Morphometric Analysis of the Sella Turcica and Sphenoid Sinus: A Retrospective Cross-Sectional Study / Análisis Morfométrico de la Silla Turca y Seno Esfenoidal: Un Estudio Transversal Retrospectivo

SUMMARY: This study evaluated the effects of ethnicity, sex, and age on the linear dimensions of the sella turcica (ST) and the pneumatization patterns of the sphenoid sinus (SS). In this cross-sectional retrospective study, we examined digitally standardized computed tomography scans of 100 Jordanians. These study participants comprised 50 men and 50 women, and their age ranged from 23 years to 77 years. We assessed linear ST dimensions and SS pneumatization patterns and correlated this data to age and sex. Furthermore, we compared the data with different ethnic groups from previous studies. The mean (standard deviation [SD]) length, diameter, width, and depth of the ST were 9.98 (1.89) mm, 12.45 (2) mm, 11.96 (1.76) mm, and 8.38 (1.63) mm, respectively. The mean (SD) interclinoid diameter was 8.84 (2.03) mm. These measurements were not significantly correlated with sex or age. With regards to pneumatization patterns of the sphenoid sinus, the conchal type was observed in 2 % of the study participants. Presellar involvement was observed in 30 % of the patients. The sellar and postsellar type was observed in 66 % and 2 % of patients, respectively. In our study, ST measurements did not differ significantly between the sexes. Pneumatization patterns of the SS differed from the patterns reported for other races. The findings of this study could assist neurosurgeons, orthodontists, and forensic medical investigators in diagnosing and planning treatment for pituitary gland pathologies.

Este estudio evaluó los efectos de la etnia, el sexo y la edad sobre las dimensiones lineales de la silla turca y los patrones de neumatización del seno esfenoidal (SE). En este estudio retrospectivo transversal, examinamos tomografías computarizadas estandarizadas digitalmente de 100 jordanos. Los participantes del estudio comprendían 50 hombres y 50 mujeres entre los 23 y los 77 años de edad. Evaluamos las dimensiones lineales del SE y los patrones de neumatización del SE y correlacionamos estos datos con la edad y el sexo. Además, comparamos los datos con diferentes grupos étnicos de estudios previos. La media (desviación estándar) de la longitud, el diámetro, el ancho y la profundidad del SE fueron 9,98 (1,89) mm, 12,45 (2) mm, 11,96 (1,76) mm y 8,38 (1,63) mm, respectivamente. El diámetro interclinoideo medio era de 8,84 (2,03) mm. Estas medidas no se correlacionaron significativamente con el sexo o la edad. Con respecto a los patrones de neumatización del seno esfenoidal, el tipo conchal se observó en el 2 % de los participantes del estudio. Se observó afectación preselar en el 30 % de los pacientes. El tipo selar y postsillar se observó en el 66 % y el 2 % de los pacientes, respectivamente. En nuestro estudio, las medidas del SE no difirieron significativamente entre los sexos. Los patrones de neumatización de la silla turca diferían de los patrones informados para otras razas. Los hallazgos de este estudio podrían ayudar a los neurocirujanos, ortodoncistas e investigadores médicos forenses en el diagnóstico y el tratamiento de las patologías de la hipófisis.

A rare case of adrenal hemangioma: A case report

Adrenal hemangiomas are rare benign tumors arising from the endothelial cells lining the blood vessels, which are made up of angioblastic cells. They are usually identified incidentally on radiographic imaging and post-operative histopathology is usually the definitive diagnosis. Computed tomography and magnetic resonance imaging help in the detection of silent adrenal lesions. We present a case and outline the diagnostic work-up and treatment of incidentally detected adrenal hemangioma in a 66-year-old woman.

