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Cariello V, Smaldone MC, Durante A, Pizzicato P, Rossi A, Minelli R, Ferrara D, Esposito F, Zeccolini M, Rossi E. Congenital tibial pseudarthrosis: A challenge in pediatric radiology. Radiol Case Rep 2024; 19:2502-2507. [PMID: 38585392 PMCID: PMC10997800 DOI: 10.1016/j.radcr.2024.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024] Open
Abstract
Congenital pseudarthrosis of the tibia (CPT) is a rare disorder affecting the skeletal system in pediatric population with an estimated incidence of 1:140,000 to 1:250,000 newborns. It is characterized by deformity of the tibia, including anterolateral bowing of the bone diaphysis and/or narrowing of the medullary canal, leading to instability or fracture. CPT can be either idiopathic or associated with underlying conditions such as type 1 neurofibromatosis (NF1), fibrous dysplasia, or Campanacci's osteofibrous dysplasia. Diagnosis is based on clinical and imaging findings, using conventional radiography and magnetic resonance imaging (MRI). The disorder is characterized by recurrent pathological fractures of the tibia or fibula during childhood, often beginning by the age of 2 years. Treatment options include surgical and nonsurgical management.
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Affiliation(s)
- Valentina Cariello
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Piazza Miraglia, Naples 80138, Italy
| | - Maria C. Smaldone
- Department of Radiology, AORN “Santobono-Pausilipon”, Via Posillipo 226, Naples 80123, Italy
| | - Adele Durante
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Piazza Miraglia, Naples 80138, Italy
| | - Paolo Pizzicato
- Department of Radiology, AORN “Santobono-Pausilipon”, Via Posillipo 226, Naples 80123, Italy
| | - Antonio Rossi
- University “Campus Biomedico”, Via Álvaro del Portillo 21, Rome 00128, Italy
| | - Rocco Minelli
- Department of Radiology, University of Molise “Unimol”, Via Francesco De Sanctis 1, Campobasso 86100, Italy
| | - Dolores Ferrara
- Department of Radiology, AORN “Santobono-Pausilipon”, Via Posillipo 226, Naples 80123, Italy
| | - Francesco Esposito
- Department of Radiology, AORN “Santobono-Pausilipon”, Via Posillipo 226, Naples 80123, Italy
| | - Massimo Zeccolini
- Department of Radiology, AORN “Santobono-Pausilipon”, Via Posillipo 226, Naples 80123, Italy
| | - Eugenio Rossi
- Department of Radiology, AORN “Santobono-Pausilipon”, Via Posillipo 226, Naples 80123, Italy
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Di Pilla MA, Capuano MA, Rossi M, Di Pilla G, Minelli R, Pizzicato P, Rossi A, Paviglianiti G, Irace D, Vallone G, Salvia AA, Smaldone MC, Cariello V, Zeccolini R, Rossi E. Leiomyosarcoma of the inferior vena cava. Radiol Case Rep 2024; 19:382-386. [PMID: 38033672 PMCID: PMC10682502 DOI: 10.1016/j.radcr.2023.09.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 12/02/2023] Open
Abstract
Inferior vena cava leiomyosarcoma is a rare malignant mesenchymal tumor that originates from the smooth muscle cells of the venous media and is more frequent in females in the V-VI decade of life. Due to scarce and specific symptoms, diagnosis is not simple, and often metastases to the liver, lungs, and/or lymph nodes are already present. A 44-year-old male patient arrives at our institution presenting diffuse abdominal pain and a sense of weight associated with lumbar pain. He showed nothing relevant except for a moderate consumption of alcohol. Ultrasound examination of the abdomen revealed liver enlargement with hyperechoic nodularity and clear margins. Furthermore, the presence of a voluminous solid nodular formation was found, with an inhomogeneous echostructure and moderate vascularization on Doppler. Inferior vena cava leiomyosarcoma is a rare malignancy. The diagnosis is usually established after surgery, however, recurrences are common and the role of chemoradiation therapy remains to be defined. The only potential treatment is surgical resection with possible vessel reconstruction and en bloc removal of adjacent structures with 5 and 10-year survival rates of 49% and 29%, respectively.
