Radiology Case Reports最新文献

英文中文

Cardiac metastasis from squamous cell carcinoma of the oral cavity: A rare case report 口腔鳞状细胞癌的心脏转移：罕见病例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-25 DOI: 10.1016/j.radcr.2024.10.139

Mark Marreros MD , Nicolas Dulguerov MD , Maxime Mermod MD, PhD

A 58-year-old male with squamous cell carcinoma of the floor of mouth underwent surgical planning for tumor resection and floor of mouth reconstruction. Unexpectedly, preoperative cervico-thoracic computed tomography (CT) indicated possible right ventricular intramural thrombosis, prompting initiation of unfractionated heparin. Follow-up echocardiography revealed no thrombus reduction, raising concerns of intracardiac metastasis. Positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose with computed tomography (¹⁸F-FDG PET/CT) showed a hypermetabolic mass in the right ventricle, raising concern for a distant tumor metastasis. Under anti-coagulation, the patient experienced recurrent tumor-related hemorrhage, necessitating urgent lingual artery embolization. Due to disease progression, surgical options were dismissed in favor of palliative chemo-immunotherapy, which both led to significant regression of both primary and metastatic lesions.

一名患有口底鳞状细胞癌的 58 岁男性接受了肿瘤切除和口底重建手术。意想不到的是，术前颈胸计算机断层扫描（CT）显示可能存在右心室壁内血栓，因此开始使用非分细肝素。随访超声心动图显示血栓没有减少，这引起了对心内转移的担忧。2-脱氧-2-[氟-18]氟-D-葡萄糖正电子发射计算机断层扫描（18F-FDG PET/CT）显示右心室有高代谢肿块，令人担忧肿瘤远处转移。在抗凝治疗下，患者出现了复发性肿瘤相关出血，需要紧急进行舌动脉栓塞治疗。由于病情恶化，患者放弃了手术治疗，转而接受姑息性化疗和免疫治疗，结果原发病灶和转移病灶均明显消退。

引用次数: 0

The path of least resistance: The unusual extradigestive journey of a nasogastric tube following oropharyngeal perforation 阻力最小的路径口咽部穿孔后鼻胃管不寻常的消化外旅程

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-25 DOI: 10.1016/j.radcr.2024.10.159

Anass Benomar MD, MSc, FRCPC , Rui-Ning Gong MD , An Ni Wu MD , Michele Khayat MD , Hamza Laref DMD, MD , Marc-Jacques Dubois MD, FRCPC , Pierre Bourgouin MD, FRCPC , Patrick P. Bourgouin MD, FRCPC

Nasogastric tube placement is frequently performed in various medical settings. While generally deemed safe in patients without risk factors, complications may occur due to malposition, justifying the need of systematic confirmation of position with chest radiographs. We present the case of a critically ill male adult patient for whom the tube position was initially deemed very unusual on postinsertion radiographs, prompting further workup which ultimately confirmed an oropharyngeal perforation with a left parapharyngeal, left visceral, retrotracheal, and right retrodiaphragmatic course, and resulting in a recurrent pneumothorax and empyema treated by surgical decortication.

鼻胃管置入术经常在各种医疗环境中进行。虽然在没有风险因素的患者中通常被认为是安全的，但由于位置不正可能会导致并发症，因此需要通过胸部 X 光片系统地确认位置。我们介绍了一例重症男性成人患者的病例，插管后的 X 光片显示插管位置非常不正常，因此需要进一步检查，最终证实患者口咽部穿孔，并有左侧咽旁、左侧内脏、气管后和右侧膈后病变，导致复发性气胸和肺水肿，经手术去骨膜化治疗。

引用次数: 0

Early neurological deterioration with severe headache as the initial manifestation: A case report 以剧烈头痛为首发症状的早期神经系统恶化：病例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-25 DOI: 10.1016/j.radcr.2024.10.131

Meichun Tao MD , Yaping Yang PhD , Hao Cheng MD , Mei Dong PhD

Severe headache as the initial clinical manifestation of early neurological deterioration (END) is uncommon. The emergence of severe headache should be promptly recognized as a potential indicator of large vessel stenosis. Here, we describe a male patient who initially presented with severe headache accompanied by transient left limb weakness, which subsequently progressed to persistent weakness. Imaging studies revealed severe stenosis at the origin of the right internal carotid artery, along with the presence of asymmetrically prominent cortical veins (APCV). Despite the administration of pregabalin orally and tramadol intramuscularly, his headache persisted. However, significant alleviation of his headache symptoms was observed following the improvement of cerebral perfusion.