Characteristics and management of solitary fibrous tumor in lacrimal drainage system / 国际眼科杂志(Guoji Yanke Zazhi)

@#Solitary fibrous tumor is a rare mesenchymal tumor originating from fibroblasts. It was first reported in the pleura. In recent years, more and more cases of solitary fibroma in the extra pleural area have been reported. It has been reported that the tumor can occur in almost all sites. The structure and function of the lacrimal drainage system has its particularity, and there are still few reports about solitary fibroma of the lacrimal drainage system. Therefore, this article summarizes the existing reports of solitary fibroma of the lacrimal drainage system to analyse its clinical characteristics and treatment.

Difficulty in Diagnosing of Renal Choriocarcinoma: Case Report / Dificuldade no diagnóstico do coriocarcinoma renal: relato de caso

ABSTRACT Choriocarcinoma is a rare highly malignant tumor. We report a case of 35-year-old woman, with a history of four months menstrual irregularity and human chorionic gonadotropin persistently positive that presented transvaginal ultrasound normal and the computed tomography scan of the chest showed three nodules and abdominal scan evinced a hypervascularized solid nodular lesion on left kidney. An ultrasound-guided biopsy of left kidney was performed with a pathologic diagnosis of renal choriocarcinoma. After chemotherapy the human chorionic gonadotropin was negative and the patient returned to normal menstrual cicles.

RESUMO O coriocarcinoma é um tumor altamente maligno raro. Relatamos um caso de mulher de 35 anos, com história de irregularidade menstrual de quatro meses e gonadotrofina coriônica humana persistentemente positiva que apresentava ultrassonografia transvaginal normal e a tomografia computadorizada de tórax com três nódulos e a abdominal evidenciava um nodular sólido hipervascularizado lesão no rim esquerdo. Uma biópsia guiada por ultrassom do rim esquerdo foi realizada com diagnóstico patológico de coriocarcinoma renal. Após a quimioterapia, a gonadotrofina coriônica humana foi negativa e a paciente retornou aos ciclos menstruais normais.

Role of computed tomography scan in diagnosis of retroperitoneal masses

Background: In the vast and ever-expanding field of surgery there are only few subjects which have provoked controversy; curiosity related to correct management of patients suffering from various condition of the abdomen. This becomes very true when the patient has a retroperitoneal mass clinically. The problem of retroperitoneal mass was intriguing, fascinating and certainly most perplexing. The present study was planned with the objective to study the various clinical presentations of retroperitoneal mass, and their radiological findings, and co-relation between these various findings.Methods: This was a prospective, cross-sectional study. The study included 30 patients clinically diagnosed having retroperitoneal mass, attending the department of general surgery.Results: The most common affected age group was of 40-50 years (9, 30.00%). The most frequent presenting symptoms were abdominal lump (28, 93.33%). Pallor was the commonest clinical sign (20, 66.67%). Retroperitoneal lymph node masses were the commonest (12, 40.00%) malignant lesions. Retroperitoneal lymphadenopathy was the most common lesion.Conclusions: The retroperitoneum has long been an area poorly visualised by conventional radiographic techniques and in this respect, computed tomography scan has great advantages over other modalities. Hence the modern surgeon should no longer be considered a ‘shadow-gazer' but an anatomist in-vivo.

Colecistitis enfisematosa: presentación de tres casos / Emphysematous cholecystitis: a report of three cases

Antecedentes: la colecistitis enfisematosa (CE) es una forma de presentación infrecuente de la colecistitis aguda. Material y métodos: presentecedentes patológicos, mientras que los otros eran diabéticos. A todos se les realizó tomografía computarizada (TC). Dos pacientes fueron sometidos a colecistectomía videolaparoscópica (CL) con buena evolución, mientras que en un caso se realizó colecistostomía percutánea (CP). Discusión: la CE se refiere a la presencia de gas en la luz o en la pared de la vesícula biliar. La tasa de morbilidad es del 50%. Los pacientes suelen padecer diabetes, pero puede presentarse en pacientes más jóvenes sin factores de riesgo. La TC es el método de elección para el diagnóstico. El tratamiento definitivo es la CL, aunque la CP es otra opción válida. Conclusión: la CL se considera un enfoque eficaz y seguro para el tratamiento de la CE.

