Iranian Journal of Radiology Iranian Journal of Radiology Iran J Radiol http://www.Iranjradiol.com 1735-1065 2008-2711 10.5812/iranjradiol en jalali 2017 6 26 gregorian 2017 6 26 10 2
en Boards and Committees Boards and Committees issue-information issue-information http://www.Iranjradiol.com/index.php?page=article&article_id=12798
en Table of Contents Table of Contents issue-information issue-information http://www.Iranjradiol.com/index.php?page=article&article_id=12796
en 10.5812/iranjradiol.3734 Peripheral Osteoma of the Mandibular Notch: Report of a Case Peripheral Osteoma of the Mandibular Notch: Report of a Case HEAD & NECK IMAGING case-report case-report

Osteoma is a benign, slow-growing osteogenic tumor that sometimes arises from the craniomaxillofacial region, such as the sinus, temporal or jaw bones. Osteoma consists of compact or cancellous bone that may be peripheral, central or extraskeletal type. Peripheral osteoma arises from the periosteum and is commonly a unilateral, pedunculated mushroom-like mass. Peripheral osteoma of the mandible is relatively uncommon, and peripheral osteoma of the mandibular notch is extremely rare, although many cases arise from the mandibular body, angle, condyle, or coronoid process. We report here an unusual peripheral osteoma of the mandibular notch in a 78-year-old nonsyndromic female.

Osteoma is a benign, slow-growing osteogenic tumor that sometimes arises from the craniomaxillofacial region, such as the sinus, temporal or jaw bones. Osteoma consists of compact or cancellous bone that may be peripheral, central or extraskeletal type. Peripheral osteoma arises from the periosteum and is commonly a unilateral, pedunculated mushroom-like mass. Peripheral osteoma of the mandible is relatively uncommon, and peripheral osteoma of the mandibular notch is extremely rare, although many cases arise from the mandibular body, angle, condyle, or coronoid process. We report here an unusual peripheral osteoma of the mandibular notch in a 78-year-old nonsyndromic female.

Tomography, X-Ray Computed;Osteoma;Mandible Tomography, X-Ray Computed;Osteoma;Mandible 74 6 http://www.Iranjradiol.com/index.php?page=article&article_id=3734 Toshinori Iwai Toshinori Iwai Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp; Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp; Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp Toshiharu Izumi Toshiharu Izumi Department of Radiology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan Department of Radiology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan Junichi Baba Junichi Baba Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp Jiro Maegawa Jiro Maegawa Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan Kenji Mitsudo Kenji Mitsudo Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp Iwai Tohnai Iwai Tohnai Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan +81-45787 2659, iwai104oams@yahoo.co.jp
en 10.5812/iranjradiol.4064 Radiologic Findings in Cutis Laxa Syndrome and Unusual Association with Hypertrophic Pyloric Stenosis Radiologic Findings in Cutis Laxa Syndrome and Unusual Association with Hypertrophic Pyloric Stenosis PEDIATRIC IMAGING case-report case-report

Cutis laxa (CL) is a rare congenital and acquired disorder characterized by loose and redundant skin with reduced elasticity. Three types of congenital cutis laxa have been recognized. Other findings are pulmonary emphysema, bronchiectasia, hernia and diverticulosis. We describe a female neonate involved by cutis laxa syndrome and a positive family history. We focus on the radiologic findings of this case such as multiple bladder diverticulosis, GI diverticulosis and very rare accompanying hypertrophic pyloric stenosis (HPS).

Cutis laxa (CL) is a rare congenital and acquired disorder characterized by loose and redundant skin with reduced elasticity. Three types of congenital cutis laxa have been recognized. Other findings are pulmonary emphysema, bronchiectasia, hernia and diverticulosis. We describe a female neonate involved by cutis laxa syndrome and a positive family history. We focus on the radiologic findings of this case such as multiple bladder diverticulosis, GI diverticulosis and very rare accompanying hypertrophic pyloric stenosis (HPS).

Cutis Laxa;Diverticulum;Pyloric Stenosis Cutis Laxa;Diverticulum;Pyloric Stenosis 94 8 http://www.Iranjradiol.com/index.php?page=article&article_id=4064 Mehdi Alehossein Mehdi Alehossein Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran Masoud Pourgholami Masoud Pourgholami Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Kamyar Kamrani Kamyar Kamrani Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran Mohammad Soltani Mohammad Soltani Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Afshin Yazdi Afshin Yazdi Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Payman Salamati Payman Salamati Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran, Iran. Tel: +98-2166581579, Fax: +98-2166581580 Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran, Iran. Tel: +98-2166581579, Fax: +98-2166581580
en 10.5812/iranjradiol.4876 Breast Ductal Carcinoma in Situ: Morphologic and Kinetic MRI Findings Breast Ductal Carcinoma in Situ: Morphologic and Kinetic MRI Findings BREAST IMAGING brief-report brief-report Conclusion

Non-mass-like lesions, lesions with focal or segmental distribution, with a “plateau” enhancement curve type were the most frequent findings of DCIS lesions on MRI.

Background

Adequate diagnosis of ductal carcinoma in situ (DCIS) could lead to efficacious treatment. Due to the fact that DCIS lesions can progress to invasive carcinomas and that the sensitivity of the standard examination – mammography – is between 70 and 80%, use of a more sensitive diagnostic tool was needed. In detection of DCIS, contrast-enhanced magnetic resonance imaging (CE-MRI) has the sensitivity up to 96%.

Objectives

Morphological features and kinetic parameters were evaluated to define the most regular morphological, kinetic and morpho-kinetic patterns on MRI assessment of breast ductal carcinoma in situ (DCIS).