Re-examination revealed the resolution of cortical vein dilation. This case underscores the importance of recognizing severe headache and APCV as potential indicators of large vessel stenosis and early neurological deterioration (END). Improving cerebral perfusion may serve as an effective means of alleviating headache symptoms in such cases.

严重头痛作为早期神经功能恶化（END）的最初临床表现并不常见。出现剧烈头痛时，应立即将其视为大血管狭窄的潜在指标。在此，我们描述了一名男性患者，他最初表现为剧烈头痛，伴有一过性左侧肢体无力，随后发展为持续性无力。影像学检查显示，右侧颈内动脉起源处严重狭窄，同时存在不对称突出的皮质静脉（APCV）。尽管口服了普瑞巴林，肌肉注射了曲马多，但他的头痛依然存在。然而，随着脑灌注的改善，他的头痛症状明显缓解。本病例强调了认识到严重头痛和 APCV 是大血管狭窄和早期神经功能恶化 (END) 的潜在指标的重要性。改善脑灌注可作为缓解此类病例头痛症状的有效手段。

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引用次数: 0

Imaging features of the brachial plexus in neurogenic thoracic outlet syndrome: A case report 神经源性胸廓出口综合征的臂丛影像特征：病例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-23 DOI: 10.1016/j.radcr.2024.10.158

Hoang Tu Minh MD , Nguyen Minh Duc MD , Nguyen-Van Cong MD , Ma Mai Hien MD , Le-Van Thuy MD , Ngo Hai Son , Tran Xuan Thach , Hoang Dinh Au MD, PhD

Neurogenic thoracic outlet syndrome (NTOS) is characterized by the compression of the brachial plexus in the thoracic outlet region, caused by various etiologies. We report a case with clinical symptoms and imaging findings from ultrasound and magnetic resonance imaging (MRI) of NTOS due to an elongated C7 transverse process and a fibrous band of the middle scalene muscle, which was confirmed in decompression surgery.

神经源性胸廓出口综合征（NTOS）的特点是胸廓出口区域的臂丛神经受到压迫，其病因多种多样。我们报告了一个病例，其临床症状以及超声和核磁共振成像（MRI）的影像学检查结果均显示，该病例是由于 C7 横突变长和中间头皮肌纤维带引起的 NTOS，减压手术证实了这一点。

引用次数: 0

Prostate puzzle: Unconventional prostatic STUMP findings in a middle-aged patient prompt closer examination 前列腺之谜：一名中年患者的非常规前列腺 STUMP 发现促使我们进行更仔细的检查

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.104

Mohammadrzea Elhaie , Abolfazl Koozari , Mohammad Reza Khademi

A 41-year-old male presented with obstructive urinary symptoms and an enlarged prostate. Subsequent testing revealed a remarkably high PSA level of 150 ng/mL, considerably above normal limits, raising concern for possible malignancy. Transrectal ultrasound showed an enlarged heterogeneous prostate measuring 74×80×75mm. PSMA PET/CT detected intense tracer uptake. While MRI and biopsy ruled out carcinoma, they indicated Stromal Tumors of Uncertain Malignant Potential (STUMP), an uncommon diagnosis in younger patients. This complex case highlights the essential role of advanced multimodal imaging and immunohistochemistry in diagnosing atypical prostatic lesions of uncertain malignant potential like STUMP, given their histologic similarity to benign conditions posing diagnostic difficulties. A multidisciplinary approach led to the STUMP diagnosis and decision for long-term monitoring instead of radical prostatectomy due to STUMP's unpredictable behavior. This report reinforces the need for diligence when evaluating seemingly benign but diagnostically challenging presentations that could conceal conditions like STUMP, and the importance of a multidisciplinary approach for accurate diagnosis and management of such rare prostatic proliferations.

一名 41 岁的男性出现泌尿系统梗阻症状和前列腺增生。随后的检查发现，前列腺特异抗原（PSA）水平高达 150 纳克/毫升，大大超过了正常值，令人担心可能是恶性肿瘤。经直肠超声检查显示前列腺增大，大小为 74×80×75mm。PSMA PET/CT 检测到强烈的示踪剂摄取。虽然核磁共振成像和活组织检查排除了癌症的可能性，但却显示存在恶性潜能不确定的间质瘤（STUMP），这在年轻患者中并不常见。这个复杂的病例凸显了先进的多模态成像和免疫组化技术在诊断STUMP等恶性潜能不确定的非典型前列腺病变中的重要作用，因为它们在组织学上与良性病变相似，给诊断带来了困难。由于 STUMP 的行为难以预测，多学科方法导致了 STUMP 的诊断，并决定进行长期监测，而不是根治性前列腺切除术。本报告强调，在评估看似良性但诊断困难的病例时，需要谨慎对待，因为这些病例可能隐藏着 STUMP 等病症，同时也强调了多学科方法对于准确诊断和处理此类罕见前列腺增生症的重要性。