Background: Emphysematous cholecystitis (EC) is a rare presentation of acute cholecystitis. Material and methods: We report three cases of EC in two men and one woman between 55 and 79 years. One of the patients was otherwise healthy while the other two were diabetics. A computed tomography (CT) scan was performed in all the cases. Two patients underwent video-assisted laparoscopic cholecystectomy with favorable outcome and one patient underwent percutaneous cholecystostomy. Discussion: Emphysematous cholecystitis is characterized by the presence of gas in the gallbladder lumen or wall. Mortality rate is 50%. Most patients are diabetics, but EC may present in younger patients without risk factors. Computed tomography scan is the method of choice for the diagnosis. Cholecystectomy is indicated as definite treatment, but percutaneous cholecystostomy may be a valid option. Conclusions: Laparoscopic cholecystectomy and antibiotics are effective and safe to treat.

An Analysis of Role of Computed Tomography Scan Abdomen in Differentiating Perforated from Non-perforated Appendicitis Accurately and Comparing with Histopathology Reports

Background: Acute appendicitis is one of the most common abdominal surgical emergencies requiring accurate diagnosis. Itis characterized by obstruction of its lumen, leading to inflammation and finally perforation. To define its prognosis, choose anappropriate surgical procedure and to decide non-surgical treatment, the pre-operative diagnosis of perforated or non-perforatedappendicitis is very important.Aim of the Study: This study aims to analyze the diagnostic accuracy of computed tomography (CT) scan abdomen indifferentiating perforated from non-perforated appendicitis using histopathology as the final diagnosis.Materials and Methods: Aprospective, cross-sectional analytical study, wherein 85 patients diagnosed with acute appendicitisreferred to the radiological department for CT scan abdomen were included in the study. Patients aged between 15 and 70 yearswere included in the study. CT scan abdomen with and without contrast was performed on a Toshiba 64 Multislice CT scanner(Toshiba Medical Systems Corp., Tokyo, Japan) which was used for all the patients. All the CT scans were interpreted by the sameconsultant radiologists with a minimum of 5 years of experience. The radiological features for the diagnosis of non-perforatedacute appendicitis by CT were based on swollen appendix, thickened enhancing wall, and smudging of surrounding fat planes,whereas the radiological features for perforated appendicitis used were, with abscess formation, phlegmon, extraluminal air,extraluminal appendicolith, and focal defect in the appendicular wall. Histopathology of the specimen collected following surgerywas undertaken by the hospital consultant pathologist of more than 5-year experience.Observations and Results: Among the 85 patients included in this study for the analysis of CT scan abdomen features, therewere 57 (67.05%) males and 28 (32.94%) females with a male-to-female ratio of 2.03:1. The mean age of the patients was38.90 ± 6.70 years. The incidence of non-perforated appendicitis was 66/85 (77.64%) including males 44/85 (51.76%) andfemales 22/85 (25.88%). The incidence of perforated appendicitis was 19/85 (22.35%) and males were 12/85 (14.11%) and 7/85(8.23%) were female. Patients aged 15–45 years of both genders constituted to 63/85 (74.11%) of the total patients. Amongthese patients, presenting with non-perforated appendicitis was 51/85 (60%) and perforated appendicitis was 12/85 (14.11%).Conclusions: Multislice CT scan abdomen was considered as the modality of choice for acute appendicitis not only to confirmthe diagnosis but also it plays an important role in assessment of appendicular complication, particularly in the detection ofperforated appendix. Using one or more of the five radiological signs of CT scan abdomen to identify appendicular perforationraised the sensitivity significantly reaching 94.12%.

