Reversible posterior leukoencephalopathy syndrome (PLS) is characterized by headache, altered mental function, visual disturbances and seizures. Neuroimaging studies suggest a white-matter oedema, predominantly in the posterior parietal-temporal-occipital regions of the brain. We present the case of a 30-year-old woman who had suffered her first attack of acute intermittent porphyria (AIP). Following 1 week of abdominal pain she developed several generalized seizures, and hallucinations, and exhibited a progressive deterioration of the consciousness. T2-weighted images, especially fluid-attenuated inversion recovery (FLAIR) sequences showed bilateral lesions in the posterior frontal, parietal and occipital cortex and subcortical white matter. Following treatment with haematin and a high carbohydrate diet the patient's condition improved. Follow-up magnetic resonance imaging (MRI) revealed complete resolution of the lesions. To our knowledge, this is the first report concerning a completely reversible PLS in AIP.
ZusammenfassungBerichtet wird über eine 43-jährige Patientin mit unklarer hepatischer Raumforderung. Anamnestisch vorbekannt waren eine langjährige Einnahme oraler Kontrazeptiva sowie eine schwere Kontrastmittelallergie. Im Rahmen der zunächst ausschlieûlich durchgeführten morphologischen Bildgebung mittels nativer Abdomen-Computertomographie (CT) sowie Magnetresonanztomographie (MRT) des Abdomens konnte die später histopathologisch gesicherte Diagnose eines Leberzelladenoms (HCA) nicht eindeutig festgestellt und eine fokale noduläre Hyperplasie (FNH) bzw. ein hepatozelluläres Karzinom (HCC) nicht sicher ausgeschlossen werden. Mit Hilfe der Leberfunktionsszintigraphie mit 99m Tc-HIDA (Hepatobiliary iminodiacetic acid) gelang der definitive Ausschluss einer FNH, so dass die zur endgültigen Differenzierung zwischen HCA und HCC notwendige chirurgische Resektion durchgeführt werden konnte. Anhand des beschriebenen Falles wird der Stellenwert der einfach durchführ-baren und im Vergleich zu den genannten morphologisch-bildgebenden Verfahren (CT und MRT) sehr kostengünstigen Leberfunktionsszintigraphie mit 99m Tc-HIDA zur Differenzialdiagnose bei unklaren hepatischen Raumforderungen dargelegt. Schlüsselwörter Lebertumoren´Differenzialdiagnose´Leberfunktionsszintigra-phie´Abdomen Magnetresonanztomographie´Abdomen Computertomographie AbstractThis report deals with a 43-year-old female patient suffering from an accidentally diagnosed hepatic mass of unknown origin. A long-time use of oral contraceptives as well as a severe allergy to contrast medium was known at the time of the initial diagnosis. The later histo-pathologically confirmed diagnosis of a hepatic adenoma (HCA) could firstly not been proven with native abdominal computer tomography (CT) as well as magnetic resonance tomography. Furthermore, a follicular nodular hyperplasia (FNH) as well as a hepato-cellular carcinoma (HCC) could not been excluded by morphological imaging with CT and MRT. Due to functionally imaging with liver scintigraphy with 99m Tc-HIDA (Hepatobiliary iminodiacetic acid) a FNH could been definitively excluded so that for the definitive differentiation between HCA and HCC the necessary surgical resection followed by histological examination could been performed. With this case report, the impact of the easily performable and as compared to morphological imaging with CT and MRT very costeffective liver scintigraphy with 99m Tc-HIDA for the differential diagnosis of hepatic masses of unknown origin could been shown.
This case report describes a 65-year old man with symptomatic abdominal and pelvic splenosis. 50 Years ago he has had splenectomy after a road traffic accident. Ultrasound and CT revealed a bulky mass in the iliac fossa and multifocal intraabdominal nodules suggesting peritoneal carcinomatosis. Scintigraphy with Tc-99m-labelled heat damaged red blood cells led to definitive diagnosis. RBC-scintigraphy is a specific, easy performable diagnostic tool. It is cost-effective and can avoid other diagnostic procedures or explorative surgery.
In patients with an acute swelling of a lower limb an aorto-iliac aneurysm, though a rare cause, should be considered.
This case report describes a 77-year old woman with a leiomyosarcoma of subhepatic inferior caval vein. The presented symptom was unspecific abdominal pain. Ultrasound and CT suggested a primary liver tumor. MRI revealed retroperitoneal location of the neoplasm. The tumor was resected completely and ICV was replaced by a PTF-graft. Vascular leiomyosarcoma is a rare tumor entity, which often is diagnosed in advanced stage. Depending on location it can be mistaken for neoplasms of other organs.
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.