Melanoma of the lacrimal sac: An extremely rare location From a radiologist perspective.

Lacrimal sac tumors are rare with epithelial tumors being the most common type. Melanoma of the lacrimal sac is an exceptional finding. Few cases have been reported so far in the literature. We report the case of a sixth year old male, with no pathological background, who was referred to the hospital for chronic dacryocystitis resistant to treatment. Computed tomography dacryocystography and magnetic resonance imaging were performed, in favor of a large mass of the lacrimal sac and lacrimal canal suggestive of melanoma. Biopsy confirmed the diagnosis. PET-CT was positive and showed abnormal activity in the lung, liver and bones, in favor of metastasis.

Pretreatment [18F]FDG PET/CT and MRI in the prognosis of nasopharyngeal carcinoma.

OBJECTIVE: The present study aimed to assess the prognostic interest of metabolic and anatomic parameters derived from 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) and head and neck magnetic resonance imaging (HN-MRI) for better management of nasopharyngeal carcinoma (NPC). METHODS: In this study, pre-treatment [18F]FDG PET/CT and HN-MRI parameters of NPC patients diagnosed between January 2017 and December 2018, were prospectively investigated. Correlation between those parameters and 4-year patient's survival outcomes was evaluated using Kaplan-Meier and Cox-regression analyses. RESULTS: Our results revealed a significant association between pre-treatment nodal-maximum standardized uptake value (N-SUV max) and N categories (p = 0.01), between pre-treatment node-to-tumor SUV ratio (NTR) and both tumor size (p = 0.01) and N categories (p = 0.009), as well as between metabolic tumor volume (MTV) and both tumor size and NPC overall stage (p < 0.000). In multivariate analyses, pre-treatment N-SUV max, NTR and MTV were significant independent predictors of overall survival, distant metastasis-free survival, and progression-free survival (PFS) (p < 0.05). N-SUV max and MTV were also found to be significant independent predictors of loco-regional recurrence-free survival (p < 0.05), whereas HN-MRI detection of skull-base bone invasion was an independent factor associated with worse PFS in NPC (p = 0.03). CONCLUSIONS: The present study highlights N-SUV max, NTR and MTV derived from [18F]FDG PET/CT, and skull-base bone invasion defined by HN-MRI, as promising metabolic and anatomic prognosis biomarkers for NPC.

Unusual Location of a Giant Cell Tumour.

Giant cell tumours (GCT) are rare aggressive non-cancerous tumours which usually affect the long bones. We describe a case of GCT of the first rib in a young woman without a relevant history. The patient presented a left cervico-thoracic mass which was biopsied in our department (CT-guided biopsy). She was referred to the thoracic surgery department after histological results. LEARNING POINTS: Giant cell tumours (CGT) are benign tumours that usually occur on long bones with costal localization being a rare entity.Ultrasound can be a useful tool to assess the nature of the lesion.Diagnosis is based on lesion biopsy, but aggressive surgical resection can be performed.CGT should be considered in the differential diagnosis of costal tumours.

[Imaging features of multiple maxillomandibular brown tumors: a case report]. / Imagerie des tumeurs brunes maxillo-mandibulaires multiples: à propos d'un cas.

Brown tumors are rare osteolytic lesions occurring in 1.5-1.7% of patients with chronic end-stage renal failure. They are caused by PTH-induced bone remodeling. We here report the case of a young woman on hemodialysis for chronic end-stage renal failure with painless maxillo-mandibular swellings occurred 7 months before. Clinical examination showed facial deformity with two maxillary and mandibular masses to palpation. Laboratory tests revealed hypocalcemia, hyperphosphatemia with hyperparathyroidism. CT scan of the face revealed multiple osteolytic masses in the maxillary and mandibular bones, with significant bone rarefaction and signs of diffuse bone resorption. The diagnosis of multiple brown tumors of the face was retained based on clinical, biological and radiological features. Brown tumors are a rare entity usually characterized by maxillomandibular involvement in patients with chronic renal failure. Practitioners should suspect them, hence the interest in this study.

Amyotrophic Monoplegia Secondary to Posttraumatic Rupture of the Brachial Plexus's Roots: A Case Report and Review of the Literature.

Brachial plexus lesions most often occur in multiple trauma. We report a case of a 37-year-old patient who presented an upper left limb total sensitivomotor deficit and amyotrophy after a cervical and upper limb trauma. Cervical magnetic resonance imaging (MRI) was performed. It noted pseudomeningoceles at the levels of C6-C7, C7-D1, and D1-D2 in T1 hyposignal , T2 and STIR hypersignal , not enhanced by the injection of Gadolinium extending in foraminal and extraforaminal spaces without visualization of the corresponding rootlets. Traumatic brachial plexus injury is a potentially serious debilitating injury which can be well explored on MRI.

Sinonasal Chondrosarcoma, an Unusual Location.

INTRODUCTION: Chondrosarcoma is a tumour with a cartilaginous matrix frequently encountered in long bones and the pelvis with rare sinonasal location. PATIENT AND METHODS: We report the case of a 25-year-old patient who was referred to us for an extension work-up for sinonasal chondrosarcoma confirmed by anatomopathological examination. RESULTS: Facial magnetic resonance imaging (MRI) confirmed by a CT scan showed an osteolytic tumour process of the hard palate and walls of the left maxillary sinus that was locally advanced. CONCLUSION: The sinonasal location of a chondrosarcoma is rare. Characterized by cross-sectional imaging, confirmation was provided by histological assessment. LEARNING POINTS: The sinonasal location of a chondrosarcoma is rare.A slow-growing tumour with a cartilage matrix in adults, it is revealed mainly by neurosensorial signs and mass effect in its sinonasal location.Radiological characterization includes areas with a weak signal on T1- and T2-weighted images in MRI, not enhanced by gadolinium, corresponding to the cartilage matrix.

Unusual Location of a Recurrent Epidermoid Cyst.

INTRODUCTION: Epidermoid cysts of the temporal bone are rare, benign and slow-growing lesions. PATIENT AND METHODS: We report the case of a 69-year-old female patient followed up for a symptomatic intradiploic epidermoid cyst of the temporal scale and left mastoid region, which had been operated on but recurred. RESULTS: MRI demonstrated a well-limited lesion seen as a hyposignal on T1-weighted images, hypersignal on T2-weighted images, on FLAIR and on diffusion-weighted images not enhanced by gadolinium. The tumour was compressive, and bone lysis was seen on CT. CONCLUSION: Epidermoid cysts of the temporal bone are rare, benign lesions whose diagnosis is based on fluid signals seen on MRI but absent on FLAIR sequences. LEARNING POINTS: Epidermoid cysts of the temporal bone are rare, benign and slow-growing lesions.Larger cysts are easier to identify.Diagnosis is based on the presence of a fluid signal on all MRI sequences except for FLAIR imaging, and on confirmation by pathological examination.