Patients and Methods

We retrospectively assessed eighteen patients with 23 histologically confirmed lesions (mean age, 52.4 ± 10.5 years). All patients were clinically and mammographically examined prior to MRI examination.

Results

DCIS appeared most frequently as non-mass-like lesions (12 lesions, 52.17%). The differences in the frequency of lesion types were statistically significant (P<0.05). The following morphological patterns were detected: A: no specific morphologic features, B: linear/branching enhancement, C: focal mass-like enhancement, D: segmental enhancement, E: segmental enhancement in triangular shape, F: diffuse enhancement, G: regional heterogeneous enhancement in one quadrant not conforming to duct distribution and H: dotted or granular type of enhancement with patchy distribution. The difference in the frequency of the proposed patterns was statistically significant (P<0.05). There were eight lesions with mass enhancement, and six with segmental lesions: regional and triangular. There was no statistically significant difference in the frequency of enhancement curve types (P>0.05). There was no significant difference in the frequency of morpho-kinetic patterns.

Conclusion

Non-mass-like lesions, lesions with focal or segmental distribution, with a “plateau” enhancement curve type were the most frequent findings of DCIS lesions on MRI.

Background

Adequate diagnosis of ductal carcinoma in situ (DCIS) could lead to efficacious treatment. Due to the fact that DCIS lesions can progress to invasive carcinomas and that the sensitivity of the standard examination – mammography – is between 70 and 80%, use of a more sensitive diagnostic tool was needed. In detection of DCIS, contrast-enhanced magnetic resonance imaging (CE-MRI) has the sensitivity up to 96%.

Objectives

Morphological features and kinetic parameters were evaluated to define the most regular morphological, kinetic and morpho-kinetic patterns on MRI assessment of breast ductal carcinoma in situ (DCIS).

Patients and Methods

We retrospectively assessed eighteen patients with 23 histologically confirmed lesions (mean age, 52.4 ± 10.5 years). All patients were clinically and mammographically examined prior to MRI examination.

Results

DCIS appeared most frequently as non-mass-like lesions (12 lesions, 52.17%). The differences in the frequency of lesion types were statistically significant (P<0.05). The following morphological patterns were detected: A: no specific morphologic features, B: linear/branching enhancement, C: focal mass-like enhancement, D: segmental enhancement, E: segmental enhancement in triangular shape, F: diffuse enhancement, G: regional heterogeneous enhancement in one quadrant not conforming to duct distribution and H: dotted or granular type of enhancement with patchy distribution. The difference in the frequency of the proposed patterns was statistically significant (P<0.05). There were eight lesions with mass enhancement, and six with segmental lesions: regional and triangular. There was no statistically significant difference in the frequency of enhancement curve types (P>0.05). There was no significant difference in the frequency of morpho-kinetic patterns.

Carcinoma, Intraductal, Non infiltrating;Magnetic Resonance Imaging;Breast Neoplasms;Image Enhancement;Gadolinium DTPA Carcinoma, Intraductal, Non infiltrating;Magnetic Resonance Imaging;Breast Neoplasms;Image Enhancement;Gadolinium DTPA 99 102 http://www.Iranjradiol.com/index.php?page=article&article_id=4876 Mirjan M. Nadrljanski Mirjan M. Nadrljanski Department of Diagnostic Imaging, Institute of Oncology and Radiology of Serbia (IORS), Serbia; Department of Diagnostic Imaging, Institute of Oncology and Radiology of Serbia (IORS), Pasterova, Serbia +381-13353769, dr.m.nadrljanski@gmail.com Department of Diagnostic Imaging, Institute of Oncology and Radiology of Serbia (IORS), Serbia; Department of Diagnostic Imaging, Institute of Oncology and Radiology of Serbia (IORS), Pasterova, Serbia +381-13353769, dr.m.nadrljanski@gmail.com Biljana B. Marković Biljana B. Marković Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia (KCS), Serbia; Department of Radiology, Faculty of Medicine, University of Belgrade, Serbia Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia (KCS), Serbia; Department of Radiology, Faculty of Medicine, University of Belgrade, Serbia Zorica Č. Milošević Zorica Č. Milošević Department of Diagnostic Imaging, Institute of Oncology and Radiology of Serbia (IORS), Serbia; Department of Radiology, Faculty of Medicine, University of Belgrade, Serbia Department of Diagnostic Imaging, Institute of Oncology and Radiology of Serbia (IORS), Serbia; Department of Radiology, Faculty of Medicine, University of Belgrade, Serbia
en 10.5812/iranjradiol.7370 Effectiveness of Puncture-Aspiration-Injection-Reaspiration in the Treatment of Hepatic Hydatid Cysts Effectiveness of Puncture-Aspiration-Injection-Reaspiration in the Treatment of Hepatic Hydatid Cysts ABDOMINAL IMAGING research-article research-article Conclusion

PAIR therapy is an effective minimally invasive treatment for Gharbi type I-III hepatic hydatid cysts. It is a cost effective and safe procedure with significant reduction in the duration of hospital stay.

Results

Ten patients (66.7%) had Gharbi type I cysts, two (13.3%) had type II and three (20%) had type III cysts. All the patients (100%) showed reduction in cyst size over a 3-6 month period. Pseudomass appearance with solidification was seen in 73% of the patients and calcification was seen in 46.6%. None of the patients developed anaphylaxis, recurrence or peritoneal seedlings. Pain at the injection site was the most common complication observed.

