80 research outputs found
Osteoblastoma of the sacrum: report of 18 cases and analysis of the literature
No full textRetrospective case series.(1) To analyze clinical and radiographical
characteristics, treatment, and outcome in patients with sacral
osteoblastoma, (2) to evaluate progression-free survival and local
recurrence rate, and (3) to identify prognostic factors.Osteoblastoma is a rare tumor
that has been reported to affect the sacrum from 7% to 17%.
Symptoms are various and the diagnosis is often delayed.From 1980 to 2010, 18 patients with sacral osteoblastoma
(16 males and 2 females) were treated at Rizzoli Institute. Lesion
involved S1 (2 cases), S1–S2 (3 cases), S2 (1 case), S2–S3 (1 case),
S2–S4 (1 case), S3 (2 cases), S3–S4 (5 cases), S4 (1 case), and almost
the entire sacrum in 2 cases. According to Enneking classifi cation
for benign bone tumors, 13 (72%) were diagnosed at stage 2
and 5 (28%) at stage 3. Mean tumor volume was 64 cm 3 (range,
2–441 cm 3 ). Nine patients had preoperative magnetic resonance
imaging. Five patients had a previous inadequate intralesional
surgery elsewhere. Treatment consisted in intralesional surgery (16
cases), intralesional surgery and radiotherapy (1 case), and wide
resection (1 case). Local adjuvants used were phenol (7 patients),
cryocoagulation with “iceball” technique (1 case). Embolizations
were performed in 7 patients.At a mean of 8.4 years (range, 1-28 yr), 15 patients (83%) remained continuously disease free, whereas 3 patients had local recurrence (17%). Progression-free survival was 87% at 5 years and 74% at 10 years. No statistical difference was found between patients who received or not local adjuvants (P = 1.254), older or younger than 20 years (P = 0.970), at stage 2 or 3 (P = 0.826), evaluated preoperatively with or without magnetic resonance imaging (P = 0.160), primarily treated versus patients with previous intralesional surgery elsewhere (P = 0.131).In our series, curettage was successful in most of the patients. Local adjuvants did not seem to reduce the risk of local recurrence when combined with intralesional surgery
Meningeal hemangiopericytoma only diagnosed at the time of late bone metastasis
No full textHemangiopericytoma is a rare neoplasm. Primary meningeal hemangiopericytomas account for 1 to 7% of all meningeal tumors. In the literature, meningeal hemangiopericytomas are mainly case reports, which confirm an aggressive behavior with a high rate of local recurrence and extracranial metastasis. Metastasis can be seen many years after initial surgical excision of the primary tumor, and the most common sites include the bone, liver and lung. We present a pathological study of four meningeal hemangiopericytomas with bone metastases. All patients are male with a mean age of 46.5 years. Metastases only involved bone. Three out of four lesions were initially misdiagnosed as meningiomas. Only one case was initially correctly diagnosed as meningeal hemangiopericytoma. All patients underwent surgery with complete resection. Only the patient immediately diagnosed with meningeal hemangiopericytoma received postoperative radiation therapy. Three patients had bone metastases without local recurrence including the one who received radiation therapy. One patient recurred locally after 7 years, and bone metastasis was found at the same time. Our cases confirm that meningeal hemangiopericytomas are a separate entity and have a high recurrence rate despite complete surgical resection, with extracranial metastases, mainly to bone, even after long intervals
Difficulty distinguishing benign notochordal cell tumor from chordoma further suggests a link between them
No full textMuch discussion about benign notochordal cell tissue in vertebrae has centered on the nature of its relationship, if any, to chordoma. Often referred to as benign notochordal cell tumors (BNCTs), these lesions have unique morphological features, however, differentiating between notochordal cells in discs, BNCT, and chordoma can be difficult. They are described as radiologically distinct from chordoma, with lysis, contrast enhancement, and a soft tissue mass indicating chordoma
Survival analysis of patients with chondrosarcomas of the pelvis
No full textStudies for patients with pelvic chondrosarcomas are limited. This study determines the outcome of patients with pelvic chondrosarcomas, and whether there is any association with tumors' grade, type, stage, margins and pelvic location
Surgical treatment and results of 62 patients with epithelioid hemangioendothelioma of bone.
No full textOBJECTIVE: Purpose of this retrospective study was (1) to evaluate overall survival and survival to local recurrence of patients with unifocal and multifocal tumor and (2) to evaluate survival to local recurrence after intralesional or wide surgery.
