软骨母细胞瘤合并动脉瘤样骨囊肿1例

患者男,24岁,以“右髋部酸痛半年,摔伤后疼痛2h”为主诉入院,继往半年前出现右股骨大粗隆部酸痛,以活动性为明显,休息可缓解,未就诊治疗,因2h前不慎扭伤后感觉右髋酸痛难忍,行走困难,遂就诊我院。既往体健,否认肺结核及肝炎等传染疾病史,有青霉素过敏史。查体:右髋部未见明显肿胀,未见瘀血、瘀斑,右股骨大粗隆部压痛( ),叩击痛( ),右髋部活动因患者疼痛无法配合检查,右下肢末梢血运良好,皮肤感觉无明显异常,四肢肌力、肌张力、感觉均正常。X线平片及多层螺旋CT扫描示右股骨大粗隆部一椭圆形低密度骨质破坏区,长轴与骨干一致,大小约6.8cm×…     

Dramatic response of aneurysmal bone cyst to denosumab: Case report and literature review

Denosumab, a monoclonal antibody that specifically targets cytokine receptor activator of nuclear factor‐kappa B ligand (RANKL), is a potentially viable option in resistant aneurysmal bone cysts.     

CT诊断动脉瘤样骨囊肿1例

患者男,76岁,间断性咳嗽3个月,左胸痛5天就诊.门诊检查后,以缩窄性心包炎、心包少量积液入院.住院次日晨突发右侧腰痛,肾区叩痛阳性,卧位时疼痛加剧,立位时好转.彩超急诊检查,CDFI见右肾不规则血流充盈缺损区(见图),大小约18 mm×18 mm;肾门处近缺血区分支动脉流速增快,峰速1.2 m/s.腹主动脉流速正常.彩超诊断:右肾动脉血栓形成(分支动脉).腹部CT示右肾动脉短节断样造影剂充盈缺损,考虑为右肾动脉血栓形成.当日下午心电监护下使用尿激酶50万U快速静滴溶栓治疗,于10 min内滴入完毕后,患者腰痛明显好转,连用3日溶栓药物治疗,胸痛、腰痛症状消失,病情好转出院.     

CT诊断动脉瘤样骨囊肿1例

患者男,12岁,于4个月前无明显诱因发现右眼球较左侧突出,右眼溢泪,右侧鼻塞,并进行性加重.体检:右侧眼球突出,鼻中隔左偏,右鼻腔外侧壁内移,鼻道内见新生物,呈椭圆形,色泽同鼻腔黏膜,表面不光滑,质韧,中鼻甲辨别不清,副鼻窦区无压痛.眼部超声:右眼眶内占位性病变.副鼻窦冠状位CT扫描:右筛窦窦腔囊状膨大,窦壁骨质吸收变薄,形成一完整骨壳,壳内见一宽大的液-液平面,呈上低下高密度(图1),并可见致密骨性房隔及片状骨化影(图2).病灶累及相邻上颌窦、蝶窦、额窦与鼻腔.CT诊断:右筛窦良性肿瘤性(样)病变,考虑:①动脉瘤样骨囊肿;②骨巨细胞瘤;③非骨化性纤维瘤.手术所见:右鼻腔内椭圆形肿物,充满鼻腔上部及筛窦,瘤体内侧游离,外侧与筛窦融为一体,中鼻甲辨别不清.穿刺瘤体抽出陈旧性血性物.切除瘤体为不规则椭圆形,外覆黏膜及骨质,骨质薄如蛋壳,内为血性液体,间杂胆固醇结晶样骨化物,无骨膜.手术病检报告:纤维组织囊壁中含有不规则骨小梁,内侧多见血窦,散见多核巨细胞并有钙化.病理诊断:动脉瘤样骨囊肿.     

非骨化性纤维瘤合并动脉瘤样骨囊肿1例

病例男,12岁,因十余天前活动时感右小腿酸痛不适,自行休息后症状改善不明显,遂来院检查.门诊查体:患儿右小腿七端轻度压痛,局部无红肿,右膝关节无屈伸功能障碍,末梢血运良好.     

