ABSTRACT
PURPOSE: The goal of this study was to assess the performances of magnetic resonance imaging (MRI) and multidetector-row computed tomography (MDCT) in determining tumor location, suggesting the specific diagnosis of tumors involving the peripharyngeal space and identifying findings suggestive for malignancy using histopathological findings as standard of reference. MATERIAL AND METHODS: The MDCT and MRI examinations of 99 patients with a total of 102 tumors located in the retropharyngeal, carotid and parapharyngeal spaces were retrospectively reviewed. MDCT and MRI examinations were independently analyzed for tumor location and specific histological type of tumor. Finally, benign or malignant criteria were evaluated. Agreement between imaging features and final histopathological diagnosis that served as the standard of reference was assessed with the Kappa statistic. RESULTS: Regarding tumor location almost perfect agreement was obtained between imaging findings and histopathological findings (kappa=0.86 and 0.92 for MDCT and MRI, respectively). Agreement between the results of imaging and histopathological findings regarding malignancy was substantial for MDCT (Kappa=0.73), MRI (Kappa=0.65). A definite histopathological diagnosis was suggested on the basis of imaging findings for 84 tumors and in agreement with the final histopathological diagnosis in 77/84 tumors (92%). CONCLUSION: MDCT and MRI provide accurate information to localize and characterize peripharyngeal tumors. These two examinations provide complementary data to identify imaging criteria that suggest malignancy.
Subject(s)
Magnetic Resonance Imaging , Multidetector Computed Tomography , Pharyngeal Neoplasms/diagnostic imaging , Adipose Tissue/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Carotid Artery, Internal/diagnostic imaging , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Multimodal Imaging , Retrospective Studies , Young AdultABSTRACT
Cutaneous head and neck tumors mainly comprise malignant melanoma, squamous cell carcinoma, trichoblastic carcinoma, Merkel cell carcinoma, adnexal carcinoma, dermatofibrosarcoma protuberans, sclerodermiform basalioma and angiosarcoma. Adapted management requires an experienced team with good knowledge of the various parameters relating to health status, histology, location and extension: risk factors for aggression, extension assessment, resection margin requirements, indications for specific procedures, such as lateral temporal bone resection, orbital exenteration, resection of the calvarium and meningeal envelopes, neck dissection and muscle resection.
Subject(s)
Head and Neck Neoplasms/surgery , Skin Neoplasms/surgery , Carcinoma/pathology , Carcinoma/surgery , Diagnostic Imaging , Facial Muscles/surgery , Head and Neck Neoplasms/pathology , Humans , Lymph Node Excision , Lymph Nodes/pathology , Melanoma/pathology , Melanoma/surgery , Meninges/surgery , Neoplasm Invasiveness , Neoplasm Metastasis/diagnosis , Orbit Evisceration , Parotid Gland/surgery , Skin Neoplasms/pathology , Skull/surgery , Temporal Bone/surgeryABSTRACT
INTRODUCTION: Adenocarcinoma of the ethmoid is an aggressive tumor, with potential extension to surrounding structures. Leptomeningeal extension is a rarely reported entity. CASE REPORT: A carpenter, aged 55, developed multifocal cranial nerve-related symptoms 1 week after resection of adenocarcinoma of the ethmoid, evolving towards deteriorated general health status and death 10 weeks later. Brain MRI showed diffuse contrast enhancement of the cranial nerves, and repeated cerebrospinal fluid (CSF) examination found increased protein concentration associated with decreased glucose concentration, without malignant cells. The diagnosis of carcinomatous meningitis was based on the association of clinical, CSF and brain MRI data. DISCUSSION/CONCLUSION: Leptomeningeal dissemination of adenocarcinoma of the ethmoid is rare; diagnosis is guided by clinical signs. MRI reveals neurological spread, but the presence of malignant cells in the CSF is sufficient for diagnosis. Due to poor prognosis, the only currently available treatments are palliative.
Subject(s)
Adenocarcinoma/secondary , Ethmoid Sinus , Meningeal Carcinomatosis/secondary , Paranasal Sinus Neoplasms/pathology , Humans , Male , Meningeal Carcinomatosis/diagnosis , Middle AgedABSTRACT
INTRODUCTION: Acinic cell carcinoma is a rare form (2-4%) of parotid tumor. It is, however, the most frequent form of bilateral parotid tumor and the second most frequent form in children. CASE REPORT: A 22-year-old man had several years' history of left parotid tumor, discovered to be acinic cell carcinoma. MRI found a synchronous contralateral tumor of the same histologic nature. DISCUSSION/CONCLUSION: This case highlights the need for rigorous examination of the contralateral parotid in case of parotid tumor and especially of acinic cell carcinoma.