A Clinical Study on Role of Coronary Computed Tomography Angiogram in the Diagnosis of Coronary Artery Disease

Background: In the recent past, cardiac computed tomography (CT) angiography is being performed for the diagnosis and treatment of coronary artery disease (CAD) and congestive heart failure. The differentiation of ischemic from non-ischemic cardiomyopathy, characterization of hypertrophic cardiomyopathy, and delineation of congenital heart defects are its primary diagnostic applications. Aim of the Study: The aim was to study the clinical applications of coronary CT angiography (CCTA) in patients with suspected CAD and identify factors that affect CCTA findings. Materials and Methods: Two hundred and fourteen patients diagnosed with CAD were included in the study. Patients aged between 36 and 76 years were included. Patients with chest trauma and prior thoracic surgery (coronary stenting or coronary artery bypass grafts) were excluded. Demographic data of the patients were recorded including age, gender, blood pressure, body mass index, smoking habits, intake of alcohol, previous history of angina, diabetes, and hypertension were recorded. The duration of symptoms was classified into five groups: <1 week, 1 week to 1 month, 1–3 months, 3–6 months, and more than 6 months. All the patients were investigated with lipid profile, serum creatinine, and blood glucose levels. All the patients were subjected to CCTA. The percentage of abnormal CCTA was observed and recorded. Abnormality of coronary arteries was expressed as atherosclerotic changes identified on CCTA scans, which is reflected in either an involvement of the right coronary artery (RCA), or the left coronary artery (LCA), or both of RCA and LCA. Significant coronary stenosis indicates that more than 50% lumen stenosis due to the presence of plaques was considered. Observations and Results: Two hundred and fourteen patients with diagnosed CAD were included in the study, aged between 36 and 76 years. The mean age was 56 ± 2.10 years. There were 153 (71.49%) males and 61 (28.50%) were female, with a male-to-female ratio of 3.44:1. The youngest patient was aged 37 years and the eldest patient was 75 years with a mean age of 56 ± 2.10 years. There were 114/214 (53.27%) patients with abnormal CCTA scans and among them 84/114 (73.68%) were male and 30/114 (26.31%) were female. The most common symptom of presentation was pain in the chest elicited in 139 (64.95%) of the patients in this study, followed by history of hypertension in 89 (41.58%) patients. It was observed that there was no significant difference in the percentage of abnormal CCTA findings between male and female patients (P = 0.19), (with P value taken as statistically significant at <0.05). Similarly, no significant difference was found between the sex (male/female) and duration of symptoms (P = 0.71). Conclusions: CCTA is a non-invasive, outpatient-based procedure suitable in patients without actionable CAD, obviating unnecessary invasive examination of coronary vessels. CT angiography findings are directly related to patient age and duration of symptoms, with increased abnormal findings reported in elderly population with the duration of symptoms more than 6 months. Moreover, there was a direct correlation between the involvement of coronary arteries and the patient age.

Clinical Study on Findings of Ultrasound and Computed Tomography Scan in the Diagnosis of Ovarian Mass Lesions

Background: Ultrasonography (USG) is a simple and noninvasive diagnostic tool that gives lots of data to accurately characterize most of the ovarian mass lesions with a sensitivity and specificity of 88–96% and 90–96%, respectively. However, the presence of significant variability in the terminology and definition of USG findings has led to the need for more standardization and uniformity in adnexal USG. Computed tomography (CT) scan is used primarily in patients with ovarian malignancies, either to assess disease extent before surgery or as a substitute for second-look laparotomy. Moreover, spiral CT has several advantages such as its rapidity and possibility of identifying all potential sites of peritoneal implants or lymphadenopathy as well as of the primary tumor site. Aim of the Study: The study was to the clinical findings of both USG and CT scan of abdomen and pelvis in the accurate diagnosis of ovarian mass lesions. Materials and Methods: A total of 104 patients with mass lesions of the ovary were included and subjected to USG and CT scan of abdomen and pelvis. Transabdominal and transvaginal USG studies were undertaken in all the patients. USG findings and CT scan findings were observed recorded and analyzed. Ovarian pathologies were categorized as benign, malignant, and metastasized and the results of CT and USG were compared. Observations and Results: A total of 104 patients with ovarian mass lesions attending the Radiology Department of a Tertiary Teaching Hospital in Kerala were included in the study; patients were aged between 18 and 68 years with a mean age of 42.46 ± 5.70 years. Patients aged between 19 and 58 years accounted for more than 80% of the entire subjects. Hemorrhagic cyst was the most common mass lesion diagnosed in this study and accounted for 28 (26.92%) patients. Tubo-ovarian abscess accounted for 19/104 (18.26%) of the total cases. This was followed by mucinous cystadenoma 17/104 (16.34%), serous cystadenoma in 13/104 (12.50%) cases, polycystic ovarian disease in 11/104 (10.57%), mature cystic teratoma in 7/104 (6.73%), simple cyst in 6 (5.76%), Brenner tumor in 2/104 (1.92%), and endometrioma in 1/104 (0.96%) patients. Conclusions: CT scan and USG are two excellent noninvasive methods to differentiate ovarian mass lesions from benign and malignant lesions and both imaging techniques seemed to be comparable in differentiating malignant from benign ovarian tumors. CT scan was more sensitive than USG, but sonography is more specific than CT scan in diagnosis of malignant lesions. USG has high positive predictive value as compared to CT scan to diagnose malignant lesions.

