Diagnóstico radiológico del encondroma protuberans humeral / Radiological diagnosis of enchondroma protuberans of the humerus

El encondroma protuberans (EP) es un tumor exofítico de estirpe cartilaginosa, poco frecuente, que se describe como una lesión ósea intramedular que protruye por uno de los lados del hueso afecto a través de un defecto cortical, extendiéndose a las partes blandas adyacentes. Sus peculiares características de imagen hacen que los diagnósticos diferenciales principales sean el osteocondroma, el condrosarcoma y los tumores condrales periósticos. En este artículo describimos los hallazgos radiológicos del EP en el húmero en dos pacientes y revisamos la bibliografía, resaltando las características de imagen que pueden permitir un diagnóstico definitivo. Identificar la conexión entre los dos componentes de la lesión a través de un defecto cortical es un hallazgo clave en el diagnóstico. Con las técnicas de imagen disponibles, especialmente la resonancia magnética (RM), podemos establecer el diagnóstico de este tipo de lesiones, permitiendo la elección del tratamiento adecuado y disminuyendo la posibilidad de recidivas locales o malignización (AU)

Enchondroma protuberans (EP) is an uncommon exophytic cartilaginous tumor described as an intramedullary osseous lesion that protrudes through a cortical defect in one of the sides of the affected bone and expands to the adjacent soft tissues. Due to its peculiar features on imaging studies, the main differential diagnosis is with osteochondroma, chondrosarcoma, and periosteal chondral tumors. In this article, we describe the imaging findings in two patients with EP in the humerus. We review the literature and discuss the imaging features that can enable a definitive diagnosis. The identification of the connection between the two components of the lesion through a cortical defect is a key finding for the diagnosis. Available imaging techniques, especially MRI, make it possible to establish the diagnosis in this type of lesions and thus to choose the appropriate treatment, reducing the chance of local recurrence and malignant transformation (AU)

[Radiological diagnosis of enchondroma protuberans of the humerus]. / Diagnóstico radiológico del encondroma protuberans humeral.

Enchondroma protuberans (EP) is an uncommon exophytic cartilaginous tumor described as an intramedullary osseous lesion that protrudes through a cortical defect in one of the sides of the affected bone and expands to the adjacent soft tissues. Due to its peculiar features on imaging studies, the main differential diagnosis is with osteochondroma, chondrosarcoma, and periosteal chondral tumors. In this article, we describe the imaging findings in two patients with EP in the humerus. We review the literature and discuss the imaging features that can enable a definitive diagnosis. The identification of the connection between the two components of the lesion through a cortical defect is a key finding for the diagnosis. Available imaging techniques, especially MRI, make it possible to establish the diagnosis in this type of lesions and thus to choose the appropriate treatment, reducing the chance of local recurrence and malignant transformation.

[Tumors of the oral cavity: the usefulness of dynamic CT]. / Neoplasias de la cavidad oral. Aportaciones del estudio de tomografía axial computarizada dinámica.

OBJECTIVE: To demonstrate the usefulness and importance of including "puffed-cheek" dynamic CT (PCCT) in the protocol for the diagnosis and staging of tumors of the oral cavity. MATERIAL AND METHODS: This is a prospective study of 62 (38 male and 24 female) patients with epidermoid carcinoma of the oral cavity diagnosed and treated at our hospital during an 18-month period. The site of the primary tumor was the tongue (n=19), floor of the mouth (n=3), lip (n=3), gums (n=6), retromolar trigone (n=7), buccal mucosa (n=8), and a combination of the last three locations (n=16). In addition to conventional CT examination, all patients underwent dynamic CT of the oral cavity while maintaining their cheeks puffed out. RESULTS: PCCT provided additional information in 39 patients (63%), giving a better view of the tumor, its extension, or both. PCCT detected eight lesions (17%) that were not visible on the conventional CT study; these lesions were located in the tongue (n=3), retromolar trigone (n=1), buccal mucosa (n=3), and upper gum (n=1). PCCT was especially useful for evaluating lesions with superficial extension, in particular those in the buccal mucosa, retromolar trigone, and gums. PCCT provided no additional information about the tumors on the floor of the mouth. CONCLUSIONS: The habitual contact between the mucosal surfaces of the oral cavity makes some clinically obvious lesions difficult to identify at CT. The interposition of air acts as a natural contrast, separating the gums from the mucosa of the buccomaseteric region; PCCT provides relevant information and should be included in the imaging workup in patients with tumors of the oral cavity.