Objectives

This study was performed to evaluate the effectiveness of PAIR therapy in the treatment of hepatic hydatid disease.

Patients and Methods

This cross sectional study was carried out on 15 consecutive patients (Male: 2, Female: 13; Age group: 11-80 years) with hepatic hydatid disease and were treated by PAIR therapy and followed up for a period of 1 year. The cysts were punctured under local anesthesia with an 18G needle using sonographic guidance. Betadine (10% povidone iodine + 1% free iodine) was used as scolicidal agent and allowed to act for 30 min. Cysts larger than 5 cm (n = 5) were drained using an 8F pig tail catheter. The therapeutic response was studied by assessing the reduction in the cyst size, progressive solidification of the cyst, calcification of the wall and increase in the echogenicity of the cyst with pseudomass appearance on serial ultrasound examinations performed on the next day, after 1 month, at 3 months, 6 months and 1 year after the procedure.

Background

Hydatid disease of the liver is endemic in cattle rearing areas of the world. A variety of treatment options are available in its management. The common treatment options are medical therapy, surgery and puncture-aspiration-injection-reaspiration (PAIR) therapy.

Conclusion

PAIR therapy is an effective minimally invasive treatment for Gharbi type I-III hepatic hydatid cysts. It is a cost effective and safe procedure with significant reduction in the duration of hospital stay.

Results

Ten patients (66.7%) had Gharbi type I cysts, two (13.3%) had type II and three (20%) had type III cysts. All the patients (100%) showed reduction in cyst size over a 3-6 month period. Pseudomass appearance with solidification was seen in 73% of the patients and calcification was seen in 46.6%. None of the patients developed anaphylaxis, recurrence or peritoneal seedlings. Pain at the injection site was the most common complication observed.

Objectives

This study was performed to evaluate the effectiveness of PAIR therapy in the treatment of hepatic hydatid disease.

Patients and Methods

This cross sectional study was carried out on 15 consecutive patients (Male: 2, Female: 13; Age group: 11-80 years) with hepatic hydatid disease and were treated by PAIR therapy and followed up for a period of 1 year. The cysts were punctured under local anesthesia with an 18G needle using sonographic guidance. Betadine (10% povidone iodine + 1% free iodine) was used as scolicidal agent and allowed to act for 30 min. Cysts larger than 5 cm (n = 5) were drained using an 8F pig tail catheter. The therapeutic response was studied by assessing the reduction in the cyst size, progressive solidification of the cyst, calcification of the wall and increase in the echogenicity of the cyst with pseudomass appearance on serial ultrasound examinations performed on the next day, after 1 month, at 3 months, 6 months and 1 year after the procedure.

Background

Hydatid disease of the liver is endemic in cattle rearing areas of the world. A variety of treatment options are available in its management. The common treatment options are medical therapy, surgery and puncture-aspiration-injection-reaspiration (PAIR) therapy.

Echinococcosis;Image-Guided Biopsy;Povidone Iodine Echinococcosis;Image-Guided Biopsy;Povidone Iodine 68 73 http://www.Iranjradiol.com/index.php?page=article&article_id=7370 Raman Rajesh Raman Rajesh Department of Radiodiagnosis, JSS Medical College, India +91-9481822984, rajeshiyer81@gmail.com; Department of Radiodiagnosis, JSS Medical College, India +91-9481822984, rajeshiyer81@gmail.com Department of Radiodiagnosis, JSS Medical College, India +91-9481822984, rajeshiyer81@gmail.com; Department of Radiodiagnosis, JSS Medical College, India +91-9481822984, rajeshiyer81@gmail.com Dhiman S. Dalip Dhiman S. Dalip Department of Radiodiagnosis, Indira Gandhi Medical College, India Department of Radiodiagnosis, Indira Gandhi Medical College, India Jhobta Anupam Jhobta Anupam Department of Radiodiagnosis, Indira Gandhi Medical College, India Department of Radiodiagnosis, Indira Gandhi Medical College, India Azad Jaisiram Azad Jaisiram Department of Radiodiagnosis, Indira Gandhi Medical College, India Department of Radiodiagnosis, Indira Gandhi Medical College, India
en 10.5812/iranjradiol.5143 Appearance of Uterine Scar Due to Previous Cesarean Section on Hysterosalpingography: Various Shapes, Locations and Sizes Appearance of Uterine Scar Due to Previous Cesarean Section on Hysterosalpingography: Various Shapes, Locations and Sizes WOMEN’S IMAGING pictorial-essay pictorial-essay

In this study, we demonstrate the appearance of anatomic defects of the uterine cavity on HSG after cesarian section. We define different shapes such as thin linear defect, focal saccular outpouching, unilateral or bilateral diverticula (dog-ear like) and fistula and different locations such as the uterine body, lower uterine segment, uterine isthmus and the upper endocervical canal.

Cesarean section is the most commonly performed surgical procedure involving the uterus in fertile women. Cesarean section involves an incision made in the lower uterine segment or isthmus. Various changes in the site of the cesarean incision may be seen due to wall weakness and fibrosis. The scar may have various shapes; unilateral or bilateral, single or multiple, wedge-shaped or linear. Awareness of the appearance and locations of uterine defects due to previous cesarean section is necessary in order to differentiate them from normal variations and other pathologies mimicking it.

Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes that is used predominantly in the assessment of infertility and evaluation of abnormalities of the uterus and fallopian tubes. Some of the abnormalities that can be detected by HSG include congenital anomalies, polyps, leiomyomas, synechiae and adenomyosis. HSG is also used to evaluate any scarring on the uterus and fallopian tubes.

