Presacral space is a potential space between the rectum anteriorly and lumbosacral spine posteriorly containing derivatives from various primitive germ cell types which serve as origin to a myriad of tumors. Imaging plays a vital role in diagnosis, characterization, assessing extent and evaluation of spread. We present a series of six cases of pediatric presacral tumors with intraspinal extension. The series comprises of an immature sacrococcygeal teratoma (Altman type II), a malignant sacrococcygeal teratoma (Altman type IV), a neuroblastoma, a rhabdomyosarcoma, a clear cell sarcoma and an Ewing’s sarcoma of the ilium which can be broadly categorized as tumors of germ cell, neuroblastic, mesenchymal, osteogenic origin. In spite of overlapping imaging features, careful retrospective observation revealed few distinctive features that would aid in optimal characterization of tumors with a fair degree of certainty.In summary, the salient imaging features that aid in differentiation are the epicentre of the tumor, pattern and degree of bone involvement, status of sacral foramina and neural elements and internal characteristics such as presence of fat, calcification, hemorrhage, necrosis, etc.
Association between trivial head trauma and basal ganglia infarct has been reported frequently in the recent years. We present the case of an infant who presented with neurological deficits following trivial head trauma and in whom all the routine hematological and laboratory investigations were unremarkable. Nonenhanced computed tomography imaging of the brain demonstrated calcification of lenticulostriate arteries in bilateral gangliothalamic complexes with a hypodense area in the left lentiform nucleus centered around one of the calcified vessels consistent with an infarct. It is hypothesized that a severe persistent form of fetal sonographic lenticulostriate vasculopathy that later undergoes mineralization predisposes infants to thrombosis following infarct, precipitating an infarct. Mineralizing microangiopathy is an underlying cause of infantile stroke and generally carries a good prognosis.
Background: Neonatal hypoxic ischemic encephalopathy (HIE) occurs as a result of any event that causes hypoxia and hypoperfusion to the developing neonatal brain. In addition to being a major cause of neonatal mortality, it is also associated with significant long-term neurological deficits. Multicystic encephalomalacia is a sequelae to global hypoxic ischemic injury which is characterized by cortical atrophy, basal ganglia/thalamic atrophy, and cystic necrosis of cerebral white matter. In this report, we present an unusual finding of cystic necrosis of thalami in HIE. Case Presentation: We present the case of a term neonate with a history of prolonged labor and meconium aspiration who developed HIE stage III. The neonate initially required ventilator support and was gradually weaned off but was reintubated in view of neonatal sepsis. Magnetic resonance imaging done on day 23 revealed diffuse cortical and white matter atrophy, signal intensity alteration in basal ganglia and thalami, and multiple well-defined areas of cerebrospinal fluid signal intensity in the white matter, consistent with multicystic encephalomalacia. An additional unusual finding was cystic necrosis, symmetrically involving bilateral posterior thalami. Conclusion: According to our observation, severe prolonged hypoxic ischemic insult does not only result in central gray matter atrophy but can also cause cystic neuronal necrosis of the same.
Background: Vascular leiomyosarcoma is a rare but most common vascular tumor of the inferior vena cava.Case presentation: We present the case of an incidentally diagnosed extraluminal leiomyosarcoma of the inferior vena cava in a 62 year old patient who presented with abdominal pain following blunt trauma. Ultrasonography showed a lobulated hypoechoic lesion in the upper abdomen. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a circumscribed lobulated near homogeneously enhancing retroperitoneal lesion in anterior relation to the infrarenal inferior vena cava, right paramedian in location with imperceptible vena caval lumen at the site of maximum contact. In positron emission tomography (PET) CT the lesion showed mild fluorodeoxyglucose (FDG) uptake with no distant metastases. CT guided biopsy with immunohistochemical analysis showed leiomyosarcoma. Patient underwent surgical resection with inferior vena cava reconstruction.Conclusions: Leiomyosarcoma of the inferior vena cava is a rare tumor of vascular origin. Imaging plays an imperative role in the diagnosis and preoperative evaluation. This article also provides a comprehensive literature review of the radiological features of inferior vena caval leiomyosarcoma that would aid in optimal preoperative characterization and evaluation.
Background Falcotentorial meningiomas are rare tumors that arise from the junction of the falx cerebri and the tentorium. Accurate preoperative imaging plays a crucial role in surgical planning and management. Magnetic resonance imaging (MRI) is the preferred imaging modality for meningiomas. In this report, we present a case of type 1 falcotentorial meningioma and discuss the role of preoperative imaging and management. Case presentation A 62-year-old female patient presented with gradually progressive bilateral lower limb weakness. Contrast-enhanced MRI showed a circumscribed lobulated extraaxial lesion near the falcotentorial junction with an adjacent dural tail, consistent with a type 1 falcotentorial meningioma. Based on these radiological features, the patient was diagnosed with a type 1 falcotentorial meningioma. The patient was referred for neurosurgical evaluation for further management. Conclusion Falcotentorial meningiomas are rare tumors that require careful preoperative imaging and surgical planning. Radiological reporting should include the relationship of the tumor to the vein of Galen to aid neurosurgical approach. Complete surgical resection is the preferred therapy, but subtotal resection can be considered in certain cases.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.