Neoplasias de la cavidad oral. Aportaciones del estudio de tomografía axial computarizada dinámica / Tumors of the oral cavity: the usefulness of dynamic CT

Objetivos. Demostrar las aportaciones y la importancia en el diagnóstico y la estadificación de las neoplasias de cavidad oral de una tomografía computarizada dinámica hinchando los carrillos (TCHC) incluida en el protocolo de estudio. Material y métodos. Estudio prospectivo de 62 pacientes con carcinoma epidermoide de cavidad oral, diagnosticados y tratados en nuestro hospital en un periodo de 18 meses. Las localizaciones de la lesión tumoral primaria fueron: lengua (n = 19), suelo de la boca (n = 3), labio (n = 3), encía (n = 6), trígono retromolar (n = 7), mucosa bucal (n = 8) y una combinación de las tres últimas localizaciones (n = 16). En estos pacientes al estudio de TC convencional se añadió una TC dinámica restringida a la cavidad oral, en la que el paciente mantenía hinchados los carrillos. Resultados. Con la TCHC se obtuvo información adicional en 39 pacientes (63%), mejorando la visualización del tumor y/o su extensión. Se detectaron 8 lesiones (17%) no visibles en el estudio estándar (lengua [n = 3], trígono retro-molar [n = 1], mucosa bucal [n = 3] y encía superior [n = 1]). La maniobra fue de especial utilidad para evaluar lesiones con extensión superficial, especialmente en los tumores de la mucosa bucal, el trígono retromolar y la encía. No obtuvimos información adicional en las neoplasias del suelo de la boca. Conclusiones. El contacto habitual entre las superficies mucosas de la cavidad oral dificulta la identificación de algunas lesiones. La interposición de aire como contraste natural, separando la mucosa de la encía de la región bucomasetérica, aporta información relevante, por lo que hemos incluido la TCHC como exploración rutinaria adicional en el protocolo de estudio de los pacientes con neoplasia de la cavidad oral

Objective. To demonstrate the usefulness and importanceof including “puffed-cheek” dynamic CT (PCCT) in the protocol for the diagnosis and staging of tumors of the oral cavity. Material and methods. This is a prospective study of 62 (38 male and 24 female) patients with epidermoid carcinoma of the oral cavity diagnosed and treated at our hospital during an 18-month period. The site of the primary tumor was the tongue (n = 19), floor of the mouth (n = 3), lip (n = 3), gums (n = 6), retromolar trigone (n = 7), buccal mucosa (n = 8), and acombination of the last three locations (n = 16). In addition to conventional CT examination, all patients underwent dynamic CT of the oral cavity while maintaining their cheeks puffed out. Results. PCCT provided additional information in 39 patients(63%), giving a better view of the tumor, its extension,or both. PCCT detected eight lesions (17%) that were not visible on the conventional CT study; these lesions were located in the tongue (n = 3), retromolar trigone (n = 1), buccal mucosa (n = 3), and upper gum (n = 1). PCCT was especially useful for evaluating lesions with superficial extension, in particular those in the buccal mucosa, retromolar trigone, and gums. PCCT provided no additional information about the tumors on the floor of the mouth. Conclusions. The habitual contact between the mucosal surfaces of the oral cavity makes some clinically obvious lesions difficult to identify at CT. The interposition of air acts as a natural contrast, separating the gums from the mucosa of the buccomaseteric region; PCCT provides relevant informationand should be included in the imaging workup in patientswith tumors of the oral cavity

[Bone metastasis versus insufficiency fractures due to pelvic radiotherapy for gynecologic neoplasm]. / Metástasis óseas versus fracturas por insuficiencia en pelvis irradiadas por neoplasia ginecológica.

Five cases of patients with gynecological neoplasm (four cervix carcinoma and one endometrial sarcoma) who underwent pelvic external radiotherapy and intracavitary brachytherapy in whom pathologic pelvic uptake was found in the bone scan are presented. The diagnosis was pelvic insufficiency fractures due to radiotherapy adverse effects on the skeletal system confirmed by CT and by the favorable scintigraphy and clinical outcome. Both bone metastases and insufficiency fractures must be considered in the differential diagnosis of bone pain in irradiated pelvises. The bone scintigraphy detects these insufficiency fractures early and can show a typical symmetric uptake pattern. In asymmetric lesions, the CT and clinical follow-up as well as the scintigraphic evolution of the lesions should confirm the findings of the bone scintigraphies.

[Familial mixed hearing loss associated with X chromosome and stapedial gusher]. / Hipoacusia mixta familiar asociada al cromosoma X con gusher estapedial.

Perilymphatic and/or CSF loss through the oval window during stapedectomy is called a gusher. This rare disorder is associated with X-linked progressive mixed hearing loss. It is related with mutations in the POU3F4 gene at locus DFN3 on Xq21. Our study of the cases seen in our department yielded information and clinical and radiological findings that could be useful for the clinical management, early diagnosis, and prevention of erroneous therapeutic indications.