Cystic Teratoma of the Sacrococcygeal Region in Adult: A Case Report

Sacrococcygeal teratoma is the most common solid tumor to occur in neonates, in whom it mostly takes the form of an obvious exophytic mass. They are, however, rarely found in adults. We report the CT and histopathologic findings of an adult cystic teratoma arising from the lower sacrococcygeal region that was discovered incidentally. Unenhanced CT scans showed an oval-shaped, cystic lesion with hyperattenuating content and no contrast enhancement. After surgery, the gross specimen was seen to be a cystic lesion filled with mucin. Microscopy revealed three germ cell layers in the cystic wall and the lesion was confirmed as cystic teratoma.

Inflammatory Myofibroblastic Tumor of Perineal Soft Tissue: A Case Report

Inflammatory myofibroblastic tumor is a rare benign condition of unknown etiology, and it may simulate malignancy. It is composed of myofibroblast, plasma cells and histiocytes and is found in lung, the liver, orbit, skin, mesentery, retroperitoneum and maxillary sinus. We report a case of inflammatory myofibroblastic tumor of perineal subcutaneous fat in a 35-year-old woman who complained of a palpable mass. Ultrasonography revealed a well-marginated lobulated hypoechoic lesion with peripheral poorly-defined hyperechoic strands in the subcutaneous fat of the right perineum. The lesion demonstrated low signal intensity on T1-weighted images and of heterogenous high signal intensity on T2-weighted images, compared with surrounding muscle. After intravenous injection of gadolinium, it showed clear homogeneous enhancement but poorlydefined adjacent strands. The final histologic diagnosis was inflammatory myofibroblastic tumor.

Thin Slice Thickness Double-Dose Contrast-Enhanced CT in the Detection of Brain Metastases

PURPOSE: To compare the usefulness of double-dose contrast-enhanced CT (DDCE-CT) and conventional contrast-enhanced CT (CCE-CT) in the detection of metastatic brain lesions. MATERIALS AND METHODS: Sixteen patients with brain metastases were evaluated with both CCE-CT and thinslice DDCE-CT. For CCE-CT, an initial injection of 100 ml contrast medium was given, and DDCE-CT with both 10-mm and 5-mm thickness was performed after the addition of an extra 100 ml of contrast medium. The numbers of metastatic lesions detected by CCE-CT and by DDCE-CT were compared, as were the findings of contrast-enhanced MRI (CE-MRI) and thin-slice DDCE-CT in seven patients who underwent both these procedures. RESULTS: Fourteen metastatic brain lesions were detected by CCE-CT, 22 by 10-mm-thickness DDCE-CT, and 36 by 5-mm thickness DDCE-CT. Thus, almost 2.6 times more lesions were detected by thin-slice DDCE-CT than by CCE-CT. Metastatic lesions were detected by 10-mm-thickness DDCE-CT in 16 patients and by CCECT in seven; in five, edema only was detected, while in four there were no detectable metastases. CCE-CT detected four lesions of less than 5 mm in diameter, while 10-mm-thickness DDCE-CT and 5-mm-thickness DDCE-CT detected seven and 18 lesions, respectively. Eleven lesions were detected by thin-slice DDCE-CT and 17 by CE-MRI in the seven patients who underwent both CE-MRI and DDCE-CT. The lesions detected only by CE-MRI were less than 5 mm in diameter and were discovered in the cerebellum or inferior temporal lobe. CONCLUSION: Thin-slice DDCE-CT was superior to CCE-CT in detecting metastatic brain lesions.

Inflammatory Pseudotumor of the Pancreas: A Case Report

Inflammatory pseudotumors are tumor-like benign lesions of uncertain pathogenesis and have most commonly been reported in the lungs. In the pancreas they are rare. We describe a case of inflammatory pseudotumor of the pancreas which was seen to be isoattenuating at non-contrast CT, and as a well-defined nodule with homogeneous enhancement in the pancreatic tail at contrast-enhanced CT. After a preoperative diagnosis of islet cell tumor, partial pancreatectomy of the pancreatic tail, with splenectomy, was performed. The gross specimen was a yellowish-white, solid mass and the lesion was histopathologically confirmed as inflammatory pseudotumor with an extensive area of sparse cellular fibrosis and collagen deposition.