ABSTRACT
The case of a 9-year-old girl with intracranial hemorrhage due to a giant aneurysm of distal middle cerebral artery is reported. Cerebral aneurysms are rare in children, particularly in the first decade of life. Aneurysms in childhood occur more frequently in peripheral branches and they are more often giant in size. Clinical features and pathogenesis of this lesion are discussed.
Subject(s)
Intracranial Aneurysm/diagnosis , Cerebral Angiography , Cerebral Arteries/diagnostic imaging , Child , Female , Humans , Intracranial Aneurysm/surgery , Magnetic Resonance ImagingABSTRACT
Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm height (z score = 2.17), pubertal development on stage G II, P II, and 4 cm3 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the referred syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.
Subject(s)
Arachnoid Cysts/complications , Kallmann Syndrome/complications , Adolescent , Arachnoid Cysts/diagnosis , Brain/diagnostic imaging , Humans , Kallmann Syndrome/diagnosis , Magnetic Resonance Spectroscopy , Male , Tomography, X-Ray ComputedABSTRACT
O papiloma invertido é um tumor epitelial incomum que compromete a regiäo nasal e os seios paranasais. Este tumnor, embora originariamente benigno, tem alto grau de recorrência, podendo sofrer transformaçäo maligna. Ele pode destruir estruturas ósseas e se estender para as fossas cranianas anteriores e média, e tornar-se, desse modo, indistinguível radiologicamente de lesäo malígna. 8 pacientes com papiloma invertido histologicamente confirmados säo descritos e os seus achados radiológicos apresentados e comparados com os da literatura
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Head and Neck Neoplasms/analysis , Papilloma/analysis , Radiography/instrumentation , BrazilABSTRACT
Fourteen children with adrenal cortical carcinoma were evaluated by ultrasonography. The neoplasms, 2.5 cm-19 cm in maximum diameter, were all well circumscribed. The four smaller lesions were either homogeneously hypoechoic (2 patients) or generally hyperechoic (2 patients). In the 10 patients with larger tumors, a complex predominantly echogenic pattern was demonstrated, eight of which contained radiating linear echoes, the "scar sign". This finding, although not specific, when present in a large adrenal mass, is suggestive of a cortical carcinoma. Associated findings of vascular invasion or retroperitoneal adenopathy supported the diagnosis of a malignant adrenal neoplasm in 3 patients.
Subject(s)
Adrenal Cortex Neoplasms/pathology , Adrenal Cortex Neoplasms/diagnosis , Child , Child, Preschool , Female , Humans , Infant , Male , UltrasonographyABSTRACT
Four children with benign intraperitoneal lipomatous tumors (mesenteric lipoma, mesenteric lipoblastoma, omental lipoblastoma and mesenteric mesenchymoma) are reported. The ultrasonographic findings of these unusual pediatric masses are described and correlated with their conventional radiologic and pathologic appearance. The pre-operative diagnosis of these entities can be suggested by these features.
Subject(s)
Lipoma/diagnostic imaging , Peritoneal Neoplasms/diagnostic imaging , Child , Child, Preschool , Female , Humans , Infant , Lipoma/pathology , Male , Mesenchymoma/diagnostic imaging , Mesenchymoma/pathology , Mesentery , Omentum , Peritoneal Neoplasms/pathology , Radiography , UltrasonographyABSTRACT
Sonography was utilized to evaluate 12 patients with hypertrophy of the septum of Bertin. To confirm the diagnosis, angiography was used in 7 patients and radionuclide imaging in 2. Three sonographic characteristics were found: (1) an isoechogenic, ellipsoid mass with an echogenic linear rim of renal sinus fat; (2) contiguity of the mass with a normal-placed septum of Bertin; and (3) the occurrence of the mass effect always at the level of the emergence of the renal vein. The sonographic findings could be divided into two definite types. Type I showed moderate hypertrophy with a mass effect ranging from 1.1 by 2.3 cm to 2.0 by 3.2 cm in diameter, usually presenting with a smooth contour and discrete mass effect on the intravenous pyelogram (IVP). Type II showed severe hypertrophy with a mass effect ranging from 3.2 by 4.0 cm to 3.5 by 4.5 cm in diameter, usually presenting with a lobulated contour and irregular stretching of the calyceal system on IVP. The differential diagnosis is discussed. In conclusion, we found that sonography associated with excretory urography is an accurate method for the diagnosis of hypertrophy of the septum of Bertin.
