Malignant proliferating trichilemmal tumor in abdominal wall: Report of a rare case at an uncommon site with literature review

The proliferating trichilemmal tumor (PTT) is a very rare cutaneous neoplasm that rarely is malignant. PTTs mainly occur in the scalp of elderly women. Only 10% occur in places other than scalp. We present a 62‐year‐old male patient with malignant PTT in his abdominal wall.     

Hepatic cyst with intracystic bleeding: contrast-enhanced sonographic findings

Intracystic bleeding is a relatively rare complication of hepatic cysts, which is very difficult to diagnose by conventional sonography (US). Hence, a new US technique has been sought for this purpose. We present the case of a hepatic cyst with intracystic bleeding in which contrast-enhanced US showed microbubbles oozing from the cyst wall into the cystic cavity. Contrast-enhanced US is now an important diagnostic tool for diagnosing liver tumors, but contrast-enhanced US findings relating to intracystic bleeding have not been reported. Our observations suggest that this technique may be a useful new diagnostic tool for this purpose.     

乳腺颗粒细胞瘤超声表现1例

患者女,47岁,因“发现右乳肿块2年余”就诊。体格检查:右乳上象限12点钟方向可扪及一大小约2.5 cm×2.0 cm肿块,质硬、边界不清、活动欠佳,与皮肤粘连?局部皮肤无红肿及破溃。超声检查:右乳12点钟方向距乳头3.2 cm可见一大小约2.3 cm×1.8 cm×1.7 cm均匀低回声区,形状不规则,边缘不清晰,纵横比>1,周边可见成角毛刺状回声,似有厚薄不均的高回声晕,后方回声衰减(图1);CDFI示肿块周边可探及少许点状血流信号(图2);应力式弹性成像示肿块质地较硬(图3)。超声提示:右乳上象限12点钟方向占位,BI-RADS 4C类,考虑乳腺癌可能。     

环指末节血管球瘤1例

患者,女,39岁,主因左手环指末节桡侧疼痛7个月就诊.无外伤史,疼痛呈间歇性,冷水刺激诱发或加剧疼痛.查体局部皮肤呈淡紫色,触痛明显,Love 氏试验阳性.X线平片示右手环指末节甲粗隆下方桡侧骨质轻度凹陷,骨皮质尚完整,边界清楚,无骨膜反应(图1).MRI检查:右手环指末节甲粗隆下方桡侧软组织内,可见长T1长T2信号影,边界清楚,T1WI增强后病变均匀强化(图2～4).手术病理:血管球瘤(图5).     

Prenatal sonographic findings of duodenal duplication: Case report

We report a rare case of duodenal duplication cyst that was suspected prenatally. Routine prenatal sonography (US) at 19 weeks' gestation showed an abdominal cystic mass on the left side of the abdomen. Follow‐up US examinations showed a partial “double‐wall” sign, highly suggestive of enteric duplication, and changes in cyst size and wall thickness. Postnatal US examination suggested enteric duplication cyst. A laparotomy revealed a duodenal cyst that was completely resected. The antenatal US findings associated with this condition, the accuracy of its antenatal diagnosis, and its differential diagnosis are discussed. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound 41 :1–5, 2013     

右侧下颌骨巨大表皮样囊肿影像表现1例

患者男,37岁.无明确颌面部外伤史,2年前偶然发现右侧下颌骨稍肿大,无其他症状,当时未处理.此后肿块缓慢增大,偶感疼痛,近1个月来患者自觉肿块疼痛频繁发作,口服抗感染药物后症状无缓解,遂到我院进一步诊治.     