MATERIAL AND METHODS: We reviewed 62 patients with epithelioid hemangioendothelioma of bone, treated from 1985 to 2010. Histological sections and immunohistochemistry were evaluated. Tumor presented as unifocal in 49 patients and as multifocal in 13.
RESULTS: Mean follow-up was 9 years. Five patients (10%) with unifocal tumor progressed to multifocal. Overall survival was 92% at 10 years. Survival with unifocal tumor was significantly higher than survival with multifocal tumor. Survival to local recurrence was 76% at 10 years, significantly higher after wide resection than after intralesional surgery, while there was no statistical difference comparing unifocal and multifocal tumor. At multivariate analysis both variables showed no statistically significance.
CONCLUSION: Wide surgical excision reduces the risk of local recurrence, but functional results and morbidity need to be considered individually when defining surgical indications. Due to the risk of radiation-induced sarcomas, radiation therapy should be reserved to those cases not amenable to wide surgery or when lesions are seated locations difficult to treat. J. Surg. Oncol. © 2014 Wiley Periodicals, Inc.
© 2014 Wiley Periodicals, Inc
Sociodemographic determinants of knowledge on the figure of radiologist: results of a survey in a large university hospital
No full textBackground: Despite overlaying an irreplaceable role as a key diagnostic tool in modern
medicine, the role of radiologist still appears to be unclear to patients.
Methods: We conducted a survey in outpatient clinic of Radiological Sciences Department of the
University Hospital “A. Gemelli” in Rome, aiming to assess how correctly patients identify the figure of
the radiologist. The patients were interviewed by the trained physician using structured questionnaire.
Results: We included the number of 259 patients. Majority were female 63.3%, most were 60-69
years old (24.3%), have finished second grade secondary school (35.1%) and were subjected to
magnetic resonance (28.6%) while the least were subjected to mammography (8.1%). Only 38.7%
answered correctly to question No 1 “Who performed your examination?”, and only 30.9% correctly
identified the radiologist as a person interpreting the exam (question No 2 “Who is going to interpret
your radiological examination?”). Overall, 16.8% responded correctly to the both questions.
Significantly less patients with primary school (OR: 0.18, CI 95% 0.06-0.49) and first grade secondary
school (OR: 0.37, CI 95% 0.18-0.75) correctly addressed the question No 1 in compare to those with
second grade secondary school. The first grade secondary education (OR: 0.43, CI 95% 0.20-0.92)
was inversely associated with correct answer to question No 2. Patients with primary education were
significantly less prone to give both correct answers (OR: 0.12, CI 95% 0.02-0.60).
Conclusion: We report insufficient knowledge among patients on radiologist’s role in healthcare
system. The level of knowledge is associated with level of education
Cardiac silhouette findings and mediastinal lines and stripes: radiograph and CT scan correlation.
No full textDespite the increased use of CT imaging, chest radiography remains a very important diagnostic modality in the evaluation of lung parenchymal and mediastinal diseases, providing a vast amount of useful information. This information is generally derived from the relationships among the normal anatomic structures of the mediastinum, pleura, and lungs, which represent the basis of the "cardiac silhouette" and "mediastinal lines-and-stripes" concepts that potentially play an important role in the establishment of a diagnosis or a spectrum of diagnoses before proceeding to CT imaging. The capability of recognizing an abnormal chest radiograph on the basis of the displacement, deformation, or obscuration of one of these structures when compared with those in normal findings is often mandatory prior to requesting a potentially useful CT scan examination. Therefore, radiologists, trainees, and physicians must be familiar with the anatomic basis of those findings to be able to recognize the normal and abnormal appearance of structures when developing an appropriate differential diagnosis. In this review, we briefly describe the cardiac silhouette concepts and the mediastinal lines-and-stripes configurations as they relate to the radiographic and CT scan appearance of structures for a spectrum of pathologic diseases and list the possible underlying causes of the displacement, deformation, or obscuration of the structures
Multi-slice CT (MSCT) angiography for assessment of traumatic lesions of lower limbs peripheral arteries.
No full textA pictorial review of coronary artery bypass grafts at multidetector row CT
No full textMultidetector row CT scanners with submillimeter spatial resolution and high temporal resolution are now available and are increasingly used for noninvasive assessment of vascular disease including coronary arteries and grafts. The entire heart and graft course can be scanned within a single breath-hold, and contrast-enhanced images are reconstructed through retrospective ECG gating. In this pictorial review, we describe the CT findings of the most commonly used coronary artery bypass grafts on both axial images and two-dimensional and three-dimensional images providing a correlation with conventional coronary angiography
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