A Comparative Study of Chest X-ray and Chest High-resolution Computed Tomography in Blunt Trauma Chest Patients

Introduction: Computed tomography (CT) scan is an accurate tool for the detection of injuries in a trauma setting and is able to find the injuries that were occult in chest X-ray (CXR). In past years, the utility of CT scan was limited to severe trauma injuries but now is used in less severely injured trauma patients. The study aimed to compare the efficacy of CXR and chest CT scans in patients with chest trauma. Materials and Methods: The present study was conducted in the Department of Surgery of Medical Institute. For the study, we prospectively view the previous medical records of the patients who were admitted in our surgical ward for blunt chest trauma and received both CXR and high resolution CT chest scans. A total of 95 patients were included in the study. Data regarding the study were collected. Results: Out of 95 patients, 79 were males and 16 females. The mean age of the patients was 32.42 years ranging from 2 to 90 years. The most common cause for blunt trauma to the chest according to our results was a road traffic accident. We observed that CT scan is more accurate as compared to CXR in the detection of certain cases such as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax. Conclusion: Chest CT scan is highly sensitive in the detection of thoracic injuries following blunt chest trauma. In day-to-day practice, CT scan is better in visualizing as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax

Changing Modalities in the Management of Lung Cancer after the Invention of Computed Tomography

Introduction: Lung cancer is the leading cause of cancer-related mortality in both men and women. The prevalence of lungcancer is second only to that of prostate cancer in men and breast cancer in women. Lung cancer recently surpassed heartdisease as the leading cause of smoking-related mortality. Most lung carcinomas are diagnosed at an advanced stage, conferringa poor prognosis. The need to diagnose lung cancer at an early and potentially curable stage is obvious. In addition, mostpatients who develop lung cancer smoke and have smoking-related damage to the heart and lungs, making aggressive surgicalor multimodality therapies less viable options.Aim: This study aims to access the role of computerized tomography in the surgical management of carcinoma of the lung.Materials and Methods: This is a prospective study from 2014 to 2019, a period of 5 years. Atotal of 22 cases entered in the study.In this study, we compare both pre-operative computed tomography (CT) image and intraoperative findings and level of operability.Results: CT imaging will continue to play a major role in the evaluation of lung cancer. With the advent of non-invasive imagingmodalities like multi-slice/spiral CT scan, the use of invasive screening and staging procedures including bronchography hasbeen pushed to the periphery of staging workup; a total of 35 patients with carcinoma lung were studied. Seven patients werewith carcinoma lung Stage II, one patient with carcinoma Stage III, and 27 were in Stage IV. Seven patients underwent primarysurgical treatment. Other patients were treated appropriately with chemotherapy or radiotherapy or a combination of both.Conclusion: CT is still the cornerstone of imaging studies in the pre-operative staging and post-therapeutic evaluation of lungcancer. Treatment of lung cancer depends on the cancers specific cell type, how far it has spread and the patient’s performancestatus. CT is very useful for this purpose.

