Radioguided exploration is a useful tool to guide the cytoreduction of NETs. The correct choice of radiopharmaceutical, its dose, and the interval between injection and exploration are critical for obtaining optimal results.
Cocoon-like formations in patients with stage IV gastroenteropancreatic NETs is rare and may be a terminal disease progression that has not been previously recognized. The best treatment option remains unknown. Surgical treatment is not advisable, with the exception of type 1 abdominal cocoons.
There are two basic mechanisms of bowel control: anatomic and neurologic. The structures involved in bowel control include the colon, rectum, internal and external anal sphincters, and pelvic musculature. Also involved is the process of neural innervation. A pediatric patient's bowel function and control are altered as a result of spinal pathology. Upper motor neuron lesions leave the reflex arc intact but with a lack of voluntary control. Stimulation and timing are important in the development of a successful bowel program for pediatric patients with these lesions. In contrast, lower motor neuron lesions impair the reflex arc and result in a flaccid bowel. The pediatric patient's rectum may be extremely compliant and store copious amounts of hard stool. In such cases, bowel control is much more difficult to attain. This article presents implications for rehabilitation nursing practice for each type of lesion in pediatric rehabilitation patients.
Extension of the normal thymus into the posterior mediastinum is rare. The CT appearance of this anomaly in an infant is presented. A mass of soft-tissue density extended from the anterior mediastinum to the posterior chest wall. The absence of any tissue-cleavage plane in the lesion and a smooth continuous lateral margin are signs of posterior extension of the thymus, and they help to distinguish this from a normal anterior thymus being present with a posterior tumor.
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