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Affiliation(s)
| | - Marco Alex Capuano
- Life and Health Department “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Mariangela Rossi
- Department of Radiodiagnostics “F. Veneziale”, Molise Regional HealthCompany (ASREM), Isernia, Italy
| | - Gianni Di Pilla
- Department of Radiodiagnostics “F. Veneziale”, Molise Regional HealthCompany (ASREM), Isernia, Italy
| | - Rocco Minelli
- Life and Health Department “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Paolo Pizzicato
- U.O.S.D. Diagnostic Imaging P.O. Pausilipon - AORN Santobono –Pausilipon, Naples, Italy
| | | | - Giuseppe Paviglianiti
- U.O.C. Pediatric Radiology PO G. Di Cristina-ARNAS Civico Benfratelli, Palermo, Italy
| | - Donatella Irace
- A.O.U. Federico II, Department of Translational Medical Sciences, Pediatric Section, Naples, Italy
| | - Gianfranco Vallone
- Life and Health Department “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Antonio A.H. Salvia
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Valentina Cariello
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Raffaele Zeccolini
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Eugenio Rossi
- U.O.S.D. Diagnostic Imaging P.O. Pausilipon - AORN Santobono –Pausilipon, Naples, Italy
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Di Pilla MA, Capuano MA, Rossi M, Di Pilla G, Minelli R, Pizzicato P, Rossi A, Paviglianiti G, Irace D, Vallone G, Salvia AA, Smaldone MC, Cariello V, Zeccolini R, Rossi E. Liposarcoma of the spermatic cord: The state of art and our experience. Radiol Case Rep 2023; 18:3941-3944. [PMID: 37680656 PMCID: PMC10480435 DOI: 10.1016/j.radcr.2023.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 09/09/2023] Open
Abstract
Liposarcoma of the spermatic cord is a malignant neoformation so rare that less than 200 cases are reported in the world. It is a tumor that originates from adipose tissue and when it is found in the spermatic cord it can deceptively simulate an inguinal hernia and not be easily identified. The present work describes the case of a 37-year-old man with liposarcoma of the spermatic cord who arrives at our institution with painless swelling of the left testicle. Physical examination revealed a painless swelling in the scrotal sac. The scrotal ultrasound examination revealed a mass, measuring 8 cm (cranio-caudal) × 5.4 cm (latero-lateral) × 8 cm (antero-posterior) and characterized later with a basal CT examination of the abdomen. The patient was subsequently surgically treated with excision of the tumor, plus hernial plastic with plug and mesh. Histological examination revealed a mature adipocyte neoplasm whose morphological and molecular characteristics (amplification of the MDM2 gene) are consistent with the diagnosis of dediferrentiated liposarcoma variety CO-MINGLED, G2 (sec. FNCLCC). The patient is currently under cancer surveillance with no signs of loco-regional recurrence. Spermatic cord liposarcoma is an extremely rare malignancy. It's not easy to identify as it can simulate an inguinal hernia, hydrocele, lipoma, funicular cyst, or testicular tumor. Diagnosis is usually established postsurgery, however, relapses are common and the role of chemo-radiotherapy remains to be defined.
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Affiliation(s)
| | - Marco Alex Capuano
- Life and Health Department “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Mariangela Rossi
- Department of Radiodiagnostics “F. Veneziale”, Molise Regional HealthCompany (ASREM), Isernia, Italy
| | - Gianni Di Pilla
- Department of Radiodiagnostics “F. Veneziale”, Molise Regional HealthCompany (ASREM), Isernia, Italy
| | - Rocco Minelli
- Life and Health Department “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Paolo Pizzicato
- U.O.S.D. Diagnostic Imaging P.O. Pausilipon - AORN Santobono –Pausilipon, Naples, Italy
| | | | - Giuseppe Paviglianiti
- U.O.C. Pediatric Radiology PO G. Di Cristina-ARNAS Civico Benfratelli, Palermo, Italy
| | - Donatella Irace
- A.O.U. Federico II, Department of Translational Medical Sciences, Pediatric Section, Naples, Italy
| | - Gianfranco Vallone
- Life and Health Department “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Antonio A.H. Salvia
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Valentina Cariello
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Raffaele Zeccolini
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Eugenio Rossi
- U.O.S.D. Diagnostic Imaging P.O. Pausilipon - AORN Santobono –Pausilipon, Naples, Italy
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Vallone G, Pizzicato P, Rossi E, Brunese L. The Role of Ultrasound in Chronic Intestinal Diseases in Pediatric Patients. Ultraschall Med 2022; 43:436-455. [PMID: 36198305 DOI: 10.1055/a-1891-6421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Chronic inflammatory bowel diseases (IBD) are chronic disorders of the gastrointestinal tract, with an increasing incidence in pediatric populations. Ultrasound of the intestinal wall represents the first-line imaging technique in children since it is a noninvasive method, is free of ionizing radiation, and is inexpensive. Furthermore, the absence of intestinal wall thickening has a good negative predictive value for IBD, which is greater for Crohn's disease than for ulcerative colitis. Ultrasound is used for the diagnosis of disease, for the differential diagnosis in IBD, in the follow-up of known IBD, in the definition of the site and extent of the disease, for the diagnosis of intestinal complications, for the evaluation of disease activity, in the definition of prognostic parameters, and in the post-operative follow-up.
