SUMMARY:Oncocytomas of the salivary glands are rare benign epithelial tumors which occur most commonly in the parotid gland. The aim of our study was to characterize the clinical-radiologicpathologic spectrum of parotid oncocytomas in a series of 10 cases seen in our institution between January 2003 and November 2008. The CT features of parotid oncocytomas in the largest imaging series of this rare but important benign lesion include a well-defined enhancing tumor with a "deformable" appearance when large, and a non-enhancing curvilinear cleft or cystic component. These CT findings are potentially helpful in distinguishing these benign lesions from other parotid tumors in clinical scenarios that preclude surgical resection or when biopsy results are non-diagnostic. Further studies are advocated to validate the specificity and positive predictive value of these imaging features.O ncocytomas of the salivary gland, which were first described by Jaffé in 1932, are benign epithelial tumors that occur most commonly in adults in their sixth to eighth decades, [1][2][3][4][5][6] with no clear sex predilection. 3,4,[6][7][8][9] These neoplasms are histologically composed of monotonous sheets of oncocytes, epithelial cells named by Hamperl in 1931, which are characterized by an intensely eosinophilic and granular cytoplasm. These metabolically altered epithelial cells accumulate numerous cytoplasmic mitochondria through the process of oncocytic metaplasia. 1,4,5,7,[10][11][12] Synonyms for this tumor include oncocytic adenoma, oxyphilic granular-cell adenoma, and oxyphilic adenoma.Oncocytomas are rare, comprising just 0.5%-1.5% of salivary gland tumors. 4,[7][8][9][13][14][15][16] The parotid gland is the most commonly involved salivary gland, accounting for 78%-84% of salivary gland oncocytomas.2,3 Oncocytomas occurring in the submandibular gland and the minor salivary glands have been reported but are relatively uncommon. 2,7,9 CT is one of the established first-line imaging modalities used in the assessment of major salivary gland tumors. 2,17,18 To the authors' knowledge, there is limited description of the CT imaging features of parotid gland oncocytomas in the published literature, apart from a few case reports. 15,16,[19][20][21] Because the surgical resection of parotid tumors is generally the treatment of choice and allows histopathologic confirmation, the identification of specific CT imaging features suggestive of benign parotid oncocytomas will become helpful in terms of simply managing the patient expectantly when certain clinical scenarios arise-for example, if the patient declines surgical intervention, when patient factors such as age and multiple comorbidities preclude surgical resection, or when biopsy results are not diagnostic. In this study, we describe the CT features of 10 histopathologically proved cases of parotid oncocytomas, the largest imaging series in the published literature, to our knowledge. Materials and MethodsA review of parotid tumors that were discussed at combined clinicalradiologic-...
We report a case of phenytoin extravasation complicated by eschar formation. Pre-operative MRI study showed a large non-enhancing area over the dorsum of the imaged right wrist and hand corresponding with the site of phenytoin extravasation and raising the suspicion of subcutaneous tissue necrosis. The MRI findings correlated well with the intra-operative findings. We believe that pre-operative MRI in drug extravasation cases can characterise the type of soft tissue injury and define the extent of injury. This helps the surgeon in the surgical approach and treatment options.
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