Colonic Perforation Following Percutaneous Nephrolithotomy: Retrorenal Colon - A Case Report

Colonic perforation is an unusual and serious complication of percutaneous nephrolithotomy. It can result in more complicatedopen exploration of the abdomen, involving colostomy construction. The necessity of a second operation for the closure of thecolostomy causes financial and emotional burden on the patients and surgeons.

Differentiation between benign and malignant solid pseudopapillary tumors of the pancreas by computed tomography scan / 中国癌症杂志

Background and purpose: Solid pseudopapillary tumor of the pancreas (SPTP) is rare, and there are some differences between benign and malignant SPTP not only in clinical treatment but also in future prognosis. The purpose of this study was to investigate the characteristics of benign and malignant SPTP and differential diagnosis on computed tomography scan, in order to improve the accuracy of preoperative diagnosis. Methods: A total of 69 SPTP patients cofirmed by pathology were included. Each patient was diagnosed through the clinical and CT features by 3 radiologists. Results: Thirteen (18.84％) patients (9 females and 4 males) were confirmed as malignant SPTP. The tumors in 56 (81.16％) patients (45 females and 11 males) were diagnosed as benign SPTP. There was no significant difference in gender (P=0.458) between the groups. The mean age of malignant SPTP patients was significantly higher than that of benign SPTP patients [39 (16-56) years vs 31 (14-56) years, P=0.001]. The mean tumor size was 6.2(2.2-12.0)cm in malignant group and 5.5(1.2-13.0) cm in benign group, respectively. The size of tumor was equal or larger than 5.0 cm in 31 patients (benign vs malignant 21∶10, P=0.014). Twenty-eight lesions showed incomplete fibrous pseudocapsule (benign vs malignant 19∶9, P=0.028). There were no significant differences in lesion location, morphology, proportion of cystic or solid component between malignant and benign groups (P＞0.05). Conclusion: Malignant SPTP patients were significantly older than benign SPTP patients. The large tumor size (≥5 cm) and incomplete fibrous pseudocapsule may suggest malignancy of SPTP.

Pneumatization of the Frontal and Sphenoid Sinus in Korean Adults: A Study of Using Computed Tomography Scans / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For safe sinus surgery, it is essential to understand the anatomical structure and developmental state of the paranasal sinuses. Structural abnormalies such as aplastic and marked hypoplastic sinuses may not be amenable to sinus surgery or balloon sinuplasty. The purpose of this study is to evaluate the degree of pneumatization of the frontal and sphenoid sinuses in Korean adults. SUBJECTS AND METHOD: This retrospective study utilized CT images of 1190 sides from 595 Korean adults. The frontal sinus was classified into normal, hypoplasia, aplasia and unilateral hidden aplasia. The sphenoid sinus was evaluated the incidence regarding the aplasia and unilateral hidden hypoplasia. RESULTS: Bilateral frontal sinus hypoplasia was observed in 8.5% of women and 4.2% of men (p 0.05). Bilateral frontal sinus aplasia was observed in 7.1% of women and 2.9% of men (p 0.05). Unilateral hidden frontal sinus aplasia was observed in 1.7% of women and 1.5% of men (p>0.05). There was no bilateral sphenoid sinus aplasia and only one woman had unilateral sphenoid sinus aplasia. Unilateral hidden sphenoid sinus hypoplasia was observed in 1.4% of women and 2.9% of men (p>0.05). CONCLUSION: Bilateral frontal sinus hypoplasia and aplasia are more common in women than in men. Although the incidences of unilateral hidden frontal sinus aplasia and hidden sphenoid sinus hypoplasia are low, sinus surgeons should carefully review CT for sinus surgery or balloon sinuplasty.

Multiple Intraorbital Glass Foreign Bodies.

