Nipple Areola Complex Involvement in Invasive Carcinoma Breast.

A variety of factors including tumor biology and distance of the tumor from the nipple have been associated with nipple areola complex involvement in patients with breast cancer. Preoperative understanding regarding these factors can help in modifying the surgical options including preservation of nipple areola complex (NAC) and breast conservation. Nipple sparing surgery (breast conservation surgery/skin sparing mastectomy with immediate reconstruction) for breast cancer has gained widespread interest with the aim of achieving oncologically safe and cosmetically acceptable outcome. To study the proportion of cases with nipple areola complex involvement in invasive carcinoma breast and to describe the variables predictive of nipple areola complex involvement in patients undergoing excision of tumor along with NAC for invasive carcinoma breast. A cross-sectional study was conducted among 136 patients who underwent mastectomy in Regional Cancer Center, Thiruvananthapuram. Tumor nipple distance was assessed preoperatively using mammogram and postoperatively by histopathological examination. Nipple involvement was seen only among 4.4%. Preoperative assessment of tumor to nipple distance, tumor size, location, and stage of the disease agrees with the histopathological examination. Only a small proportion of breast cancer has NAC involvement and preoperative assessment could help the surgeon in deciding on the feasibility of NAC preservation.

Pediatric Primary Ovarian Angiosarcoma: From Rarity to a Realization.

BACKGROUND: Angiosarcoma is an uncommon high-grade sarcoma in children. Visceral angiosarcoma involving the ovary is extremely rare. Because of the lack of recurrent cytogenetic alterations, histopathological identification of this uncommon tumor in unusual sites like the ovary demands pathologic expertise. Complete surgical resection and radiotherapy are the chief treatment modalities determining survival, with chemotherapy contributing a minor role. CASE: We discuss a 11-year-old prepubertal girl who presented with primary angiosarcoma of the ovary. SUMMARY AND CONCLUSION: Early realization of such exceptional presentations of these tumors is needed to achieve the best treatment outcome.

Bilateral perirenal space fibromatosis with renal infiltration: case report and review of literature.

Fibromatosis and/or desmoid tumors which constitute less than 1% of all neoplasms and 3.0% of all soft-tissue tumors are pathologically benign proliferations of the fibroblasts but are locally aggressive with infiltrative type of growth and tendency toward recurrence. Bilateral symmetrical perirenal involvement has been described in many conditions which can be renal, subcapsular, or perirenal in origin. However, bilateral perirenal fibromatosis as an isolated presentation was very uncommon. We report an exceptionally rare case of bilateral perirenal fibromatosis with renal infiltration.

Unusual continuous intra-abdominal spread of primary testicular lymphoma along the spermatic cord and gonadal vessels: Report of 2 cases.

Primary testicular lymphoma (PTL) is an uncommon neoplasm (<5% of all testicular tumors). Testicular lymphoma presents with homogeneous mass, hyperintense on T1-weighted images, and iso-to-hypointense on T2-weighted images with strong diffusion restriction and homogeneous contrast enhancement. Seminoma testis, a close differential due to T2 hypointensity and homogeneousity, can be differentiated by its lower diffusion restriction and younger age group. Involvement of spermatic cord and epididymis is rare with seminoma. Intra-abdominal extension along the gonadal vein is not reported. PTL disseminates to extranodal sites. However, extension of PTL along the spermatic cord and gonadal vein up to the inferior vena cava is a rare phenomenon. We report 2 cases of PTL with involvement of epididymis and spermatic cord and further continuous extension along the gonadal vein up to the inferior vena cava. These findings are very rare and when present may help to differentiate testicular lymphoma from other testicular tumors.

Osmotic myelinolysis: Does extrapontine myelinolysis precede central pontine myelinolysis? Report of two cases and review of literature.

Osmotic myelinolysis is an acute, rare, demyelinating process. After the initial description of the condition by Adam and colleagues in 1959, many case series have been published describing the central and extrapontine myelinolysis. Imaging has a definitive role in establishing the diagnosis of osmotic myelinolysis in vivo and diffusion-weighted imaging reveals earliest changes in affected brain parenchyma. We report two cases of patients with proven malignancy who developed extrapontine myelinolysis after treatment for hyponatremia and progressed to central pontine myelinolysis within a week. This was confirmed with magnetic resonance (MR) imaging and clinical assessment. This temporal progression of MR features, especially on diffusion-weighted imaging, from extrapontine to central pontine myelinolysis in osmotic injury has not been described in literature to the best of our knowledge. An early MRI of the brain in suspected/high-risk cases of osmotic myelinolysis may show features of extrapontine myelinolysis in the form of restricted diffusion in bilateral basal ganglia and may serve as a guide for predicting progression, prognosticating and deciding further treatment of pontine myelinolysis. We propose that in a significant number of cases, central pontine myelinolysis may be predicted by doing an early MRI of the brain with diffusion-weighted imaging, when extrapontine symptoms start to develop. This can potentially increase the window period and possibilities for therapeutic intervention and may even help in prevention.