In this study, we demonstrate the appearance of anatomic defects of the uterine cavity on HSG after cesarian section. We define different shapes such as thin linear defect, focal saccular outpouching, unilateral or bilateral diverticula (dog-ear like) and fistula and different locations such as the uterine body, lower uterine segment, uterine isthmus and the upper endocervical canal.

Cesarean section is the most commonly performed surgical procedure involving the uterus in fertile women. Cesarean section involves an incision made in the lower uterine segment or isthmus. Various changes in the site of the cesarean incision may be seen due to wall weakness and fibrosis. The scar may have various shapes; unilateral or bilateral, single or multiple, wedge-shaped or linear. Awareness of the appearance and locations of uterine defects due to previous cesarean section is necessary in order to differentiate them from normal variations and other pathologies mimicking it.

Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes that is used predominantly in the assessment of infertility and evaluation of abnormalities of the uterus and fallopian tubes. Some of the abnormalities that can be detected by HSG include congenital anomalies, polyps, leiomyomas, synechiae and adenomyosis. HSG is also used to evaluate any scarring on the uterus and fallopian tubes.

Hysterosalpingography;Cesarean Section;Uterus Hysterosalpingography;Cesarean Section;Uterus 103 10 http://www.Iranjradiol.com/index.php?page=article&article_id=5143 Firoozeh Ahmadi Firoozeh Ahmadi Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Iran +98-2123562446, dr.ahmadi1390@gmail.com Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Iran +98-2123562446, dr.ahmadi1390@gmail.com Leila Torbati Leila Torbati Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Farnaz Akhbari Farnaz Akhbari Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Gholam Shahrzad Gholam Shahrzad Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
en 10.5812/iranjradiol.7234 Colloid Carcinoma of the Extrahepatic Biliary Tract with Metastatic Lymphadenopathy Mimicking Cystic Neoplasm: A Case Report Colloid Carcinoma of the Extrahepatic Biliary Tract with Metastatic Lymphadenopathy Mimicking Cystic Neoplasm: A Case Report case-report case-report

Colloid carcinoma, also called mucinous carcinoma, is classified as a histologic variant of adenocarcinoma. Because the colloid carcinoma of the biliary tree is exceedingly rare, the imaging characteristics and the clinical features of colloid carcinoma remain relatively unknown. We report a case of colloid carcinoma of the common bile duct and its accompanied metastatic lymphadenopathies with characteristic imaging findings reflecting abundant intratumoral mucin pools.

The patient is a previously healthy 52-year-old woman who presented with dyspepsia for two months. Multiple imaging modalities including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) showed diffuse bile duct dilatation with an obstructive lesion of the distal extrahepatic biliary duct (EHD) as well as two masses in the peripancreatic area. The peripancreatic masses appeared cystic with posterior acoustic enhancement on ultrasound, low density on CT imaging, and high signal intensity on T2-weighted MRI. The lesion in the distal EHD exhibited similar characteristics on CT and MRI. A Whipple procedure was performed and histological specimens showed malignant cells with large mucin pools that was consistent with a diagnosis of colloid carcinoma of the EHD with metastatic lymphadenopathies.

Colloid carcinoma, also called mucinous carcinoma, is classified as a histologic variant of adenocarcinoma. Because the colloid carcinoma of the biliary tree is exceedingly rare, the imaging characteristics and the clinical features of colloid carcinoma remain relatively unknown. We report a case of colloid carcinoma of the common bile duct and its accompanied metastatic lymphadenopathies with characteristic imaging findings reflecting abundant intratumoral mucin pools.

The patient is a previously healthy 52-year-old woman who presented with dyspepsia for two months. Multiple imaging modalities including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) showed diffuse bile duct dilatation with an obstructive lesion of the distal extrahepatic biliary duct (EHD) as well as two masses in the peripancreatic area. The peripancreatic masses appeared cystic with posterior acoustic enhancement on ultrasound, low density on CT imaging, and high signal intensity on T2-weighted MRI. The lesion in the distal EHD exhibited similar characteristics on CT and MRI. A Whipple procedure was performed and histological specimens showed malignant cells with large mucin pools that was consistent with a diagnosis of colloid carcinoma of the EHD with metastatic lymphadenopathies.

Adenocarcinoma, Mucinous;Bile Ducts, Extrahepatic;Lymphatic Diseases;Ultrasonography Adenocarcinoma, Mucinous;Bile Ducts, Extrahepatic;Lymphatic Diseases;Ultrasonography 90 3 http://www.Iranjradiol.com/index.php?page=article&article_id=7234 Na Yeon Han Na Yeon Han Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Beom Jin Park Beom Jin Park Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea; Department of Radiology, Anam Hospital, Korea University College of Medicine, No. 126-1, 5-Ka Anam-dong, Sungbukku, Seoul 136-705, Korea. Tel: +82-2-920-5657, Fax: +82-2-929-3796 Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea; Department of Radiology, Anam Hospital, Korea University College of Medicine, No. 126-1, 5-Ka Anam-dong, Sungbukku, Seoul 136-705, Korea. Tel: +82-2-920-5657, Fax: +82-2-929-3796 Deuk Jae Sung Deuk Jae Sung Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Min Ju Kim Min Ju Kim Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Sung Bum Cho Sung Bum Cho Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Dong Sik Kim Dong Sik Kim Department of Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Korea Jeong Hyeon Lee Jeong Hyeon Lee Department of Pathology, Anam Hospital, Korea University College of Medicine, Seoul, Korea Department of Pathology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
en 10.5812/iranjradiol.8559 The Cost-Utility Analysis of PET-Scan in Diagnosis and Treatment of Non-Small Cell Lung Carcinoma in Iran The Cost-Utility Analysis of PET-Scan in Diagnosis and Treatment of Non-Small Cell Lung Carcinoma in Iran CHEST IMAGING research-article research-article Conclusion

The technical performance of PET scan is significantly higher than similar technologies for staging and treatment of NSCLC. In addition, it might slightly improve the treatment process and lead to a small level of increase in the quality adjusted life year (QALY) gained by these patients making it cost-effective for the treatment of NSCLC.

