Imaging findings of a torsed pedunculated uterine leiomyoma: A case report.

Torsion of a pedunculated uterine leiomyoma is an incredibly rare occurrence, considered a surgical emergency due to the risk of ischemic gangrene and resulting reactive peritonitis. Imaging modalities have traditionally played a limited role in evaluation of leiomyoma torsion due to modest sensitivity and specificity. We present the case of a 58-year old female with a known pedunculated fibroid who presented with acute abdominal pain. Computed tomography and ultrasound findings suggested a preoperative diagnosis of leiomyoma torsion, confirmed intraoperatively. While direct visualization at surgery remain the primary means of diagnosis of pedunculated fibroid torsion, familiarity of potential imaging findings in conjunction with the clinical presentation may enable the interpreting radiologist to consider this entity in the differential prospectively.

Bone scintigraphy findings in calciphylaxis.

Calciphylaxis is a poorly understood condition involving vascular calcification and thrombosis that leads to skin necrosis. Unfortunately, a noninvasive definitive test for calciphylaxis does not currently exist, and diagnosis relies on clinical symptoms and risk factors. Imaging can help guide diagnosis of this rare disorder. We present a pathology-proven case of calciphylaxis and the corresponding imaging findings seen on bone scintigraphy.

Progression of Multiple Myeloma Detected on Cardiac Scintigraphy with 99mTc Sestamibi.

It is important to understand normal and abnormal radiotracer biodistribution patterns in patients who undergo cardiac Tc-2-methoxyisobutyl-isonitrile (Tc-sestamibi) scans to provide important clinical guidance. Our case describes a 75-year-old man with a history of multiple myeloma in remission, who presented to the emergency department for unrelated chest pain and shortness of breath. The patient underwent a nuclear cardiac stress test with Tc-sestamibi scintigraphy as part of his cardiac workup. The images demonstrated diffuse radiotracer uptake in the skeletal structures raising concern for progression of multiple myeloma, of which, subsequent biopsy confirmed the presence of recurrent disease.

Leptomeningeal carcinomatosis and bilateral internal auditory canal metastases from ovarian carcinoma.

Ovarian cancer, a leading cause of death in women, typically spreads locally and rarely metastasizes to the brain or seeds the leptomeninges. We present a case of a 62-year-old woman with a history of treated ovarian cell carcinoma who developed bilateral sensorineural deafness and right-sided facial weakness and on imaging was found to have bilateral internal auditory canal (IAC) masses and leptomeningeal carcinomatosis, pathologically proven by cerebrospinal fluid cytology. We discuss her magnetic resonance imaging and positron emission tomography-computed tomography findings and review the imaging characteristics of IAC metastases. Finally, we review the literature on leptomeningeal carcinomatosis from ovarian cancer and discuss the high incidence of bilateral IAC metastases in patients with leptomeningeal carcinomatosis.