A retroperitoneal bronchogenic cyst clinically mimicking an adrenal mass: three case reports and a literature review

Bronchogenic cysts are a congenital primitive foregut-derived developmental malformation, generally occurring in the posterior mediastinum. Their development in the retroperitoneum is extremely rare. Imaging techniques, such as multidetector computed tomography (MDCT), are typically effective in the detection of these lesions. Here, we describe three cases of a retroperitoneal cyst presenting as a para-adrenal mass. Only one boy presented with abdominal pain, and the other two showed no clinical symptoms. Endocrinological evaluation of all three cases was performed, and no adrenal hormone secretion was detected. All three cases were misdiagnosed preoperatively. Each patient underwent surgery, and one symptomatic patient became asymptomatic after surgery. Pathologic examination confirmed all three masses as bronchogenic cysts. The three cases showed some similar MDCT imaging features, including a complete adrenal structure, a cystic or solid mass in the adrenal region, and no obvious enhancement. Therefore, bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal masses, even though accurate preoperative diagnosis remains difficult. A contrast-enhanced MDCT scan may be useful for differentiating hyper-attenuated cysts from other soft tissue masses.     

鞍区实性动脉瘤样骨囊肿1例

病例 女，25岁，主因复视半年，右眼睑下垂10余天伴头晕，恶心入院。     

Prolapsed bladder following rupture of patent urachal cyst,mimicking bladder exstrophy: a case report and literature review

A 26-year-old pregnant woman was diagnosed with fetal bladder prolapse following rupture of a patent urachus/urachal cyst, based on the finding of cyst disappearance with replacement with an infra-umbilical, extra-abdominal solid soft-tissue mass, mimicking bladder exstrophy. The neonatal findings confirmed the prenatal diagnosis. The baby was healthy and had a successful surgical correction. This report provides clues to differentiating ruptured bladder prolapse from bladder exstrophy as follows: (1) well-documented urachal cyst with urine-filled mass in the early gestation, (2) development of solid soft-tissue mass shortly after disappearance of the urachal cyst, and (3) no other structural abnormalities (bladder exstrophy is usually associated with abnormal genitalia, epispadias, or pubic diastasis). This study underlines the differentiation between the two entities because of the vast difference in prognosis, management, and proper counseling.     

Ileal bronchogenic cyst: A case report and review of literature

We herein report a rare case of ileal bronchogenic cyst that was found in a 39-year-old Chinese man. He had no symptoms and the physical examination was normal. Tumor markers were within the normal range. Abdominopelvic enhanced computed tomography showed a mass in the lower abdominal cavity and the tumor had a complete capsule. Diagnostic laparoscopy was then performed, which showed that a spheroid mass with a complete capsule was located at the antimesenteric border of the distal ileum 20 cm from the ileocecal valve, measuring 6.0 cm × 6.0 cm × 5.0 cm. Considering that the malignancy of the tumor cannot be ruled out, and there is a risk of rupture during laparoscopic surgery, the patient was converted to an open surgery. Partial resection of the ileum with the tumor was performed, followed by a side-to-side anastomosis. The tumor was gray-red in color, filled with grayish yellow mucus and had no septum. The postoperative pathology revealed that the cystic wall was lined by pseudostratified ciliated columnar epithelium without cellular atypia. The wall consisted of bronchial mucous glands and smooth muscle fibers, and no abnormalities were found in adjacent ileum tissues. Thus, a diagnosis of bronchogenic cyst of the ileum was made.     

动脉瘤样骨囊肿的影像表现1例

动脉瘤样骨囊肿的影像表现报道已很多,但进行各种影像检查并作比较者较少,本文报道1例做了X线、CT、MRI检查的患者,现将其综合表现报告如下. 病例男,28岁.左桡骨远端桡侧包块10余年,偶有疼痛,未作治疗,近1个月逐渐增大疼痛加剧.     

原发性额骨平滑肌肉瘤一例并文献复习

患者男,47岁,2个多月前无明显诱因出现间歇性头痛、头晕,无规律,无恶心、呕吐,无四肢乏力及抽搐.外院CT检查提示:前额骨肿瘤性病变,偏恶性可能性大.为进一步治疗,2020年9月28日于我院就诊,门诊以"颅骨肿瘤"收治入院.自发病以来,患者精神、体力、食欲及睡眠情况良好,体重无明显变化,大小便正常.查体未见明显异常.实验室检查未见确切异常.既往有"尘肺"病史十余年.     

