Case of the Week From 8/28/22

History: Positive B-HCG
Describe the findings: Fetal pole measuring 6 weeks 6 days with no heart rate on M-mode. Gestational sac within 4 mm of the wall of the uterus.
What is the diagnosis? Early embryonic demise.
Why it is the most likely reason for the diagnosis? Cornual pregnancy with lack of blood supply.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week From 8/21/22

History: Recent fibroid embolization with fever. Gallium SPECT-CT Scan
Describe the findings: Gallium avid lower segment mass. Additional non-gallium avid masses, some with air fluid levels.
What is the most likely diagnosis? Gallium avid lower uterine segment mass, likely post procedure infection/inflammation. Additional non-gallium avid masses, some with air fluid levels, likely related to necrosis. Both findings can cause post intervention fever!
Why are some of the pelvic masses not gallium avid? Necrosis, loss of blood flow post procedure.

 

Case of the Week From 8/14/22

History: Neck pain.
Describe the findings: Lytic left L2 pedicle lesion with low T1 signal.
What is the differential diagnosis? Metastatic disease, myeloma. lymphoma.
What is the next step? Recommend bone scan to check for additional sites of disease.

Case of the Week From 8/7/22

History: Cognition changes.
What is the most likely diagnosis? Frontotemporal dementia (Pick’s disease)
What is the treatment for the most likely diagnosis? No known effective treatments.