Correlating MRI and histologic tumor thickness in the assessment of oral tongue cancer.

OBJECTIVE: Tumor thickness in oral tongue cancer is an important independent prognostic factor for local recurrence, nodal metastasis, and patient survival. An accurate preoperative assessment of tumor thickness is therefore essential for optimal treatment planning. The aim of our study was to evaluate the accuracy of MRI findings for the preoperative measurement of tumor thickness. SUBJECTS AND METHODS. Eighteen patients with oral tongue cancer underwent preoperative MRI of the tongue. After surgery, the glossectomy specimens were serially sectioned. The radiologic tumor thickness of contrast-enhanced T1-weighted and T2-weighted images was compared with the histologic tumor thickness using our proposed tumor thickness staging classifications. These included stage I (tumor < or = 3 mm), stage II (> 3 mm but < or = 9 mm) and stage III (> 9 mm). RESULTS: The overall accuracy in assessment of proposed tumor thickness staging using contrast-enhanced T1-weighted and T2-weighted images was 83% and 56%, respectively. The radiologic tumor thickness as measured on contrast-enhanced T1-weighted and T2-weighted images had significant correlation with histologic tumor thickness (R = 0.938 and 0.941, respectively). CONCLUSION: MR images provide satisfactory accuracy for the measurement of tumor thickness and staging of oral tongue cancer. Preoperative MRI is recommended to assist in treatment planning for patients with this disease.

Myxofibrosarcoma of the sphenoid sinus.

Myxofibrosarcoma was originally described as the myxoid variant of malignant fibrous histiocytoma (MFH). It is uncommon in the head and neck region. We hereby report a case of myxofibrosarcoma in the sphenoid sinuses. The diagnostic and management difficulties are discussed. Close collaboration between surgeon, radiologist, histopathologist and clinical oncologist in makng accurate diagnosis and appropriate management of this rare tumour are emphasized.

Free-hand, ultrasound-guided percutaneous renal biopsy: experience from a single operator.

UNLABELLED: Percutaneous renal biopsy is a useful diagnostic procedure for many renal diseases. The experience with ultrasound-guided percutaneous renal biopsy from a single operator was reviewed to identify the possible risk factors of complications after the procedure. METHODS AND RESULTS: From 1995 to 1998, 203 biopsies (141 on native kidneys with 14G needles, 62 on transplant kidneys with 18G needles) were performed on 186 individuals as clinically indicated. The biopsy tissue specimen was adequate for histological diagnosis in 96.4% of the biopsies performed. IgA nephropathy followed by lupus nephritis were the most frequent diagnoses in our locality. Haematuria was the most common complication observed: mild bleeding occurred in 4.5%, while major complications (those that required blood transfusion or other intervention) were encountered in 1.5% of patients. Impaired renal function was identified as the single most important risk factor of bleeding complication after renal biopsy, while the presence of systemic hypertension or nephrotic syndrome did not increase the risk of bleeding. There was no correlation between bleeding and the type of renal pathology or the number of needle passes. Continuous haematuria may result from blood clot retention in the bladder. Over 97% of the cases were discharged from hospital within 48 h. CONCLUSIONS: We conclude that ultrasound-guided renal biopsy remains a safe, fast, and accurate procedure for the definitive investigation of renal diseases.