Biomedical subjects
Publications and source records attributed to R De Man.
We present a case of a primary tumor of the peritoneum that manifested as a spigelian hernia in a 74-year-old woman. Multidetector computed tomography showed a large heterogeneous mass located subcutaneously on the right spigelian line connected to the abdominal cavity. We found no previous report describing a primary peritoneal tumor in a spigelian hernia.
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Congenital cysts of the seminal vesicles with ipsilateral renal aplasia or dysplasia are rare but have been well described in the literature. We report the first case where anal tenesmus was the only presenting symptom. Another unique feature was the combination of this anomaly with a duplication of the inferior vena cava.
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We describe a case of mucocele of the appendix, observed incidentally in a 42-year-old man. The plain film, ultrasound and CT features are reviewed. Adequate diagnosis and resection are important because of the risk of rupture and development of pseudomyxoma peritonei.
A case of fibrolipoma of the median nerve was described. Peripheral nerve tumors of the upper extremity are very rare. Within this group of tumors, the fibrolipoma is an exceedingly uncommon entity. It was first described in 1953, and to date less than 100 cases have been described. The purpose of this report was to point out a characteristic sign of fibrolipoma, which in our opinion allows distinction on CT and MRI between fibrolipoma and the other peripheral nerve and fatty soft tissue tumors.
Cystic lesions of the adrenal gland are rare entities. Pseudocysts account for 40% of all cystic tumors of the adrenal glands, and are a consequence of hemorrhage and degeneration. Clinical signs are aspecific. On US and CT, a well defined large mass with cystic appearance is found. Thickening and irregularity of the cystic wall areas of different attenuation values within the cyst and central calcifications are due to hemorrhage. The more complex pseudocysts should be distinguished from cystic degeneration in adrenal malignancy and from cystic hypernephroma in the renal upper pole.
We report a 36-year-old woman with a bacterial meningitis. CT after resuscitation showed a striking "reversal sign." Opinions on the pathogenesis of this sign are discussed; it indicates serious brain damage and carries a poor prognosis.
Except for glioblastomas, metastases of astrocytomas and of intracerebral tumors are in general very rare. It is well known that the process of spreading can be provoked or accelerated by surgical procedures. The presented patient, with the initial diagnosis of grade III astrocytoma developed peritoneal metastases after placement of a ventriculo-peritoneal shunt.
A case of fibrous mesothelioma is presented. Chest films suggested an elevation of the left diaphragm and a limited pleural effusion, which was confirmed on computed tomography. Percutaneous needle biopsy showed mesothelial cells. At thoracotomy the tumor was attached to the pleura of the mediastinum by a pedicle. Complete surgical resection was possible. Clinical, radiological and histological data in literature are summarized. The radiological features of the presented case correspond to those described in the literature.
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Computed tomography is mandatory in the investigation of the acute abdomen and can provide the physician with crucial information to decide whether the patient should be treated surgically or conservatively. An unusual cause of acute abdomen is presented. Computed tomography suggested the diagnosis of omental torsion and necrosis. At surgery, the greater omentum and part of the transverse colon were incarcerated in a small diaphragmatic hernia of the Morgagni type.
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