Evaluation of the changes in the shape and location of the prostate and pelvic organs due to bladder filling and rectal distension

A steep dose gradient between prostate and organs at risk [rectum and bladder] is ideal in treatment modality, so prostate displacement and deformation due to bladder filling and rectal distension play an important role in critical organs dose. This study aims to evaluate the changes in the shape and location of the prostate and pelvic organs due to bladder filling and rectal distension. Three patients who referred for transrectal prostatic biopsy [Shahid Faghihi Hospital, Shiraz, Iran] with different prostate sizes were enrolled. A 1.5-Tesla MRI system [Avanto, Siemens, Germany] and an ultrasound system [Logiq 500, GE medical systems, USA] were used to collect images of patients prostate at different stages of bladder and rectum fullness. The mean displacement of the prostate after bladder filling in the supine and left decubitus positions along the Anterior-Posterior [AP] axis was posterior by 4.9 mm [range: 0.7-6.3 mm] and along the Superior-Inferior [SI] axis was inferior by 3.4 mm [range: 1.4-5 mm]. Prostate displacement in the Left-Right [LR] axis was negligible. The mean prostate displacement after rectal distension was anterior by 7.1 mm in the supine position, 5.1 mm anterior in the left decubitus position and along the SI axis was inferior by 2.5 mm in the supine and left decubitus positions. The maximum prostate deformation due to rectal distension and bladder filling in the supine position was as large as 3.2 mm, 1.9 mm and 1.2 mm in the AP, SI and LR directions respectively. While in the left decubitus position, it was 2.6 mm, 1.2 mm and 1.3 mm in the AP, LR and SI axis respectively. It is probably of importance to evaluate the influence of the changes in the shape and location of the prostate due to bladder filling, rectal distension and patient position in post-implant brachytherapy dosimetry. Using images of the patients in the left decubitus position with full bladder and distended rectum for planning a treatment are suggested

Torsion of wandering spleen and resulting rupture of splenic hilum with whorled sign in CT: a case report

Torsion of a wandering spleen is an atypical cause of an acute abdomen. Herein we report a case of a wandering spleen in a 24 year-old female patient who presented with vague clinical findings of acute abdomen, a laparotomy was performed and the infracted spleen was removed. In such cases, prompt intervention to prevent complications is mandatory

Osteosarcoma arising from a solitary osteochondroma of the tibia

We present a case of osteosarcoma arising from an osteochondroma of the right tibia in a 71 year old man. The radiographic studies were suggestive of a malignant lesion. Histologic examination showed a conventional osteosarcoma that eroded the cartilagenous cap. The patient received postoperative chemotherapy with no evidence of metastasis until three years following the operation. The occurrence of osteosarcoma out of osteochondroma is an extremely rare event and very few cases have been reported

Giant chondroma of falx: a case report

Chondromas are benign tumors that may be found in many parts of the body. Among intracranial neoplasms, tumors of cartilaginous origin are rare. It has been shown that most of these tumors arise from the skull base. Their occurrence in other parts of the intracranial cavity is unusual. Chondroma of falx is a rare neoplasm. In this report we introduce a case of falcine chondroma arose from frontal midline area in a 17-year-old boy

Living-related liver trasplantation in children: the Shiraz experience

The liver transplantation program was established at Shiraz Nemazee Hospital in 1993. Shortage of cadaver organ supply due to various social and legal issues urged us to develop a living-related liver transplantation [LRLT] program. So far 7 [6 males, 1 female] living-related liver transplantations have been performed at this center. The mean age of patients was 8.21 years [ +/- 4.16], with a range of 4.5 to 14 years. Live donors [3 mothers, 2 fathers, and 1 brother] with a mean age of 30.83 years [ +/- 4.11] underwent procurement of the left lateral segment without mortality or any serious morbidity. The native liver disease was idiopathic cirrhosis [1 case], biliary atresia [3 cases], Budd-Chiari syndrome [1 case], neonatal cirrhosis [1 case], and cryptogenic cirrhosis [1 case]. Allografts were implanted using piggy-back surgical technique. Baseline immunosuppression consisted of a triple drug regimen including cyclosporine, mycophenolate mofetil and steroids. Acute graft rejection was treated with intra-venous bolus of methyl-prednisolone. Early death occurred in 2 patients due to vascular thrombosis. Biliary complication was observed in 1 patient. Five patients are alive with a normal functioning liver. In conclusion, LRLT program is promising in Iran. It can help to overcome the shortage of organs and minimize the mortality of patients in the waiting list