,其特征是在多个器官系统中形成良性肿瘤。该患者因右肾血管脂肪瘤自发性出血而就诊,这是TSC的常见表现,尤其是在TSC2基因突变的患者中,有可能危及生命。患者患有高血压和血脂异常等严重并发症,使其临床病程更加复杂。最初的治疗包括积极的液体复苏和血制品输注,随后进行紧急栓塞以控制活动性出血。尽管患者出现了输血相关循环负荷过重(TACO)等并发症,但病情还是成功稳定了下来。本病例强调了对 TSC 患者进行仔细监测和及时干预的必要性,因为血管肌脂肪瘤,尤其是大于 3 厘米的血管肌脂肪瘤引起出血的风险很高。考虑到临床表现的多变性和晚发症状的可能性,我们还强调了将TSC相关血管肌脂肪瘤与其他肾脏肿块区分开来的重要性。此外,它还强调了多学科方法在管理 TSC 患者中的关键作用,既要解决急性并发症,又要进行长期监测,以防止疾病复发和出现其他系统性表现。
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引用次数: 0
Parry Romberg syndrome: A case report 帕里-朗伯格综合征:病例报告
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.09.029
Parry Romberg syndrome (PRS) is a rare self-limiting disease, typically occurring in children and young adults, that causes slow progressive atrophy of one-half of the face. It primarily affects the subcutaneous tissue and skin with some cases exhibiting deeper extension to glandular, osseous and muscular structures. Neurologic and ocular involvement is variable. Neuroimaging with computed tomography (CT) scan aids in demonstrating radiological features, assessing disease severity, and detecting neurological and ocular complications. We present a severe case of PRS in a 25-year-old female with right-sided facial asymmetry, diagnosed based on medical history, clinical examination and head CT scan findings.
帕里-罗姆伯格综合征(Parry Romberg Syndrome,PRS)是一种罕见的自限性疾病,通常发生在儿童和年轻人身上,会导致半边脸缓慢进行性萎缩。该病主要累及皮下组织和皮肤,部分病例可向腺体、骨和肌肉结构深层扩展。神经系统和眼部受累情况不一。使用计算机断层扫描(CT)进行神经影像学检查有助于显示放射学特征、评估疾病严重程度以及检测神经和眼部并发症。我们介绍了一例严重的 PRS 病例,患者是一名 25 岁女性,面部右侧不对称,根据病史、临床检查和头部 CT 扫描结果确诊。
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引用次数: 0
Malignant epithelioid angiomyolipoma of the submandibular gland: A case report 颌下腺恶性上皮样血管瘤:病例报告
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.09.027
An epithelioid angiomyolipoma (a perivascular epithelioid cell tumor) is a rare mesenchymal neoplasm with distinctive cellular morphology and nonspecific imaging appearances. Mostly reported perivascular epithelioid cell tumors (PEComas) are benign; however, rarely, PEComas can be malignant with pulmonary, hepatic, nodal, and osseous metastases. We present a case of a 40-year-old man with malignant right submandibular salivary gland PEComa, metastasized to the bones, lungs, and liver. We are going to discuss the diagnosis and management options of the rare disease of metastatic PEComa of the submandibular salivary gland.
上皮样血管脂肪瘤(血管周围上皮样细胞瘤)是一种罕见的间叶肿瘤,具有独特的细胞形态和非特异性的影像学表现。大多数报道的血管周围上皮样细胞瘤(PEComas)都是良性的;但在极少数情况下,PEComas 也可能是恶性的,并伴有肺、肝、结节和骨转移。我们报告了一例 40 岁男性右侧颌下腺 PEC 瘤恶性转移至骨骼、肺部和肝脏的病例。我们将讨论颌下腺转移性 PEC 瘤这一罕见疾病的诊断和治疗方案。
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引用次数: 0
Multiloculated thoracoabdominal tuberculosis: A radiological presentation of disseminated tuberculosis 胸腹多发结核病:播散性肺结核的放射学表现
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.09.041
Tuberculosis is more frequently found among high-risk populations in the United States. It has a challenging diagnosis since it can present with diverse organ involvement that may delay the diagnosis. This is especially true regarding hepatic tuberculosis, with prevalence varying in each study but highly suggestive of underdiagnosis. An 18-year-old male with high-risk exposure to multidrug-resistant tuberculosis presented with fever, night sweats, weight loss, and cough. Imaging revealed a right lung cavitary mass with bilateral pulmonary nodules, right pleural nodular thickening traversing diaphragm extending to the liver with subcapsular hepatic lobulated hypodensities. MRI showed spinal involvement consistent with Pott's disease. It is important to consider hepatic tuberculosis in differential diagnoses for a hepatic lesion, allowing early detection and treatment to optimize patient outcomes.
