The whole body scanner's indispensable role in the management of cancer.
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In clinical oncology, outpatient ultrasonic investigation helps to assess the nature of the tumor and the spread of malignancy with a high degree of accuracy, so that an adequate treatment could be chosen and initiated as early as possible, and monitored echographically, which is expected to improve its long-term results.
A 40-year-old pregnant woman, who suffered a continuous episode of fever and anemia since the 26th week of pregnancy, was referred to our clinic for evaluation of her left flank pain and tumor. As retroperitoneal tumor was suspected by retrograde pyelography, sonography and CT, translumbar tumorectomy was performed under general anesthesia. The histological diagnosis was retroperitoneal abscess.
Magnetic Resonance Imaging (MRI) is the most recent imaging modality introduced for the study of the body. The main clinical indications of this technique concern the pathology of the brain and spinal cord. Nevertheless, recent improvements in equipment technology have widened the field of applications to other regions of the body such as the chest, abdomen, pelvis, and the musculoskeletal system. The main advantages of MRI, compared to other imaging modalities, are the high soft-tissue contrast, the capability of obtaining images in direct coronal and sagittal planes, the possibility of displaying vessels without intravenous injection of contrast media, and the lack of biologic hazard. In this article, the main clinical uses of MRI are discussed with the exclusion of Central Nervous System pathology. MRI's clinical usefulness is analyzed in detail and compared with Computed Tomography.
A case of malignant haemangiopericytoma of the pelvic retroperitoneum is described. The patient finally died of the complications of radiotherapy. In the absence of any reported long term benefits of adjuvant radiotherapy to the lesion, the lower morbidity of chemotherapy may make this form of adjuvant therapy worthy of further evaluation.
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Retroperitoneal cysts are most commonly found in relation to the small bowel but may be found in the mesentery of the colon or in the omentum. Only a few hundred cases have been reported. In the present analysis four more cases are reported and the pertinent literature is reviewed. The diagnosis is made by clinical suspicion, barium meal and/or enema, sonography and axial computerized tomography. Treatment of choice is by enucleation of the cyst, if possible. Morbidity and mortality should be very low, because of recent advances in surgery and intensive care of the patient.
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Extra-adrenal myelolipomas are rarely reported lesions, with only 18 cases found in the world literature. We report a series of three cases, all occurring in women in an age range of 68 to 83 years (mean, 77 years). One patient presented with a pelvic mass while the other two cases were incidental findings at autopsy. All lesions were presacral in location, encapsulated, and not attached to adjacent structures. Sizes ranged from 6 to 12 cm in greatest dimension and from 72 to 330 g. Color was a variegated yellow to red-brown. Microscopically, all were composed of mature fat and focal collections of normal hematopoietic elements. The nature of these lesions is not known but most authors favor a choristomatous origin. They must be distinguished from extramedullary hematopoietic tumors seen in patients with severe anemias, myeloproliferative disorders, and skeletal disease.
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