Results

The total annual running cost of a PET scan was about 8850 to 13000 million Rials, (0.9 to 1.3 million US$). The average cost of performing a PET scan varied between 3 and 4.5 million Rials (300 to 450US$). The strategies 3 (mediastinoscopy alone) and 7 (mediastinoscopy after PET scan) were more cost-effective than other strategies, especially when the result of the CT-scan performed before PET scan was negative.

Background

PET scan is a non-invasive, complex and expensive medical imaging technology that is normally used for the diagnosis and treatment of various diseases including lung cancer.

Objectives

The purpose of this study is to assess the cost effectiveness of this technology in the diagnosis and treatment of non- small cell lung carcinoma (NSCLC) in Iran.

Materials and Methods

The main electronic databases including The Cochrane Library and Medline were searched to identify available evidence about the performance and effectiveness of technology. A standard decision tree model with seven strategies was used to perform the economic evaluation. Retrieved studies and expert opinion were used to estimate the cost of each treatment strategy in Iran. The costs were divided into three categories including capital costs (depreciation costs of buildings and equipment), staff costs and other expenses (including cost of consumables, running and maintenance costs). The costs were estimated in both IR-Rials and US-Dollars with an exchange rate of 10.000 IR Rials per one US Dollar according to the exchange rate in 2008.

Conclusion

The technical performance of PET scan is significantly higher than similar technologies for staging and treatment of NSCLC. In addition, it might slightly improve the treatment process and lead to a small level of increase in the quality adjusted life year (QALY) gained by these patients making it cost-effective for the treatment of NSCLC.

Results

The total annual running cost of a PET scan was about 8850 to 13000 million Rials, (0.9 to 1.3 million US$). The average cost of performing a PET scan varied between 3 and 4.5 million Rials (300 to 450US$). The strategies 3 (mediastinoscopy alone) and 7 (mediastinoscopy after PET scan) were more cost-effective than other strategies, especially when the result of the CT-scan performed before PET scan was negative.

Background

PET scan is a non-invasive, complex and expensive medical imaging technology that is normally used for the diagnosis and treatment of various diseases including lung cancer.

Objectives

The purpose of this study is to assess the cost effectiveness of this technology in the diagnosis and treatment of non- small cell lung carcinoma (NSCLC) in Iran.

Materials and Methods

The main electronic databases including The Cochrane Library and Medline were searched to identify available evidence about the performance and effectiveness of technology. A standard decision tree model with seven strategies was used to perform the economic evaluation. Retrieved studies and expert opinion were used to estimate the cost of each treatment strategy in Iran. The costs were divided into three categories including capital costs (depreciation costs of buildings and equipment), staff costs and other expenses (including cost of consumables, running and maintenance costs). The costs were estimated in both IR-Rials and US-Dollars with an exchange rate of 10.000 IR Rials per one US Dollar according to the exchange rate in 2008.

Positron-Emission Tomography;Non-Small-Cell Lung Carcinoma;Economics Positron-Emission Tomography;Non-Small-Cell Lung Carcinoma;Economics 61 7 http://www.Iranjradiol.com/index.php?page=article&article_id=8559 Ali Akbari Sari Ali Akbari Sari Deptartment of Health Management and Economics, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran Deptartment of Health Management and Economics, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran Hamid Ravaghi Hamid Ravaghi School of Health Management and Information Sciences, Department of Health Service Management, Tehran University of Medical Sciences, Tehran, Iran; School of Health Management and Information Sciences, Department of Health Service Management, Tehran University of Medical Sciences, Tehran, Iran, Tel: +98-2188793805, Fax: +98-2188793805 School of Health Management and Information Sciences, Department of Health Service Management, Tehran University of Medical Sciences, Tehran, Iran; School of Health Management and Information Sciences, Department of Health Service Management, Tehran University of Medical Sciences, Tehran, Iran, Tel: +98-2188793805, Fax: +98-2188793805 Mohammadreza Mobinizadeh Mohammadreza Mobinizadeh Department of Health Service Management, School of Management and Economics, Science and Research Branch, Islamic Azad University, Tehran, Iran; Department of Health Service Management, School of Management and Economics, Science and Research Branch, Islamic Azad University, Tehran, Iran, Tel: +98-9127006617, Fax: +98-2181454683 Department of Health Service Management, School of Management and Economics, Science and Research Branch, Islamic Azad University, Tehran, Iran; Department of Health Service Management, School of Management and Economics, Science and Research Branch, Islamic Azad University, Tehran, Iran, Tel: +98-9127006617, Fax: +98-2181454683 Sima Sarvari Sima Sarvari Department of Medicine, Shantou University Medical College, Shantou, China Department of Medicine, Shantou University Medical College, Shantou, China
en 10.5812/iranjradiol.10031 Does Repeating CT-Guided Transthoracic Fine Needle Aspiration Increase Diagnostic Yield and Complication Rate? A Single Institution Experience Does Repeating CT-Guided Transthoracic Fine Needle Aspiration Increase Diagnostic Yield and Complication Rate? A Single Institution Experience VASCULAR AND INTERVENTIONAL RADIOLOGY research-article research-article Conclusion

This study demonstrated that repeating the TFNA procedure in pulmonary lesions improves the diagnostic yield without an increase in the rate of pneumothorax.

