ABSTRACT
Often misdiagnosed as melanoma, melanocytoma of the optic disc is a rare benign ocular lesion that requires minimal active intervention, but demands a life time follow-up. We present a case of a 32-year-old man who was referred to our institute for the management of choroidal melanoma of the optic disc, which was detected by chance when the patient presented to a general ophthalmologist with chief complaint of itching in both eyes. The patient had normal visual acuity and fundoscopy revealed classical optic disc melanocytoma. The ancillary tests confirmed the diagnosis. The patient was kept under follow-up for four years, which showed no increase in size of the lesion. The purpose of this presentation was to highlight the identifying features of ocular melanocytoma and differentiate it from other conditions requiring urgent intervention.
Subject(s)
Melanoma/diagnosis , Optic Disk/pathology , Optic Nerve Neoplasms/diagnosis , Adult , Biopsy , Fluorescein Angiography , Fundus Oculi , Humans , MaleABSTRACT
<p><b>INTRODUCTION</b>Preoperative staging is essential for the optimal treatment and surgical planning of colorectal cancers. This study was aimed to evaluate the accuracy of colorectal cancer staging done using contrast-enhanced multidetector computed tomographic colonography (CEMDCTC).</p><p><b>METHODS</b>We recruited 25 patients with 28 proven colorectal cancers. A 16-slice multidetector computed tomography scanner was used to generate two-dimensional multiplanar reformatted sagittal, coronal and oblique coronal images, and three-dimensional virtual colonography (endoluminal) images. Axial and reformatted views were analysed, and TNM staging was done. Patients underwent surgery and conventional colonoscopy, and surgical histopathological correlation was obtained.</p><p><b>RESULTS</b>The diagnostic accuracies for TNM colorectal cancer staging were 92.3% for T staging, 42.3% for N staging and 96.1% for M staging using CEMDCTC. There was excellent positive correlation for T staging between CEMDCTC and both surgery (κ-value = 0.686) and histopathology (κ-value = 0.838) (p < 0.0001), and moderate positive correlation for N staging between CEMDCTC and surgery (κ-value = 0.424; p < 0.0001). The correlation between CEMDCTC and histopathology for N staging was poor (κ-value = 0.186; p < 0.05); the negative predictive value was 100% for lymph node detection. Moderate positive correlation was seen for M staging between CEMDCTC and both surgery (κ-value = 0.462) and histopathology (κ-value = 0.649). No false negatives were identified in any of the M0 cases.</p><p><b>CONCLUSION</b>CEMDCTC correlated well with pathologic T and M stages, but poorly with pathologic N stage. It is an extremely accurate tool for T staging, but cannot reliably distinguish between malignant lymph nodes and enlarged reactive lymph nodes.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Colonography, Computed Tomographic , Methods , Reference Standards , Colorectal Neoplasms , Diagnosis , Pathology , General Surgery , Contrast Media , Lymph Nodes , Pathology , Multidetector Computed Tomography , Reference Standards , Neoplasm Staging , Methods , Prospective Studies , Reproducibility of ResultsABSTRACT
Cervical cancer can be presented as an unusual and aggressive manner in human immunodeficiency virus (HIV)-positive women. There are case reports of psoas abscess which mimick metastasis from cervical carcinoma in HIV-positive patients. However, such cases are very rare in HIV-negative women with only few case reports available in the literature. We report one case of psoas abscess mimicking metastasis in a HIV-negative woman, which was initially diagnosed as spinal tuberculosis.
