Kaposiform hemangioendothelioma of the thigh: A case report.

Kaposiform hemangioendothelioma is a rare, locally aggressive or borderline vascular tumor that typically affects infants. It presents as a purpuric cutaneous lesion and may be associated with life-threatening coagulation disorders, such as the Kasabach-Merritt phenomenon. The differential diagnosis can be challenging based on clinical presentation alone. Imaging plays a crucial role in the diagnostic workup, particularly magnetic resonance imaging. We present a case report of a 4-month-old patient with an enlarging vinous cutaneous mass on the thigh and coagulation abnormalities. Magnetic resonance imaging revealed a large, infiltrative, soft-tissue lesion with poorly defined margins and heterogeneous enhancement, that involved all muscle compartments of the thigh and was associated with lymphedema, stranding of the subcutaneous fat and cutaneous thickening. These findings were consistent with kaposiform hemangioendothelioma of the thigh and the diagnosis was confirmed by histopathological characterization.

A Random Forest-based Classifier for MYCN Status Prediction in Neuroblastoma using CT Images.

Neuroblastoma (NB) is the most common extracranial solid tumor in childhood. Genomic amplification of MYCN is associated with poor outcomes and is detected in 16% of all NB cases. CT scans and MRI are the imaging techniques recommended for diagnosis and disease staging. The assessment of imaging features such as tumor volume, shape, and local extension represent relevant prognostic information. Radiogenomics have shown powerful results in the assessment of the genotype based on imaging findings automatically extracted from medical images. In this work, random forest was used to classify the MYCN amplification using radiomic features extracted from CT slices in a population of 46 NB patients. The learning model showed an area under the curve (AUC) of 0.85 ± 0.13, suggesting that radiomic-based methodologies might be helpful in the extraction of information that is not accessible by human naked eyes but could aid the clinicians on the diagnosis and treatment plan definition. Clinical relevance - This approach represents a random forest-based model to predict the MYCN amplification in NB patients that could give a faster, earlier, and repeatable analysis of the tumor along the time.

Herlyn-Werner-Wunderlich syndrome: A case report in a young woman, with literature review.

Herlyn-Werner-Wunderlich syndrome is a rare complex congenital disorder, with combined Müllerian and mesonephric duct anomalies, presenting with uterus didelphys, unilateral blind hemivagina and ipsilateral renal agenesis. Hemivaginal obstruction usually leads to impairment of normal menstrual flow, resulting in symptoms after menarche, namely dysmenorrhea, pelvic pain or infertility. Age of presentation depends on the anatomical features of this anomaly. We report a case of a 21-year-old female presenting with few symptoms and incidental findings on transvaginal ultrasound, with typical findings of this disorder on magnetic resonance imaging, which remains the gold standard imaging technique for thorough assessment of Herlyn-Werner-Wunderlich syndrome, allowing for a correct diagnosis and adequate surgical management. Our case also highlights some unusual features, such as the presence of a blind ectopic ureter, with hematic content, and an incomplete septum within the obstructed hemivagina.

Solitary pancreatic renal cell carcinoma metastasis.

Pancreatic metastases are rare; they account for only 2% of all pancreatic malignancies and usually occur when associated with a disseminated metastatic disease. Solitary pancreatic metastases are even less frequent, and there are few reports regarding surgical resection. We report the case of a 77-year-old female patient diagnosed with a single cephalo-pancreatic metastasis of renal cell carcinoma, 16 years after a total nephrectomy. The patient underwent successful pancreaticoduodenectomy, and the diagnosis was confirmed. A subsequent positron emission tomography (PET) scan showed disease relapse, and tyrosine kinase inhibitor treatment with sunitinib was initiated. After 1 year and 4 months, the PET-computed tomography scan showed a complete radiologic response.

Solitary pancreatic renal cell carcinoma metastasis

Pancreatic metastases are rare; they account for only 2% of all pancreatic malignancies and usually occur when associated with a disseminated metastatic disease. Solitary pancreatic metastases are even less frequent, and there are few reports regarding surgical resection. We report the case of a 77-year-old female patient diagnosed with a single cephalo-pancreatic metastasis of renal cell carcinoma, 16 years after a total nephrectomy. The patient underwent successful pancreaticoduodenectomy, and the diagnosis was confirmed. A subsequent positron emission tomography (PET) scan showed disease relapse, and tyrosine kinase inhibitor treatment with sunitinib was initiated. After 1 year and 4 months, the PET-computed tomography scan showed a complete radiologic response.

Isotropic 3-D T2-weighted spin-echo for abdominal and pelvic MRI in children.

MRI has a fundamental role in paediatric imaging. The T2-weighted fast/turbo spin-echo sequence is important because it has high signal-to-noise ratio compared to gradient-echo sequences. It is usually acquired as 2-D sections in one or more planes. Volumetric spin-echo has until recently only been possible with very long echo times due to blurring of the soft-tissue contrast with long echo trains. A new 3-D spin-echo sequence uses variable flip angles to overcome this problem. It may reproduce useful soft-tissue contrast, with improved spatial resolution. Its isotropic capability allows subsequent reconstruction in standard, curved or arbitrary planes. It may be particularly useful for visualisation of small lesions, or if large lesions distort the usual anatomical relations. We present clinical examples, describe the technical parameters and discuss some potential artefacts and optimisation of image quality.