Subject(s)
Kidney Cortex/pathology , Ultrasonography , Adolescent , Adult , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Hypertrophy/diagnosis , Kidney Cortex/diagnostic imaging , Kidney Neoplasms/diagnosis , Male , Middle Aged , RadiographyABSTRACT
Os achados ultra-sonograficos observados em nove pacientes com carcinoma de celulas transicionais do rim foram correlacionados com os achados da urografia excretora, da pielografia anterograda e/ou da pielografia retrograda. Em seis pacientes a hipotese diagnostica de tumor de vias coletoras renais foi corretamente considerada baseada nos achados da urografia excretora. Nestes pacientes o exame ultra-sonografico foi util na caracterizacao adequada desta entidade, excluindo outras possibilidades diagnosticas. Em outros tres pacientes, devido a suas manifestacoes incomuns, a ultra-sonografia foi fundamental para o diagnostico. Estas manifestacoes atipicas incluiram a demonstracao de massa na periferia de saco hidronefrotico, a demonstracao de massas papilares arborescentes em rim hidronefrotico e a deteccao de massa associada a processo inflamatorio da pelvis renal. Nenhum desses aspectos por nos observados sao descritos na literatura. Os diagnosticos diferenciais, bem como uma comparacao entre os nossos achados com os encontrados em 17 casos previamente citados na literatura sao tambem apresentados
Subject(s)
Humans , Carcinoma, Transitional Cell , Kidney Neoplasms , UltrasonicsABSTRACT
Os autores relatam o estudo radiografico de dois pacientes portadores de polipo coanal e de dois pacientes portadores de polipo antro-coanal que foram examinados radiograficamente, usando-se metodos convencionais e procedimentos especiais, como angiografia e tomografia computadorizada.A contribuicao da radiologia foi a de afastar lesoes neoplasicas e fazer a localizacao anatomica precisa de afeccao, bem como o seu estadiamento
Subject(s)
Adolescent , Adult , Humans , Male , Female , Angiography , Maxillary Sinus , Polyps , Tomography, X-Ray ComputedSubject(s)
Adolescent , Adult , Humans , Male , Cryptococcosis , Lung Diseases , Lung Neoplasms , Diagnosis, DifferentialABSTRACT
Os autores relatam o valor da tomografia computadorizada no diagnostico do retinoblastoma. Sao apresentados quatro casos e descritos os achados tomograficos e o papel da tomografia computadorizada como metodo propedeutico, permitindo uma precisa localizacao e extensao do tumor e seu valor no diagnostico, planejamento cirurgico e radioterapico e prognostico
Subject(s)
Infant , Child, Preschool , Humans , Male , Female , Eye Neoplasms , Retinoblastoma , Tomography, X-Ray ComputedABSTRACT
Os exames ultra-sonograficos hepaticos de 150 pacientes com linfoma foram revistos.Destes pacientes 38 apresentaram doenca de Hodgkin e 112 um tipo de linfoma nao-Hodgkin. Manifestacao focal do linfoma hepatico foi encontrada em sete pacientes (5%).Os aspectos predominantemente encontrados foram os de lesoes focais hipoecoicas e o de lesoes focais ecogenicas com halo hipoecoico periferico (lesoes "em alvo"). Estas manifestacoes ocorreram em linfomas Hodgkin e nao-Hodgkin
Subject(s)
Humans , Liver Neoplasms , Lymphoma , UltrasonicsABSTRACT
Foram examinados 32 pacientes portadores de doenca renal policistica do adulto (D.R.P.A.) pela ultra-sonografia, na tentativa de fornecer subsidios ao tratamento e ao prognostico da doenca. Todos os casos apresentaram alteracoes renais bilaterais, sete pacientes com cistos hepaticos e um que a presenca de parenquima renal poupado te. A correlacao entre achados sonograficos e as provas de funcao renal revelou que a presenca de parenquma renal poupado em proporcao menor ou igual a 30% do volume renal e frequentemente associada a alteracoes bioquimicas da ureia e creatinina A caracterizacao de cistos predominantes atraves da correta localizacao dos mesmos foi util para o alivio sintomatico em quatro pacientes, pois possibilitou a puncao percutanea esvaziadora ou a exerese de cistos volumosos. Em outros 3 pacientes com insuficiencia renal a ultra-sonografia foi fundamental, se levarmos em conta que outros metodos diagnosticos haviam sido inconclusivos. Portanto, a ultrasonografia, alem de util no diagnostico e seguimento da D.R.P.A., pode ser importante no estadiamento, fornecendo subsidios importantes ao tratamento da doenca
