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Multiple ring enhancing lesions in a patient with unilateral limb jerking

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Chakraborty S.
Open Medicine
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2014
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vol. 9
|
issue 3
391-393
EN
Multiple ring enhancing lesions (MREL) in the brain can be caused by a variety of diseases including infections, inflammatory and neoplastic conditions. We present the case of a patient with new onset unilateral jerking movement of the arm who was found to have sixteen ring enhancing lesions (RELs) in the brain on MRI. Further workup revealed a primary small cell lung cancer. The differential diagnosis of multiple ring enhancing lesions is discussed. The astute clinician should be aware of this rare but important radiological finding.
2
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Diabetes insipidus due to pituitary metastasis in a woman with lung adenocarcinoma: a case report

100%
Hsiao C.-H., Wang C.-Y., Chung M.-T., Yang M.-S.
Open Medicine
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2011
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vol. 6
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issue 4
475-479
EN
Metastatic tumors of the pituitary are uncommon and usually asymptomatic. They are often incidental findings from imaging workups for other medical issues or from the assessment of primary tumors in other locations. Diabetes insipidus is the most common symptom resulting from pituitary tumors, including pituitary metastases. A 56-year-old woman with primary lung adenocarcinoma underwent video-assisted thoracic bilobectomy. Regular follow-up was unremarkable until 15 months after surgery, when she presented with polyuria and polydipsia suggestive of diabetes insipidus. A pituitary mass was found on brain magnetic resonance imaging; the diagnosis of lung adenocarcinoma metastasized to the pituitary was confirmed by trans-sphenoidal surgery and biopsy of the pituitary mass. Diabetes insipidus and hormonal profiles are the key to recognize the existence of pituitary metastases, and patients with primary lung cancers presenting with diabetes insipidus should be evaluated for pituitary metastases.
3
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Inguinal lymphadenopathy secondary to adenocarcinoma of caecum: A case report

100%
Hakeem A., Khan M., Dugar N., Muzaffar M., Robinson J.
Open Medicine
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2009
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vol. 4
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issue 1
131-133
EN
Various tumours have been reported to metastasise to inguinal lymph nodes. To our knowledge, caecal cancer has never been reported to metastasise to inguinal nodes. We present a case of a woman who had caecal cancer with large contralateral inguinal lymphadenopathy. She underwent right hemicolectomy with excision of the inguinal lymph node. Histology confirmed adenocarcinoma of caecum metastasising to contralateral inguinal lymph nodes.
4
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Ruptured ovarian metastatic malignant melanoma caused acute abdomen

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Habek D., Marton I., Bauman R., Prka M., Bobić M.
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EN
Ovarian metastatic malignant melanoma is a rare form of disseminated malignant melanoma. We present a rare case of acute abdomen due to rupture of ovarian metastatic malignant melanoma seven years after removal of a primary cutaneous malignant melanoma lesion, followed by reexcision of the cicatrix and axillary dissection (Clark III, Breslow IV), one year after osteoplastic parietal craniotomy for removal of recidiv metastatic lesions, and excision of the cutaneous malignant melanoma lesion on the upper leg were performed. During laparotomy because of acute abdomen, 4 L of free liquid (blood and ascites) were evacuated. The right adnexal mass was loose tumor, size 110x75 mm, with rupture on the posterior wall and hemorrhage. Unilateral adnexectomy was performed. Pathohystologic evaluation revealed tumor cells with eosinophilic, clear cytoplasm, intracytoplasmatic melanotic pigment and a great number of mitosis.Immunohistochemical results supported positivity for protein S-100, whereas results for cytoceratin 7, cytoceratin 20, pancytoceratin, epithelial membrane antigen and HMB-45 were negative. Three months after the surgery the patient died due to disseminated cerebral melanoma. An adnexal mass and the history of previous MM should be suspected to be ovarian metastatic malignant melanoma and the patient should be seen by gynecologist at least for active treatment.
5
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Cardiac metastasis of osteosarcoma

100%
Sahin H., Ceylan N., Bayraktaroglu S., Savas R.
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EN
Cardiac osteosarcoma metastasis is extremely rare and is documented in several case reports in the literature. The behaviour of osteosarcoma metastases is similar to the primary tumour. Thoracic non-enhanced computed tomography (CT) examination is beneficial in the detection of calcific cardiac metastases. In this case report, we describe a 29-year-old woman with cardiac osteosarcoma metastasis after 7 years of follow-up, compare the demographic features with previous cases and discuss the imaging findings.
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