Borderline cystic tumors of the ovary: gray-scale and color Doppler sonographic findings

PURPOSE: The aim of the study was to determine the value of gray-scale and color Doppler sonography in distinguishing borderline cystic tumors (BCTs) from benign cysts and malignant tumors of the ovary. METHODS: The gray-scale and color Doppler sonographic features of 383 ovarian lesions in 374 nonpregnant women were retrospectively studied. Sonography was performed transvaginally for all but 7 lesions, which were imaged suprapubically. All of the lesions were surgically resected via laparoscopy or laparotomy. RESULTS: The histopathologic diagnoses were 27 BCTs, 35 ovarian carcinomas, and 321 benign cysts. Sonography diagnosed 24 (89%) of 27 BCTs as malignant lesions. Patients with BCTs, were younger than those with ovarian cancer (p < 0.001). BCTs showed intracystic papillae in 17 cases (63%), diffuse internal echoes in 11 (41%), intracystic septa in 8 (30%), a heterogeneous echo pattern in 7 (26%), and a solid pattern in 4 (15%). BCTs showed blood flow in 24 cases (89%) and lower pulsatility and resistance indices (RI) compared with benign lesions (p < 0.001 for both). Multivariate analysis revealed intracystic papillae as the only independent predictor of BCTs (p < 0.001). CONCLUSIONS: When a cystic mass has papillae, this is the only abnormal finding detected by gray-scale transvaginal sonography, and color Doppler imaging shows low RI values within the mass, a BCT should be suspected.     

Inflammatory myofibroblastic tumor of the stomach with peritoneal dissemination in a young adult: imaging findings in a case report

Inflammatory myofibroblastic tumors are lesions that most often affect young adults and children. These tumors have been found in numerous extrapulmonary sites but rarely in the stomach. It is unknown whether this process is reactive or neoplastic. They are infiltrative lesions and often extend through the gastric wall, sometimes reaching adjacent organs including the esophagus, duodenum, peritoneal cavity, spleen, pancreas, and liver. These features mimic malignancy on endoscopy and radiology. We report the ultrasound, color Doppler ultrasound, and helical computed tomographic findings of a gastric inflammatory myofibroblastic tumor with peritoneal dissemination in a young adult. To our knowledge, this is the first report of color Doppler ultrasound and helical computed tomographic findings of this rare disease entity.     

Prenatal sonographic findings in a case of Wolman's disease

No published case of Wolman's disease has described the prenatal sonographic findings. We present a case in which a third‐trimester sonographic examination demonstrated fetal hepatomegaly and bilateral adrenal echogenicity suggestive of diffuse calcification. Wolman's disease, also known as lysosomal acid lipase (LIPA) deficiency, is a rare autosomal‐recessive disorder characterized by complete absence of the LIPA enzyme. The diagnosis of Wolman's disease was made postnatally by biochemical testing, which indicated absence of LIPA enzyme activity and gene sequencing, which confirmed homozygosity for the G66V mutation within the LIPA gene. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46 :66–68, 2018;     

High-frame-rate contrast-enhanced ultrasound findings of liver metastasis of duodenal gastrointestinal stromal tumor: A case report and literature review

BACKGROUNDLiver metastasis of duodenal gastrointestinal stromal tumor (GIST) is rare. Most reports mainly focus on its treatment and approaches to surgical resection, while details on its contrast-enhanced ultrasound (CEUS) findings are lacking. The diagnosis and imaging modalities for this condition remain challenging.CASE SUMMARYA 53-year-old Chinese man presented with mild signs and symptoms of the digestive tract. He underwent routine examinations after GIST surgery. Magnetic resonance imaging showed a 2.3 cm hepatic space-occupying lesion. All the laboratory test results were within normal limits. For further diagnostic confirmation, we conducted high frame rate CEUS (H-CEUS) and found a malignant perfusion pattern. Heterogeneous concentric hyper-enhancement, earlier wash-in than the liver parenchyma, and two irregular vessel columns could be observed at the periphery of the lesion during the arterial phase. Ultrasound-guided puncture biopsy was used to confirm the diagnosis of the lesion as liver metastasis of duodenal GIST. Imatinib was prescribed after biopsy, and the patient’s clinical course was monitored.CONCLUSIONH-CEUS is useful for detecting microcirculation differences, wash-in patterns, and vascular morphogenesis and diagnosing liver metastasis of duodenal GIST.     