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引用次数: 0

Successful esophagotomy after failed attempts of esophagoscopic retrieval of impacted denture 尝试食管镜取下脱落义齿失败后成功进行食管切开术

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.09.085

Saba Fatima MBBS, Muhammad Salman Ullah MD, Bushra Khalid MD, Muhammad Omer Khalid MD, Rana Uzair Ahmad MD

Ingested foreign bodies, although fairly common among children, can present in individuals of all age. Most common risk factors for such cases in adults include psychiatric illness, alcohol abuse and ill-fitting dentures. Most of the ingested foreign bodies pass through the gastrointestinal tract but intervention maybe required in case of impaction, obstruction or perforation. Foreign bodies mostly tend to get impacted at anatomical constrictions like cricopharyngeus, aortic arch and lower esophageal sphincter. We present a rare case of impacted denture in esophagus which could not be retrieved despite multiple esophagoscopic retrieval attempts leading to removal by successful esophagotomy. Investigations including X-ray and rigid esophagoscopy confirmed the presence of denture with its hooks impacted in the esophageal wall at the level of C6-C7 vertebra. Majority of the foreign bodies can be removed by flexible endoscopy or esophagoscopy but due to its impaction in esophageal wall these techniques were unsuccessful. Therefore, multidisciplinary team decided to opt for an esophagotomy with transcervical approach. Successful esophagotomy was performed with the retrieval of sharp hook like body. Our case underscores the importance of early surgical intervention in case of failed attempt to remove the foreign body through minimally invasive techniques to prevent complications in form of perforation and mediastinitis.

误食异物虽然在儿童中相当常见，但也可能出现在所有年龄段的人身上。成人最常见的风险因素包括精神疾病、酗酒和假牙不合适。大部分食入的异物都会通过胃肠道，但如果发生嵌塞、阻塞或穿孔，则可能需要进行干预。异物大多会撞击环咽、主动脉弓和下食道括约肌等解剖学收缩部位。我们介绍了一例罕见的食管内假牙撞击病例，尽管多次尝试食管镜取物，但仍无法取出，最后通过食管切开术成功取出。包括X光和硬质食管镜在内的检查证实，在C6-C7椎体水平的食管壁上存在带钩的义齿。大多数异物都可以通过柔性内镜或食管镜取出，但由于异物嵌顿在食管壁上，这些技术都不成功。因此，多学科团队决定选择经颈椎入路进行食管切开术。成功地进行了食管切开术，并取出了尖锐的钩状体。我们的病例强调了在通过微创技术取出异物失败的情况下尽早进行手术干预的重要性，以防止出现穿孔和纵隔炎等并发症。

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引用次数: 0

Intraperitoneal pelvic leiomyoma with atypical location in an old man: The role for MRI in the differential diagnosis 一名老人腹膜内的盆腔子宫肌瘤，位置不典型：核磁共振成像在鉴别诊断中的作用

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.119

Davide Turilli MD , Marco Anania MD , Vincenzo Marras MD , Claudia Pinna MD , Leandra Piscopo MD , Michele Obinu MD , Rosita Comune MD , Alberto Porcu MD , Mariano Scaglione MD , Salvatore Antonio Masala MD

Primary pelvic peritoneal masses, not arising from major organs, are uncommon in adults. Leiomyomas are a group of benign smooth muscle tumors, most commonly found in the uterus in premenopausal women (70–80%). Extra-uterine locations are very rare and more frequent in women. We highlighted the role of MRI due to its capability in soft tissue characterization, that may positively impact the therapeutical decision-making process. Herein, we present the case of a 66-year-old man with a peritoneal solid mass suspicious for a leiomyoma at Magnetic Resonance Imaging and confirmed at histologic specimen in order to discuss the crucial imaging findings that could raise suspicion of such a rare pathology in man.

