RESUMO
Tumor localization is challenging in the context of ductal carcinoma in situ (DCIS) treated with breast-conserving surgery. Conventional localization methods are generally performed under the guidance of ultrasonography or mammography and are rarely performed with magnetic resonance imaging (MRI), which is more sensitive than the aforementioned modalities in detecting DCIS. Here, we report the application of MRI-based individualized 3-dimensional (3D)-printed breast surgical guides (BSGs) for patients with breast cancer.We successfully resected indeterminate and suspicious lesions that were only detected using preoperative MRI, and the final histopathologic results confirmed DCIS with clear resection margins. MRI guidance combined with 3D-printed BSGs can be used for DCIS localization, especially for lesions easily detectable using MRI only.
RESUMO
Tumor localization is challenging in the context of ductal carcinoma in situ (DCIS) treated with breast-conserving surgery. Conventional localization methods are generally performed under the guidance of ultrasonography or mammography and are rarely performed with magnetic resonance imaging (MRI), which is more sensitive than the aforementioned modalities in detecting DCIS. Here, we report the application of MRI-based individualized 3-dimensional (3D)-printed breast surgical guides (BSGs) for patients with breast cancer.We successfully resected indeterminate and suspicious lesions that were only detected using preoperative MRI, and the final histopathologic results confirmed DCIS with clear resection margins. MRI guidance combined with 3D-printed BSGs can be used for DCIS localization, especially for lesions easily detectable using MRI only.
RESUMO
Adrenal medullary hyperplasia is an increase in the mass of the adrenal medullary cells. We report a case of a 38-year-old man presenting with pheochromocytoma-like symptoms who was preoperatively misdiagnosed with pheochromocytoma. Hypertension was associated with an intracranial hemorrhage evident in a brain computed tomography scan, in which no obvious pituitary gland enlargement was detected. An abdominopelvic CT revealed a solitary tumor in the right adrenal gland with no obvious enlargement of the contralateral adrenal gland or sympathetic chains. Lab results showed increased levels of urinary metanephrines. Based on clinical data, the patient underwent a laparoscopic right adrenalectomy bases on a diagnosis of pheochromocytoma. The patient was finally diagnosed with adrenal medullary hyperplasia with coexisting ipsilateral non-functioning adrenal cortical adenoma. Postoperatively, blood pressure and lab results were maintained in the normal range and the patient was symptomatically free during the follow-up period.