Objectives

We aimed to investigate whether repeating CT-guided transthoracic fine needle aspiration (TFNA) increases diagnostic yield and complication rate.

Patients and Methods

Patients underwent TFNA and the final diagnoses achieved were included in the study. Consequently, 316 TFNA procedures performed in 240 patients were investigated retrospectively. A diagnosis was not reached in the first TFNA in 64 patients, then they underwent repeated TFNA. The factors that affected the diagnostic yield and complication rate were recorded.

Results

The final diagnoses of 199 (82.9%) patients were malignant and 41 patients were benign. One hundred seventy six patients underwent the TFNA procedure only once. Sixty-four patients underwent a second procedure, while 12 underwent a third one. The diagnosis rate in the first procedures (diagnosis obtained in 142 out of 240 patients) was 59%. With the repeated procedures, 30 other patients were diagnosed. The diagnosis rate increased to 72% (172 out of 240 patients) (P<0.001). Twenty-nine (9.2%) pneumothoraces in 26 patients were detected in 316 TFNA procedures. In the repeated TFNA group (64 patients) there were seven pneumothoraces (11%) in the first TFNA procedure and six pneumothoraces (9%) in the repeated TFNA procedures (P=0.41). In three patients, pneumothorax was detected in the first and repeated procedures. Pneumothorax was significantly associated with the maximum diameter of the lesion (P=0.003), distance to pleura (P=0.001), contact to the pleura (P=0.0001) and smoking history (pack/year) (P=0.04).

Background

Transthoracic fine needle aspiration biopsy is a well-established and safe technique for obtaining pulmonary tissue. However, there is very little data about repeating procedure.

Conclusion

This study demonstrated that repeating the TFNA procedure in pulmonary lesions improves the diagnostic yield without an increase in the rate of pneumothorax.

Objectives

We aimed to investigate whether repeating CT-guided transthoracic fine needle aspiration (TFNA) increases diagnostic yield and complication rate.

Patients and Methods

Patients underwent TFNA and the final diagnoses achieved were included in the study. Consequently, 316 TFNA procedures performed in 240 patients were investigated retrospectively. A diagnosis was not reached in the first TFNA in 64 patients, then they underwent repeated TFNA. The factors that affected the diagnostic yield and complication rate were recorded.

Results

The final diagnoses of 199 (82.9%) patients were malignant and 41 patients were benign. One hundred seventy six patients underwent the TFNA procedure only once. Sixty-four patients underwent a second procedure, while 12 underwent a third one. The diagnosis rate in the first procedures (diagnosis obtained in 142 out of 240 patients) was 59%. With the repeated procedures, 30 other patients were diagnosed. The diagnosis rate increased to 72% (172 out of 240 patients) (P<0.001). Twenty-nine (9.2%) pneumothoraces in 26 patients were detected in 316 TFNA procedures. In the repeated TFNA group (64 patients) there were seven pneumothoraces (11%) in the first TFNA procedure and six pneumothoraces (9%) in the repeated TFNA procedures (P=0.41). In three patients, pneumothorax was detected in the first and repeated procedures. Pneumothorax was significantly associated with the maximum diameter of the lesion (P=0.003), distance to pleura (P=0.001), contact to the pleura (P=0.0001) and smoking history (pack/year) (P=0.04).

Background

Transthoracic fine needle aspiration biopsy is a well-established and safe technique for obtaining pulmonary tissue. However, there is very little data about repeating procedure.

Fine Needle Aspiration Biopsy;Invasive Procedure;Pneumothorax Fine Needle Aspiration Biopsy;Invasive Procedure;Pneumothorax 56 60 http://www.Iranjradiol.com/index.php?page=article&article_id=10031 Esra Yazar Esra Yazar Pulmonary Medicine Department, Yedikule Chest Disease Education and Training Hospital, Yedikule, İstanbul, Turkey; Pulmonary Medicine Department, Yedikule Chest Disease Education and Training Hospital, Yedikule, Turkey +90-5057781059, esraertan76@yahoo.com Pulmonary Medicine Department, Yedikule Chest Disease Education and Training Hospital, Yedikule, İstanbul, Turkey; Pulmonary Medicine Department, Yedikule Chest Disease Education and Training Hospital, Yedikule, Turkey +90-5057781059, esraertan76@yahoo.com Funda Seçik Funda Seçik Pulmonary Medicine Department, Yedikule Chest Disease Education and Training Hospital, Yedikule, İstanbul, Turkey Pulmonary Medicine Department, Yedikule Chest Disease Education and Training Hospital, Yedikule, İstanbul, Turkey Pınar Yıldız Pınar Yıldız Pulmonary Medicine Department, Yedikule Chest Disease Education and Training Hospital, Yedikule, İstanbul, Turkey Pulmonary Medicine Department, Yedikule Chest Disease Education and Training Hospital, Yedikule, İstanbul, Turkey
en 10.5812/iranjradiol.11724 Benign Mediastinal Teratoma with Intrapulmonary and Bronchial Rupture Presenting with Recurrent Hemoptysis Benign Mediastinal Teratoma with Intrapulmonary and Bronchial Rupture Presenting with Recurrent Hemoptysis CHEST IMAGING case-report case-report

Mediastinal teratomas are usually asymptomatic tumors, located most commonly in the anterior mediastinum. Very rarely, such tumors may rupture into the tracheobronchial tree, lung, pleura or pericardium. Computed Tomography (CT) is helpful in the diagnosis and differentiation of ruptured and unruptured tumors.