肺结核在美国的高危人群中更为常见。它的诊断具有挑战性,因为它可能会出现多种器官受累,从而延误诊断。肝结核的情况尤其如此,每项研究的发病率都不尽相同,但都高度提示诊断不足。一名 18 岁的男性患者因发热、盗汗、体重减轻和咳嗽而被诊断为耐多药肺结核。影像学检查发现右肺空洞性肿块,伴有双侧肺结节,右胸膜结节性增厚穿越膈肌延伸至肝脏,肝脏囊下分叶低密度。磁共振成像显示脊柱受累,与波特氏病一致。在肝脏病变的鉴别诊断中考虑肝结核非常重要,这样可以及早发现和治疗,优化患者的预后。
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引用次数: 0
Post-traumatic pulmonary embolism in the setting of cough-variant asthma 咳嗽变异性哮喘的创伤后肺栓塞
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.08.153
Post-traumatic pulmonary embolism (PE) poses diagnostic complexities, especially with underlying lung pathologies and delayed symptoms. We report a 43-year-old male who presented with cough, frothy sputum, and dyspnea following blunt chest trauma 2 weeks ago. Due to a history of asthma, an asthma exacerbation was suspected but he failed to respond to bronchodilator therapy. Doppler USG (ultrasonography) was negative for deep venous thrombi, however, elevated D-dimer levels prompted further investigation with computed tomography pulmonary angiography (CTPA), confirming the diagnosis of PE. Prompt initiation of anticoagulation and thrombolysis resulted in clinical improvement. This case underscores the need to rule out posttraumatic PE, irrespective of age, type of, or time since injury, and underlying lung disease, to ensure timely diagnosis and intervention.
创伤后肺栓塞(PE)给诊断带来了复杂性,尤其是潜在的肺部病变和延迟症状。我们报告了一名 43 岁男性患者的病例,他两周前因胸部钝挫伤而出现咳嗽、泡沫痰和呼吸困难。由于有哮喘病史,他被怀疑为哮喘加重,但对支气管扩张剂治疗无效。多普勒 USG(超声波检查)显示深静脉血栓呈阴性,但 D-二聚体水平升高促使他进一步接受计算机断层扫描肺血管造影术(CTPA)检查,确诊为 PE。及时启动抗凝治疗和溶栓治疗后,临床症状有所改善。本病例强调了排除创伤后 PE 的必要性,无论年龄、受伤类型或受伤后时间长短,也无论是否患有潜在的肺部疾病,以确保及时诊断和干预。
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引用次数: 0
Computed tomography features and surgical treatment of wandering spleen torsion: A case report 游走性脾扭转的计算机断层扫描特征和手术治疗:病例报告
Q4 Medicine Pub Date : 2024-09-24 DOI: 10.1016/j.radcr.2024.08.146
Wandering spleen is a rare clinical entity characterized by the laxity, absence, or abnormal attachment of splenic supporting ligaments leading to hypermobility and abnormal positioning of the spleen in the abdominal cavity. The abnormally increased mobility of the spleen predisposes it to torsion and infarction. Authors present a case of wandering spleen complicated to torsion and infarct in a middle aged lady. The patient presented with acute abdominal pain, diagnosed by abdominal computed tomography and underwent surgery and splenectomy.
游走性脾脏是一种罕见的临床症状,其特点是脾脏支撑韧带松弛、缺失或附着异常,导致脾脏在腹腔内活动度过大和位置异常。异常增加的脾脏活动度容易导致脾脏扭转和梗死。作者介绍了一例中年女性游走性脾脏并发扭转和梗死的病例。患者因急性腹痛就诊,经腹部计算机断层扫描确诊,并接受了手术和脾脏切除术。
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引用次数: 0
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Radiology Case Reports
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