May 2024 Cases Of The Week

Case of the Week From 5/26/24

History: History of breast cancer. 
What kind of study is this? F-19 Fluoroestradiol (Cerriana)PET Scan
What is the motivation for performing this type of scan? To look for Estrogen receptor disease that is amenable to hormone therapy. 
There is linear uptake at the left arm. Is this a normal finding? Uptake on a Cerriana scan typically stays in the arm for longer with slower flow from injection compared to other PET scans and is considered a normal variant.

Case of the Week From 5/19/24

History: Hip pain

What are the findings? Interval development of lytic changes at the osseous right acetabular adjacent to the hip prosthesis. Additional acetabular protrusio adjacent to the acetabular component.
What is the differential diagnosis? Acetabular erosion related to prosthesis (foreign body reaction), loosening, and infection.
What can be done next? Consider white blood cell imaging to rule out infection if it is of clinical concern.

2 Years ago

Today

Case of the Week From 5/12/24

History: GI bleeding.

What are the findings? Enhancing arterial phase small focal lesion at the right wall of the rectum.
What is the most likely diagnosis? Angiodysplasia of the rectum/colon .
What is the best intervention? Either waiting since 50% cease hemorrhaging on their own or interventional endoscopy.

 

Case of the Week From 5/5/24

History: Headaches.

What are the findings? Multiple T1 and T2 dark circumscribed bilateral parotid masses with restricted diffusion. 
What is the differential diagnosis? Warthin’s tumors, Pleomorphic adenomas, Squamous cell carcinoma. Other malignant parotid tumors.
What is the next best test? Contrast-enhanced MRI through the parotids.
What is most likely? Given multiplicity and signal characteristics, they are probably Warthin’s tumors. (Especially if the patient is male!)