We report a case of ruptured anterior mediastinal teratoma in a 20-year-old female presenting with recurrent hemoptysis and cough; thus, mimicking a lung malignancy or tuberculosis. CT demonstrated a heterogeneous fat containing lesion in the anterior mediastinum with extension into the lingular lobe. Subsequent fine needle aspiration cytology (FNAC) yielded plenty of anucleate squames and debris, and a clear cut diagnosis could not be made. Total excision of the tumor was performed and histopathology of the surgically excised mass confirmed the CT diagnosis.

Mediastinal teratomas are usually asymptomatic tumors, located most commonly in the anterior mediastinum. Very rarely, such tumors may rupture into the tracheobronchial tree, lung, pleura or pericardium. Computed Tomography (CT) is helpful in the diagnosis and differentiation of ruptured and unruptured tumors.

We report a case of ruptured anterior mediastinal teratoma in a 20-year-old female presenting with recurrent hemoptysis and cough; thus, mimicking a lung malignancy or tuberculosis. CT demonstrated a heterogeneous fat containing lesion in the anterior mediastinum with extension into the lingular lobe. Subsequent fine needle aspiration cytology (FNAC) yielded plenty of anucleate squames and debris, and a clear cut diagnosis could not be made. Total excision of the tumor was performed and histopathology of the surgically excised mass confirmed the CT diagnosis.

Mediastinal Teratoma;Rupture;Hemoptysis;Tomography, X-Ray Computed Mediastinal Teratoma;Rupture;Hemoptysis;Tomography, X-Ray Computed 86 9 http://www.Iranjradiol.com/index.php?page=article&article_id=11724 Farheen Badar Farheen Badar Department of Radiodiagnosis, J.N. Medical College, A.M.U, India; Department of Radiodiagnosis, J.N. Medical College, A.M.U, India. Tel: (+91)9557632800 Department of Radiodiagnosis, J.N. Medical College, A.M.U, India; Department of Radiodiagnosis, J.N. Medical College, A.M.U, India. Tel: (+91)9557632800 Shagufta Yasmeen Shagufta Yasmeen Department of Pathology, J.N. Medical College, A.M.U, India Department of Pathology, J.N. Medical College, A.M.U, India Nishat Afroz Nishat Afroz Firoz Hospital, Aligarh, India Firoz Hospital, Aligarh, India Nazoora Khan Nazoora Khan Shah F. Azfar Shah F. Azfar
en 10.5812/iranjradiol.11729 Performance of Double Reading Mammography in an Iranian Population and Its Effect on Patient Outcome Performance of Double Reading Mammography in an Iranian Population and Its Effect on Patient Outcome BREAST IMAGING research-article research-article Conclusion

This study shows no significant improvement in the cancer detection rate by double reading; however, a lower recall rate could be a more helpful consequence.

Results

Readers had consensus on BI-RADS categories in 459 breasts (71%), but diverse categories were used for 183 breasts (29%), including 132 significant and 51 non-significant discrepancies. According to weighted Kappa test, agreement between two readers in positive or negative reports was 0.78 (95% CI=0.73-0.83) and in parenchymal density, it was 0.73 (95% CI=0.7-0.77). Most of the discrepancies were between category zero versus categories 1 and 2 (63.4%). The recall rate was 36% for the first and 44% for the second reader. Among 132 significant discordant results, one case had the final diagnosis of malignancy and the others had benign or negative diagnosis. There was 0.2% increase in cancer detection rate by double reading.

Background

Considering the importance and responsibility of reporting mammography and the necessity to notice details with a high degree of precision, double reading mammography has been introduced and recommended.

Objectives

This study aimed to assess the performance of double reading of mammograms and its effect on patient outcomes.

Patients and Methods

Throughout this cross sectional study, 1284 digitized mammographic views of 642 breasts which belonged to 339 women (of which 303 were bilateral and 36 were unilateral mammographies) were enrolled. Two independent radiologists interpreted these mammograms and BI-RADS categories of both reports were compared. Discordant results were determined and assumed significant if they were in the positive (BI-RADS 0, 4, 5) versus negative (BI-RADS 1, 2, 3) groups and then significant discordant cases were followed up to determine benign versus malignant final diagnosis. The recall rate was calculated for each reader. Inter-observer agreement in breast density was determined by Kappa test.

Conclusion

This study shows no significant improvement in the cancer detection rate by double reading; however, a lower recall rate could be a more helpful consequence.

Results

Readers had consensus on BI-RADS categories in 459 breasts (71%), but diverse categories were used for 183 breasts (29%), including 132 significant and 51 non-significant discrepancies. According to weighted Kappa test, agreement between two readers in positive or negative reports was 0.78 (95% CI=0.73-0.83) and in parenchymal density, it was 0.73 (95% CI=0.7-0.77). Most of the discrepancies were between category zero versus categories 1 and 2 (63.4%). The recall rate was 36% for the first and 44% for the second reader. Among 132 significant discordant results, one case had the final diagnosis of malignancy and the others had benign or negative diagnosis. There was 0.2% increase in cancer detection rate by double reading.

Background

Considering the importance and responsibility of reporting mammography and the necessity to notice details with a high degree of precision, double reading mammography has been introduced and recommended.

Objectives

This study aimed to assess the performance of double reading of mammograms and its effect on patient outcomes.

