Case of the Week from 11/29/20

History: Shortness of breath.
What are the findings at the anterior chest wall? Extensive venous collateralization.
What is the cause for the these findings? SVC occlusion

Case of the Week from 11/22/20

History: Two CT scans one month apart. Abdominal pain.
What is the diagnosis on the first CT scan? Appendicitis.
What is the most likely cause of the second CT scan? Most likely complication is a postoperative adhesion causing a small bowel obstruction.

CT Scan 1

CT Scan 2

Case of the Week from 11/15/20

History: Endometrial cancer.
Describe the findings. Moderate hypermetabolic lesion at the left thyroid lobe without anatomically evident nodule on CT scan.
What is the differential/most likely diagnosis? Most likely thyroid adenoma. Differential includes primary thyroid cancer.
What do you need to do next? Recommend thyroid ultrasound for further anatomic characterization since thyroid ultrasound is more sensitive for thyroid nodules than CT scan.
What do you do if there are no findings on CT and positive findings on FDG-PET? Recommend thyroid ultrasound. If a nodule is anatomically present at same location on ultrasound, recommend biopsy because of higher risk of cancer in hypermetabolic nodules.

 

Case of the Week from 11/8/20

History: Hip pain.
Describe the findings.
What is the differential/most likely diagnosis? Multiple hereditary exostoses.
What are the typical complications? Fractures, bursa formation, impingement on adjacent structures (tendons, nerves, vessels), and malignant transformation. (1)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week from 11/1/20

History: Abdominal pain.
Describe the findings. Hyerdense lobulated circumscribed perirectal nodule abutting the gluteal musculature and the rectum with non-aggressive appearance.
What is the differential diagnosis? enteric duplication cyst, hemangioma, perirectal hematoma, hamartoma, myxoma, malignancy (unlikely).