RESUMO
We report the case of a patient who developed a large radiation-induced vesicovaginal fistula. She also had a paucity of the omentum due to previous laparotomy and adhesions. We were able to treat this patient successfully with a pedicled myofascial rectus abdominis flap.
Assuntos
Complicações Pós-Operatórias/cirurgia , Lesões por Radiação/cirurgia , Retalhos Cirúrgicos/métodos , Fístula Vesicovaginal/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Lesões por Radiação/etiologia , Reto do Abdome , Fístula Vesicovaginal/etiologiaRESUMO
Cavernous hemangiomas of the adrenal gland are rare. We report on a patient with a left adrenal hemangioma successfully treated by radical excision. The literature pertaining to this interesting pathological condition is reviewed.
Assuntos
Neoplasias das Glândulas Suprarrenais , Hemangioma Cavernoso , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Idoso , Feminino , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/patologia , Hemangioma Cavernoso/cirurgia , Humanos , RadiografiaRESUMO
Combined gadopentetate dimeglumine enhancement and fat-saturation (FS) spin-echo (SE) magnetic resonance (MR) imaging for the detection and characterization of renal masses was evaluated in 43 patients with a total of 71 lesions (28 solid masses and 43 cysts). SE MR sequences compared were the following: short repetition time (TR)/echo time (TE), conventional SE, short TR/TE FS SE, long TR/TE conventional SE, gadolinium-enhanced short TR/TE conventional SE, and gadolinium-enhanced short TR/TE FS SE techniques. MR findings were compared with findings of contrast-enhanced computed tomography (CT) and with pathologic findings in all patients. The sensitivities for detection of renal masses with gadolinium-enhanced FS (71 of 71 lesions) and with gadolinium-enhanced short TR/TE conventional (65 of 71 lesions) SE sequences were significantly (P less than .01) greater than with any unenhanced (short TR/TE conventional [40 of 71 lesions], or long TR/TE [39 of 71 lesions]) SE sequence. Lesion characterization was also best with the gadolinium-enhanced FS SE sequence (65 of 71 lesions correctly classified). When combined pre- and postcontrast short TR/TE FS SE images were analyzed with both qualitative (visual) and quantitative (region-of-interest measurements) assessment, lesion characterization improved even further (70 of 71 lesions were correctly characterized). All lesions detected with CT were visualized with the gadolinium-enhanced FS SE MR sequence, which in addition depicted seven cysts and two small renal cell carcinomas. In summary, the use of gadopentetate dimeglumine, especially when combined with the FS technique, was superior to unenhanced MR imaging for detection and characterization of renal lesions.
Assuntos
Carcinoma de Células Renais/diagnóstico , Meios de Contraste , Gadolínio , Neoplasias Renais/diagnóstico , Rim/patologia , Imageamento por Ressonância Magnética/métodos , Meglumina , Compostos Organometálicos , Ácido Pentético , Carcinoma de Células Renais/patologia , Combinação de Medicamentos , Feminino , Gadolínio DTPA , Humanos , Doenças Renais Císticas/diagnóstico , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
Multilocular renal cysts may occur bilaterally. A partial nephrectomy usually is curative but unroofing of the cyst may lead to recurrence. We suggest to delete the criterion of unilaterality and to base the diagnosis on histological features. The first case of bilateral multilocular renal cysts with unilateral recurrence is reported.