It is frequently difficult to identify and localize intraorbital foreign bodies despite modern-day high-resolution imaging studies. Although there can be grave complications associated with retention of organic intraorbital foreign bodies, many believe that removal of such bodies in most cases is unwarranted. A high clinical suspicion, proper choice of imaging studies, and removal by a skilled orbital surgeon probably make the risk of surgical exploration and foreign body removal less than the risk of foreign body retention. We present a case of extraconal foreign bodies (11 glass particles), which required exploration for retrieval. An initial bedside exploration led to locating two foreign bodies (glass particles of 2 × 2 cm and 1 × 1 cm size respectively). A second exploration in the ophthalmology operating theater yielded 11 foreign bodies (glass particles of various sizes) in the superior area of extraconal space.

Relato de caso: pólipo piloso da nasofaringe em adulto / Case report: a hairy polyp of nasopharynx in adult

O pólipo piloso é um tumor congênito que se manifesta, normalmente, nos primeiros anos de vida, como uma massa coberta com pele contendo glândula sebácea e pelo. Foi descrito, primeiramente, por Brown-Kelly em 1918, com predominância no sexo feminino. A manifestação clínica depende da localização e do tamanho do pólipo, mas, geralmente, causa sintomas respiratórios e alimentares. Há predileção pelo lado esquerdo do organismo, ainda não explicada (1). Não há predisposição genética ou identificação em parentes, e normalmente apresenta-se como um defeito isolado, sem relatos de malignização. O diagnóstico pode ser suspeitado através do estudo de imagem. O tratamento envolve a exérese completa da massa, não havendo necessidade de nenhuma outra complementação (2). Relatamos o caso de uma paciente de 21 anos cujo diagnóstico foi confirmado com anatomopatológico da peça cirúrgica(AU)

The hairy polyp is a congenital tumor that usually manifests in early life as a mass covered with skin containing sebaceous gland and hair. It was first described by Brown-Kelly in 1918, predominantly in females. The clinical manifestation depends on the polyp's location and size, but it usually causes respiratory and feeding symptoms. It is more likely to appear on the left side of the body, a predilection not yet explained. (1) There is no genetic predisposition or identification in relatives, and it usually presents as an isolated defect without malignant reports. The diagnosis may be suspected by imaging. Treatment involves complete excision of the mass, with no need for any other action. (2) We report the case of a 21-year-old patient whose diagnosis was confirmed by pathology of the surgical specimen(AU)

Paraneoplastic retinopathy associated with occult bladder cancer.

The aim was to report the first case of cancer‑associated retinopathy (CAR) presenting before bladder cancer diagnosis. A 71‑year‑old woman with a history of bilateral vision loss underwent subsequent complete ophthalmic examination include a fluorescein angiography, full‑field electroretinogram (ERG), serology including serum antibodies for CAR, and positron emission tomography‑computed tomography (PET‑CT) scan. The patient was diagnosed with Cite this article as: Nivean M, Muttuvelu DV, Afzelius P, Berman DC. Paraneoplastic retinopathy associated with occult bladder cancer. Indian J Ophthalmol 2016;64:248-50. This is an open access article distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as the author is credited and the new creations are licensed under the identical terms. For reprints contact: reprints@medknow.com bladder carcinoma revealed by PET‑CT. Timely recognition of this entity may be crucial for an increased patient survival thus adult onset progressive photoreceptor dysfunction, confirmed by ERG, should alert to a possible remote effect of known or occult malignancy. In the latter, PET‑CT may be exploited as a powerful diagnostic tool.

Differential Diagnosis between Neoplastic and Non-Neoplastic Brain Lesions in Radiology / Diagnóstico diferencial entre lesões cerebrais neoplásicas e não neoplásicas em radiologia