并非来自主要器官的原发性盆腔腹膜肿块在成人中并不常见。子宫平滑肌瘤是一组良性平滑肌瘤，最常见于绝经前妇女的子宫（70-80%）。子宫外的位置非常罕见，在女性中更为常见。我们强调了核磁共振成像在软组织特征描述中的作用，这可能会对治疗决策过程产生积极影响。在此，我们介绍一例 66 岁男性腹膜实性肿块病例，该病例在磁共振成像中被怀疑为子宫肌瘤，并在组织学标本中得到证实，目的是讨论可引起对男性这种罕见病变的怀疑的关键成像结果。

引用次数: 0

A rare localization of Ewing's Sarcoma in the coracoid process: A case report and literature review on scapular Ewing's sarcomas 一种罕见的位于冠状突的尤文氏肉瘤：关于肩胛尤文氏肉瘤的病例报告和文献综述

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.132

N. Bahlouli , F. Chait , C. Faraj , S. Choumad , I. Lahlou , N. Allali , M. Maachi , N. Lamalmi , L. Chat , S. El Haddad

Ewing's sarcoma can affect any bone. Primary localization in the coracoid process is extremely rare and atypical. In the literature there have been a few reports of Ewing's sarcoma of the scapula. We report the case of an adolescent who presented to our department for investigation of a swelling in the left shoulder. Imaging revealed an osteolytic mass centered on the coracoid process. Histological study was in favor of Ewing's sarcoma.

尤文氏肉瘤可影响任何骨骼。原发于冠突的情况极为罕见，也不典型。关于肩胛骨尤文氏肉瘤的文献报道很少。我们报告了一例因左肩部肿胀而到我科就诊的青少年病例。影像学检查发现，以肩铠骨突为中心有一溶骨性肿块。组织学检查结果为尤文氏肉瘤。

引用次数: 0

Cauda equina non-Hodgkin lymphoma and literature review: Report of 2 cases 马尾非霍奇金淋巴瘤和文献综述：2 个病例的报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.144

Liliang Ren , Shouming Zhang , Aijie Wang , Ranran Huang , Zhongwei Li , Guowei Zhang

Primary non-Hodgkin's lymphoma (NHL) occurring in the cauda equina region within the spinal canal is exceedingly rare. It is characterized by severe clinical symptoms, a high rate of misdiagnosis, rapid progression, poor prognosis, and significant metastasis potential. In this paper, we report 1 case of a 58-year-old female with primary NHL and another case of a 69-year-old male with secondary NHL. Both cases exhibited similar MRI findings, presenting the ``cauda equina engulfment'' sign. Early diagnosis and treatment, based on the recognition of these rare imaging features in combination with clinical history and cauda equina histopathological examination, are crucial for improving patient outcomes.

发生在椎管内马尾区域的原发性非霍奇金淋巴瘤（NHL）极为罕见。它的特点是临床症状严重、误诊率高、病情进展快、预后差、转移可能性大。本文报告了一例 58 岁女性原发性 NHL 病例和一例 69 岁男性继发性 NHL 病例。两例患者的磁共振成像结果相似，均表现为 "马尾吞咽 "征。在识别这些罕见的影像学特征的基础上，结合临床病史和马尾组织病理学检查，早期诊断和治疗对改善患者预后至关重要。

引用次数: 0

Prenatal magnetic resonance imaging of umbilical cord ulcer in a fetus with congenital small bowel atresia: A case report 先天性小肠闭锁胎儿脐带溃疡的产前磁共振成像：病例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.110

Daisuke Yamaji MD , Takuro Gonda MD, PhD , Naoko Mukuda MD, PhD , Atsushi Murakami MD, PhD , Hiroto Yunaga MD, PhD , Shinya Fujii MD, PhD

A 34-year-old woman (gravida 2, para 0) with suspected fetal small-bowel atresia on ultrasound underwent magnetic resonance imaging (MRI) at 33 weeks 3 days of gestation. In addition to small bowel atresia, a teardrop-shaped hematoma was observed adjacent to the umbilical cord associated with an umbilical cord ulcer (UCU). The fetus was delivered by induced labor on diagnosis of intrauterine fetal death. UCUs were macroscopically observed on the surface of the umbilical cord. Ultrasonography is helpful in the diagnosis of UCU. Moreover, the MRI findings on UCUs adjacent to the umbilical cord in the case of congenital small bowel atresia should be observed carefully, especially after 30 weeks of gestation. MRI findings may lead to the detection of UCU and improve fetal outcome. Therefore, we should be aware of its findings.

一名 34 岁女性（孕 2 期，para 0）在妊娠 33 周 3 天时接受了磁共振成像（MRI）检查。除了小肠闭锁外，还发现脐带旁有一个水滴状血肿，并伴有脐带溃疡（UCU）。诊断为胎儿宫内死亡后，胎儿经引产娩出。在脐带表面宏观观察到 UCU。超声波检查有助于 UCU 的诊断。此外，在先天性小肠闭锁的病例中，应仔细观察脐带附近 UCU 的核磁共振成像结果，尤其是在妊娠 30 周后。核磁共振成像结果可能会导致 UCU 的发现，并改善胎儿的预后。因此，我们应该注意磁共振成像的发现。

引用次数: 0

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