Cystic Lymphangioma of the Breast: Magnetic Resonance Imaging Features.

BACKGROUND: The aim of this study was to report magnetic resonance imaging (MRI) features of cystic lymphangiomas of the breast. METHODS: MRI of the breast was performed using a phased-array double breast coil with a 1.5-T MR scanner. Routine T1 and T2 and post-contrast sequential imaging was performed. RESULTS: The MRI characteristics of cystic lymphangioma in the breast are described. CONCLUSION: MR imaging provides for multiplanar evaluation and diagnosis of cystic lymphangioma of the breast, which is a rare occurrence.

A rare case of solitary fibrous tumour of the sigmoid mesocolon: imaging features and review of literature.

Solitary fibrous tumours are rare spindle cell tumours that generally arise from the pleura but on rare occasions arise in other locations such as the head and neck region, stomach and retroperitoneum. Very few reports exist on the imaging findings of these tumours in extra pleural sites such as the mesentery. We report the computed tomography (CT) imaging findings of a rare case of solitary fibrous tumour in a 68-year-old man who presented with a slowly enlarging painless pelvic mass. CT scan showed a well-defined, multilobulated, highly vascular pelvic mass with dense calcifications and central hypoatteunating areas arising from the mesentery.

Ovarian carcinoma metastasis to the breast and imaging features with histopathologic correlation: a case report and review of the literature.

Metastasis to the breast from primary ovarian carcinoma is rare. We describe a case in which the patient developed breast metastasis 3 years after initial treatment of a primary ovarian cancer.

Neuroimaging patterns of central nervous system metastases in neuroblastoma: report of 2 recent cases and literature review.

The authors describe imaging patterns of intracranial metastases in 2 children with grade 4 neuroblastoma. Central nervous system metastases from neuroblastoma are extremely rare and may involve the cerebral parenchyma, leptomeninges, or dura. Cerebral parenchymal metastases can be cystic with mural nodules or solid with hemorrhagic elements. The first patient in our study had multiple cystic parenchymal metastases with calcific mural nodules, while the second patient developed solid hemorrhagic parenchymal metastatic lesions along with extensive leptomeningeal and dural deposits. Central nervous system involvement in both patients occurred within a time span ranging from 12 to 14 months from the time of initial diagnosis.

Magnetic Resonance Imaging of a Benign Phyllodes Tumor of the Breast.

SUMMARY: BACKGROUND: The aim of this study was to evaluate a phyllodes tumor of the breast with magnetic resonance imaging (MRI) and magnetic resonance spectroscopy. METHODS: MRI of the breasts was performed using a phased array double breast coil with spectroscopic capability on a 1.5T MR scanner. Post-contrast sequential imaging was done, and the subtracted images were evaluated. Timesignal intensity curves were obtained. MR spectroscopy using BREASE software was also performed. RESULTS: MRI combined with MR spectroscopy was used in the diagnosis and characterization of a phyllodes tumor of the breast. CONCLUSION: MRI and MR spectroscopy may offer an in vivo imaging technique for the characterization of phyllodes tumors of the breast.

Choroidal melanoma metastasizing to maxillofacial bones.

BACKGROUND: Melanomas are malignant neoplasm of melanocytic origin, commonly seen on skin and various mucous membranes. Melanomas are the commonest intraocular malignant tumour in the adults. CASE PRESENTATION: A 50-year-old female presented with complains of painless progressive swelling in right cheek region of two months duration. Examination revealed a 6 x 4 cm bony hard swelling in right zygomatic region near and below lateral canthus of right eye with loss of vision. Investigations revealed it to be a choroidal melanoma metastasizing to the zygomatic bone. Patient was successfully treated by surgery. CONCLUSION: Choroidal melanoma, which commonly metastasizes to liver and lungs, never involves the lymph nodes and metastasis to facial bones is rare. Here we report a case of choroidal melanoma metastasizing to maxillofacial bones.