Introduction The observation of multiple lesions in a skull computed tomography (CT) scan is always cause for concern because of the frequent possibility of neoplastic etiology, although granulomatous, infectious, vascular, iatrogenic, demielinating, trauma, parasitic diseases, and strokes can produce a similar aspect on radiology. A wide range of non-neoplastic conditions can mimic a brain tumor, both clinically and radiologically, representing a potential pitfall for physicians involved in patient care. The study's goal is to alert specialists to the possibility of other neoplastic and nonneoplastic etiologies in the differential diagnosis of hypodense lesions in non-contrast. Methods We performed a literature review using PubMed, Medline, Science Direct, Embase, Clinical Trials, Ebsco, and Scielo. Articles were selected in the period of 1986 to 2015. Discussion Knowledge of various etiologies when with multiple lesions appear on computed tomography allows specialists to guide the diagnosis to appropriate treatment, avoiding the irradiation of non-neoplastic lesions and unnecessary surgeries. The most common lesions were the neoplasm (74% to 86%), especially gliomas, followed by infections (8% to 15%), and infarcts (0.6% to 6%), which represent nonneoplastic lesions. Conclusion Given the relatively high percentage of wrong neuroradiology diagnoses, most cases may require histological diagnosis, because even magnetic resonance imaging (MRI) renders difculties in distinguishing such lesions.

Introdução Observação de múltiplas lesões na tomograa computadorizada de crânio (TC) é sempre motivo de preocupação por causa da possibilidade frequente de etiologia neoplásica, embora as doenças granulomatosas, infecciosas, vascular, iatrogênica, desmielinizante, trauma, e parasitárias podem produzir aspecto semelhante na radiologia. Uma ampla gama de condições não neoplásicas pode mimetizar um tumor cerebral, tanto clínica, quanto radiologicamente, representando uma armadilha potencial para os médicos envolvidos no cuidado ao paciente. O objetivo do estudo é alertar a possibilidade de outras etiologias neoplásicas e não neoplásicas no diagnóstico diferencial de lesões hipodensas em TC sem contraste. Métodos Revisão da literatura utilizando PubMed, MEDLINE, Google Scholar, Ensaios Clínicos, EBSCO, Scielo, Tópicos em radiologia. Foram selecionados por período 1986- 2015. Discussão O conhecimento de várias etiologias, quando confrontado com múltiplas lesões na tomograa computadorizada permite o direcionamento do diagnóstico para o tratamento adequado, evitando a irradiação de lesões não neoplásicas e cirurgias desnecessárias. As lesões mais frequentes são neoplasias (74% a 86%), especialmente gliomas, seguido de infecções (8% a 15%) e infartos (0,6% a 6%), que representam lesões não neoplásicas. Conclusão Como um possível resultado da percentagem relativamente elevada de diagnósticos errados neurorradiológicos, o diagnóstico histológico faz necessário, porque mesmo Ressonância pode ser difícil na diferenciação de tais lesões.

Relationship between dynamic postural control ability and abdominal area in middle-aged people / 体力科学

Dynamic postural control ability is necessary for fall prevention in our daily lives. It has been suggested that dynamic postural control ability is highly related to the muscles in the trunk as well as the lower limbs for the keep and move of the body. In this study, we reveal relationship between dynamic postural control ability and abdominal area. Subjects including 31 middle-aged people consist of 12 men and 19 women (mean age 60.0±7.6 years). We measured visceral fat area and cross-sectional area of the trunk muscle using abdominal computed tomography scan. The unstable tilt board is used for measuring dynamic postural control ability. Through multiple regression analysis, it is possible to relate dynamic postural control ability from gender, visceral fat, and deep trunk muscle such as psoas major muscle on abdominal computed tomography scan. It is considered that dynamic postural control ability involved not only increasing the volume of deep trunk muscle but also decreasing the amount of visceral fat.

Alveolar Ridge Preservation with Beta-Tricalcium Phosphate Bone Graft and Implant Placement: A Case Report.

Various bone grafts, non-vital bone grafting materials, and membranes have been developed to counteract the significant resorption of the alveolar bone following tooth extraction with utilizing principals of guided bone regeneration (GBR). Alloplastic graft material, consisting of the pure phase of beta-tricalcium phosphate (b-TCP) in the preservation of ridge volume after tooth extraction and before dental implant placement, is a well-accepted procedure. In the present case report, b-TCP bone graft was used to preserve and augment the alveolar bone with utilizing the principles of GBR. Quantification of alveolar bone dimensions was done with the help of computed tomography scan of jaw both at baseline, i.e. before extraction and after 6 months just before implant placement.