Patients and Methods

Throughout this cross sectional study, 1284 digitized mammographic views of 642 breasts which belonged to 339 women (of which 303 were bilateral and 36 were unilateral mammographies) were enrolled. Two independent radiologists interpreted these mammograms and BI-RADS categories of both reports were compared. Discordant results were determined and assumed significant if they were in the positive (BI-RADS 0, 4, 5) versus negative (BI-RADS 1, 2, 3) groups and then significant discordant cases were followed up to determine benign versus malignant final diagnosis. The recall rate was calculated for each reader. Inter-observer agreement in breast density was determined by Kappa test.

Double Reading;Mammography;Recall Rate Double Reading;Mammography;Recall Rate 51 5 http://www.Iranjradiol.com/index.php?page=article&article_id=11729 Maryam Moradi Maryam Moradi Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-3116685555, Fax: +98-3116673584 Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-3116685555, Fax: +98-3116673584 Kobra Ganji Kobra Ganji Atieh Imaging Center, Isfahan, Iran Atieh Imaging Center, Isfahan, Iran Niloufar Teyfouri Niloufar Teyfouri Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Farzaneh Kolahdoozan Farzaneh Kolahdoozan Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
en 10.5812/iranjradiol.11748 Successful Catheter-Directed Venous Thrombolysis in an Ankylosing Spondylitis Patient with Phlegmasia Cerulea Dolens Successful Catheter-Directed Venous Thrombolysis in an Ankylosing Spondylitis Patient with Phlegmasia Cerulea Dolens VASCULAR AND INTERVENTIONAL RADIOLOGY case-report case-report

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease. Phlegmasia cerulea dolens is a severe form of deep vein thrombosis characterized by swelling, pain, and bluish discoloration. Treatment delay may cause venous gangrene, tissue ischemia, limb loss or death. Here, we present an AS case who presented with phlegmasia cerulea dolens and treated by catheter-directed thrombolysis.

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease. Phlegmasia cerulea dolens is a severe form of deep vein thrombosis characterized by swelling, pain, and bluish discoloration. Treatment delay may cause venous gangrene, tissue ischemia, limb loss or death. Here, we present an AS case who presented with phlegmasia cerulea dolens and treated by catheter-directed thrombolysis.

Spondylitis, Ankylosing;Thrombosis;Treatment;Venous Spondylitis, Ankylosing;Thrombosis;Treatment;Venous 81 5 http://www.Iranjradiol.com/index.php?page=article&article_id=11748 Hadi Rokni Yazdi Hadi Rokni Yazdi Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9124136470, Fax: +98-2166581578 Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9124136470, Fax: +98-2166581578 Nematollah Rostami Nematollah Rostami Department of Internal Medicine, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Internal Medicine, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Homa Hakimian Homa Hakimian Department of Internal Medicine, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Internal Medicine, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mehdi Mohammadifar Mehdi Mohammadifar Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahsa Ghajarzadeh Mahsa Ghajarzadeh Brain and Spinal Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran Brain and Spinal Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran
en 10.5812/iranjradiol.12015 Solitary Osteochondroma of the Thoracic Spine with Compressive Myelopathy; A Rare Presentation Solitary Osteochondroma of the Thoracic Spine with Compressive Myelopathy; A Rare Presentation MUSCULOSKELETAL IMAGING case-report case-report

A 19-year-old man presented with a 5-year history of back pain radiating to the lower extremities and paresthesis of the toes during the last year. Plain X-ray revealed a large cauliflower shaped exophytic mass at the level of T8, T9 and T10 vertebrae. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an abnormal bony mass arising from the posterior arch of T9 with protrusion to the spinal canal and marked cord compression. The cortex and medulla of the lesion had continuity with those of the T9 vertebra. Surgical en bloc resection was performed and the patient’s symptoms resolved. The histopathologic diagnosis was osteochondroma. In patients with symptoms of myelopathy, in addition to more common etiologies, one should also be aware of rare entities such as osteochondroma.

A 19-year-old man presented with a 5-year history of back pain radiating to the lower extremities and paresthesis of the toes during the last year. Plain X-ray revealed a large cauliflower shaped exophytic mass at the level of T8, T9 and T10 vertebrae. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an abnormal bony mass arising from the posterior arch of T9 with protrusion to the spinal canal and marked cord compression. The cortex and medulla of the lesion had continuity with those of the T9 vertebra. Surgical en bloc resection was performed and the patient’s symptoms resolved. The histopathologic diagnosis was osteochondroma. In patients with symptoms of myelopathy, in addition to more common etiologies, one should also be aware of rare entities such as osteochondroma.

Osteochondroma;Spine;Spinal Cord Compression Osteochondroma;Spine;Spinal Cord Compression 77 80 http://www.Iranjradiol.com/index.php?page=article&article_id=12015 Payam Mehrian Payam Mehrian National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Ali Karimi Mohammad Ali Karimi Department of Radiology, Shahid Beheshti University of medical sciences, Iran; Department of Radiology, Shahid Beheshti University of Medical Sciences, Iran Department of Radiology, Shahid Beheshti University of medical sciences, Iran; Department of Radiology, Shahid Beheshti University of Medical Sciences, Iran Shahram Kahkuee Shahram Kahkuee National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mehrdad Bakhshayeshkaram Mehrdad Bakhshayeshkaram National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran Reza Ghasemikhah Reza Ghasemikhah Department of Parasitology & Mycology, Arak University of medical sciences, Iran Department of Parasitology & Mycology, Arak University of medical sciences, Iran