ABSTRACT
Myelolipoma of the adrenal gland is a rare benign tumor. It is diagnosed incidentally in most cases because of its non-functioning nature, unless it causes symptoms due to its size. It has specific sonographic and computed tomographic features. A case is presented, magnetic resonance findings are reported for the first time and a review of the literature is conducted.
Subject(s)
Adrenal Gland Neoplasms/diagnosis , Adrenal Gland Neoplasms/surgery , Myelolipoma/diagnosis , Myelolipoma/surgery , Abdominal Pain/etiology , Adrenal Gland Neoplasms/complications , Aged , Biopsy, Needle , Female , Humans , Magnetic Resonance Imaging , Myelolipoma/complications , Tomography, X-Ray Computed , Treatment Outcome , UltrasonographyABSTRACT
A case of a medulloblastoma with extensive intradural dissemination and direct tumour spread from a lumbosacral deposit in the pelvis is presented. A review of the literature revealed six similar cases. In all of them direct invasion of contiguous structures occurred at sites of secondary deposits. Two predilection site were identified: 1. The anterior fossa with tumour invasion of the paranasal air sinuses. 2. The lumbosacral spine with tumour extension into the retroperitoneum and pelvis. Generally, this unusual mode of tumour spread indicates a final stage in the course of the disease. The possible pathogenesis is discussed.
Subject(s)
Cerebellar Neoplasms/pathology , Medulloblastoma/pathology , Adult , Cerebellar Neoplasms/diagnostic imaging , Humans , Male , Medulloblastoma/diagnostic imaging , Neoplasm Invasiveness , Tomography, X-Ray ComputedABSTRACT
The routine use of peroperative (pre-exploration) cholangiography was prospectively studied in 433 consecutive patients undergoing elective cholecystectomy. Satisfactory peroperative cholangiography was achieved in 396 patients using a C-arm image intensifier with image retention facility. Clinical indications for exploration of the common bile duct were noted for each patient but the decision for choledochotomy was determined by the cholangiographic results. Two hundred and forty-nine (63 per cent) patients had no clinical indications for duct exploration and cholangiographic findings were all normal. Of the 147 patients with positive clinical criteria, 39 (9.8%) had abnormal cholangiograms and required exploration of the common bile duct. In three patients duct exploration was negative giving a false positive rate of 0.73 per cent. The use of the image intensifier allowed dynamic study during cholangiography and optimum evaluation of the duct system. The results support the view that peroperative cholangiography could be restricted to patients with clinical indications for exploration of the common bile duct.