Prenatal diagnosis of choledochal cyst: a case report

Choledochal cyst is one of the intra-abdominal abnormalities of the biliary ducts that present as a cystic mass in the right upper quadrant abdomen. Prenatal diagnosis has been achieved by the demonstration of a connection between a dilated common bile duct and a cystic lesion. In this report, we describe a pregnant woman in whom routine fetal anomaly scan strongly suggested a choledochal cyst at 29 weeks of gestation by demonstrating a round cystic mass in the right upper quadrant of the abdomen, completely separated from the stomach, bowel loops, and gall bladder, and which showed a connection with the dilated common bile duct.     

Prenatal sonographic diagnosis of mature renal teratoma: A case report

Renal teratoma is an extremely rare condition found in adolescents and young adults. Here, we report a case in which renal teratoma was diagnosed by fetal ultrasound examination. To our knowledge, this is the first report to describe the imaging manifestation of renal teratoma in prenatal diagnosis.© 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2013     

Sonographic findings of Menetrier's disease: A case report

The ultrasonic images obtained in a patient with Menetrier's disease are presented. Identification of the normal gastric wall surrounding the whole organ and of giant mucosal folds projecting from the wall into a partially fluid-filled lumen led to the correct diagnosis.     

Spermatocytic tumor: A rare case report

BACKGROUNDSpermatocytic tumor is a rare, malignant neoplasm of the testes. Since the prognosis for this tumor type is favorable, accurate diagnosis and differentiation from other malignant testicular neoplasms (classic seminoma and lymphoma) are crucial. To add to the existing literature on the diagnosis of spermatocytic tumor, herein we report the detailed clinical and histopathologic findings for a case that we encountered.CASE SUMMARYA 60-year-old Chinese man presented with a solid mass in the right scrotum. The mass was surgically removed and spermatocytic tumor was diagnosed. On microscopy, the tumor cells displayed an unusual arrangement in lobules, presenting a pseudo-glandular appearance. To summarize and compare the diagnostic features of this tumor and those of the differential diagnoses, we report our case findings and those mentioned in the literature for various testicular tumors. Although imaging methods can detect masses early in development, their diagnostic capabilities are limited. Biopsy, histopathology, and immunohistochemistry are necessary for confirmatory diagnosis.CONCLUSIONIt is important to identify and review the key diagnostic features of spermatocytic tumor.     

Pulmonary inflammatory myofibroblastic tumor in a male child: A case report

Pulmonary inflammatory myofibroblastic tumor (IMT) is a rare condition in the normal population and specifically in the pediatric population. We reported a 9‐year‐old male child who presented with cough and intermittent fever and weight loss that was most suggestive of the infectious process. We reviewed the consideration of diagnosis and treatment.     

Epidermoid cyst of the testis: An atypical sonographic appearance

Epidermoid cysts are rare. They represent the most common benign tumor of the testis. The sonographic appearances of testicular epidermoid cysts usually include avascular, mostly lamellated, heterogeneous internal echotexture, with hypoechoic and hyperechoic concentric rings, accounting for the typical onion‐ring appearance. On MRI, epidermoid cysts show a low‐signal‐intensity center, with internal concentric rings of alternating high‐ and low‐signal intensity on T2‐weighted images, which correlates with the onion‐ring appearance. We report a patient with testicular epidermoid cyst with atypical ultrasound and MRI appearances that led to the erroneous initial diagnosis of “burned‐out” tumor. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44 :448–451, 2016;     

Granular cell tumor in a male breast: Mammographic,sonographic, and pathologic features

Granular cell tumor (myoblastoma) is a rare soft tissue tumor that can present in the breast, producing mammographic and physical exam findings that may be indistinguishable from breast carcinoma. Multifocal lesions in male patients are very unusual. We present a case of a male patient with a granular cell tumor of the breast that was imaged on mammography and sonography. Definitive diagnosis was made with ultrasound‐guided core biopsy followed by surgical excision. On clinical examination, the patient demonstrated multiple subcutaneous lesions that were also found to represent granular cell tumor. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2013