Mesothelial cyst of the spleen mimicking a metastasis: a case report

Mesothelial cyst of the spleen is a developmental disorder. Previous reports have elaborated on the radiological features of splenic mesothelial cysts as being unilocular with a smooth and well-defined margin. However, due to its rarity, it is unclear whether these characteristics are representative and specific for the diagnosis of mesothelial cysts. Herein, this case report presents an atypical case of splenic mesothelial cyst mimicking a malignant tumour, especially splenic metastasis in a 66-year-old woman with ascending colon cancer. Due to an overlapping imaging finding of hypodense splenic lesions, and considering the clinical history, a mesothelial cyst that developed as a multilocular hypodense mass from an ill-defined small nodule was inevitably misdiagnosed as metastasis. Although rare, it is important to consider the possibility of mesothelial cyst in a patient with multilocular hypodense lesions of the spleen.     

Prenatal diagnosis of mediastinal neurenteric cyst: a case report and review of the literature

Neurenteric cyst is a very rare developmental anomaly. Prenatal diagnosis of mediastinal neurenteric cysts has been reported rarely. We present a case of neurenteric cyst associated with vertebral anomalies diagnosed by prenatal ultrasonography at 31 weeks of gestation, which was treated successfully in the early neonatal period. In addition, we searched the English literature for all cases of mediastinal neurenteric cyst diagnosed in the prenatal period reported to date. We found that only 17 cases were reported previously. We reviewed the reports of these 17 patients along with our case, and we investigated the prenatal and postnatal diagnosis and treatment approaches and the factors influencing the prognosis. Fetuses with mediastinal neurenteric cysts should be monitored regularly by ultrasonography. Fetuses with no signs of hydrops are more likely to survive with proper neonatal center transfer, regular follow-up, and appropriate postnatal approach. Fetuses with hydrops findings have a high risk of fetal and neonatal death.     

Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion: A case report and review of literature

BACKGROUNDAppendiceal tumors are rare lesions that may not be easily differentiated from primary ovarian lesions preoperatively, despite the use of advanced diagnostic methods by experienced clinicians.CASE SUMMARYA 59-year-old G2P2 woman, with chronic pelvic pain, underwent a pelvic ultrasound that revealed an adnexal mass measuring 58 mm × 34 mm × 36 mm, with irregular borders, heterogeneous echogenicity, no color Doppler vascularization and without acoustic shadowing. Normal ovarian tissue was visualized in contact with the lesion, and it was impossible to separate the lesion from the ovary by applying pressure with the ultrasound probe. Ascites, peritoneal metastases or other alterations were not observed. With the international ovarian tumor analysis ADNEX model, the lesion was classified as a malignant tumor (the risk of malignancy was 27.1%, corresponding to Ovarian-Adnexal Reporting Data System category 4). Magnetic resonance imaging confirmed the presence of a right adnexal mass, apparently an ovarian tumor measuring 65 mm × 35 mm, without signs of invasive or metastatic disease. During explorative laparotomy, normal morphology of the internal reproductive organs was noted. A solid mobile lesion involved the entire appendix. Appendectomy was performed. Inspection of the abdominal cavity revealed no signs of malignant dissemination. Histopathologically, the appendiceal lesion corresponded to a completely resected low-grade mucinous appendiceal neoplasm (LAMN).CONCLUSIONThe appropriate treatment and team of specialists who should provide health care to patients with seemingly adnexal lesions depend on the nature (benign vs malignant) and origin (gynecological vs nongynecological) of the lesion. Radiologists, gynecologists and other pelvic surgeons should be familiar with the imaging signs of LAMN whose clinical presentation is silent or nonspecific. The assistance of a consultant specializing in intestinal tumors is important support that gynecological surgeons can receive during the operation to offer the patient with intestinal pathology an optimal intervention.     

Colloid cyst: a case report and literature review of a rare but deadly condition

Background: Colloid cysts are congenital benign tumors accounting for 0.2–2% of all intracranial neoplasms but representing 15–20% of all intraventricular masses. Emergency Physicians are more likely than any other group to encounter patients with a colloid cyst, a rare but life-threatening condition. The most common presenting complaint is severe episodic attacks of headache in a frontal location with associated nausea and vomiting. Objectives: To describe a rare but potentially life-threatening cause of headache so that clinicians will rapidly recognize the significance of the condition and institute timely appropriate therapy. Case Report: We describe the case of a 40-year-old man with a severe headache accompanied by confusion who was diagnosed with obstructive hydrocephalus associated with a colloid cyst in the third ventricle. Conclusion: Recognition of this rare but important diagnosis should prompt the Emergency Physician to obtain timely treatment so that rapid neurologic deterioration, herniation, and death can be prevented. A review of the pathophysiology, diagnosis, and current management is discussed.