Baylor University Medical Center Proceedings最新文献

A hyperechoic nodule in the liver has a broad differential; however, the vast majority are benign lesions. We report a case of a 29-year-old man with a history of anxiety and depression who presented to the hospital due to a 12-day history of epigastric pain with radiation to the back, fevers, and night sweats. Initial imaging revealed a small hyperechoic nodule on the liver, originally believed to be an abscess. Image-guided aspiration was attempted but no fluid could be drained. An endoscopic ultrasound was pursued to further evaluate the lesion and obtain a biopsy. An ulcerated esophageal mass was incidentally identified on endoscopy. Hepatic and esophageal biopsies demonstrated moderately differentiated adenocarcinoma, with esophageal adenocarcinoma as the primary source. This case highlights an interesting presentation for the rare occurrence of metastatic esophageal adenocarcinoma in a young, healthy individual without identifiable risk factors.

Approximately 6% of women with newly diagnosed breast cancer will present with metastatic disease. Proper staging workup and diagnosis of metastatic lesions is crucial prior to surgical treatment.¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is often included in the staging workup of locally advanced breast cancer. Recently, PET/CT with ¹⁸F-fluoroestradiol (¹⁸F-FES), a radiolabeled form of estradiol that binds to the estrogen receptor, has been approved as an additional imaging technique for the detection of estrogen receptor-positive lesions in patients with metastatic breast cancer. Though the two have been shown to have comparable sensitivity for diagnosis of metastatic lesions, there is still much debate regarding when to use ¹⁸F-FES PET/CT over ¹⁸F-FDG PET/CT imaging. We present the case of a 68-year-old patient diagnosed with estrogen and progesterone receptor-positive invasive ductal carcinoma of the left breast. Her staging workup included an ¹⁸F-FDG PET/CT that did not demonstrate any evidence of metastatic lesions. Due to discordant imaging findings, the patient then underwent ¹⁸F-FES PET/CT, which demonstrated over 90 metastatic osseous lesions. This study highlights the utility of ¹⁸F-FES PET/CT over ¹⁸F-FDG PET/CT in diagnosis of metastatic osseous lesions in a patient with metastatic estrogen receptor-positive breast cancer.

Background: Renal transplant recipients confront a substantially elevated susceptibility to renal cell carcinoma (RCC), particularly in their native kidneys as opposed to allografts.

Methods: In this systematic scoping review, exhaustive searches were conducted of the MEDLINE and EMBASE databases. Information was gathered on clinical manifestations, donor demographics, diagnostic intervals, tumor dimensions, histopathological characteristics, and therapeutic outcomes associated with RCC arising in allograft kidneys.

Results: The searches yielded a corpus of 42 case reports and 11 retrospective cohorts, encompassing a cohort of 274 patients. The majority of cases (75.4%) were clinically latent, discerned primarily through imaging modalities. Symptomatic presentations encompassed manifestations such as hematuria, elevated serum creatinine levels, abdominal discomfort, and graft-related pain. The mean temporal interval between renal transplantation and RCC diagnosis was calculated at 11.6 years, albeit displaying considerable variance. Notably, papillary and clear cell RCC emerged as the prevailing histopathological subtypes. However, the paucity of longitudinal follow-up data represents a notable caveat.

Conclusion: This investigation underscores the imperative of rigorous posttransplant surveillance regimes owing to the substantial prevalence of asymptomatic RCC instances. Future research should focus on clinical outcomes and cost-effectiveness of screening practices to develop preventive strategies.