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Affiliation(s)
- Gianfranco Vallone
- Radiodiagnostic, University of Molise, Department of Medicine and Health Sciences Vincenzo Tiberio, Campobasso, Italy
| | | | - Eugenio Rossi
- Radiodiagnostic, A.O.R.N. Santobono-Pausilipon, Napoli, Italy
| | - Luca Brunese
- Radiodiagnostic, University of Molise, Department of Medicine and Health Sciences Vincenzo Tiberio, Campobasso, Italy
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Brillantino C, Rossi E, Minelli R, Bifano D, Baldari D, Pizzicato P, Zeccolini R, Zeccolini M. Mediastinal thymoma: A difficult diagnosis in the pediatric age. Radiol Case Rep 2021; 16:2579-2585. [PMID: 34285726 PMCID: PMC8278152 DOI: 10.1016/j.radcr.2021.06.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 01/15/2023] Open
Abstract
Thymoma is a rare neoplasm of the anterior mediastinum, which originates from the epithelium of the thymic gland; it occurs mainly in middle-aged adults and is much less common in children. The tumor has slow growth and is asymptomatic in most pediatric cases, thus resulting in an accidental discovery; one-third of the young patient presents symptoms related to the compression of the tumor mass on the surrounding anatomic structures and/or related to paraneoplastic syndromes. Surgery is the treatment of choice and complete resection of the thymoma achieves excellent long-term results in terms of disease-free survival. In this article, we report the clinical case of a 21-month-old girl who came to our observation for persistent cough for over a month investigated with a chest X-ray, performed in another hospital. The X-ray showed an extensive opacification of the left hemithorax with contralateral dislocation of the mediastinum. The instrumental investigations carried out in our hospital (ultrasound, computed tomography, and magnetic resonance of the chest) showed a voluminous expansive mass of the left antero-superior mediastinum, which occupied the entire ipsilateral hemithorax and not dissociable from the thymus. At the histologic examination, the mass resulted to be a B1 thymoma with a low degree of malignancy according to the histologic classification of thymic tumors of the World Health Organization.
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Affiliation(s)
- Carmela Brillantino
- Unit of Radiology and Ultrasound, A.O.R.N. Santobono-Pausilipon, Pausilipon Hospital, Naples, Italy
| | - Eugenio Rossi
- Unit of Radiology and Ultrasound, A.O.R.N. Santobono-Pausilipon, Pausilipon Hospital, Naples, Italy
| | - Rocco Minelli
- Department Life and Health "V. Tiberio", University of Molise, Francesco De Sanctis st 1, 86100, Campobasso, Italy,Corresponding author.
| | - Delfina Bifano
- Unit of Pathological Anatomy, A.O.R.N. Santobono-Pausilipon, Pausilipon Hospital, Naples, Italy
| | - Diana Baldari
- Unit of Radiology and Ultrasound, A.O.R.N. Santobono-Pausilipon, Pausilipon Hospital, Naples, Italy
| | - Paolo Pizzicato
- Department of Radiodiagnology, Federico II University, Naples, Italy
| | | | - Massimo Zeccolini
- Unit of Radiology, A.O.R.N. Santobono-Pausilipon, Santobono Hospital, Naples, Italy
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Lupoli R, Pizzicato P, Scalera A, Ambrosino P, Amato M, Peluso R, Di Minno MND. Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis. Arthritis Res Ther 2016; 18:297. [PMID: 27964760 PMCID: PMC5155390 DOI: 10.1186/s13075-016-1194-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/24/2016] [Indexed: 12/26/2022] Open
Abstract
Background In this study, we evaluated the impact of obesity and/or overweight on the achievement of minimal disease activity (MDA) in patients with psoriatic arthritis (PsA) and patients with rheumatoid arthritis (RA) receiving an anti-rheumatic treatment. Obesity can be considered a low-grade, chronic systemic inflammatory disease and some studies suggested that obese patients with rheumatic diseases exhibit a lower rate of low disease activity achievement during treatment with anti-rheumatic drugs. Methods A systematic search was performed in major electronic databases (PubMed, Web of Science, Scopus, Embase) to identify studies reporting MDA achievement in obese and/or overweight patients with RA or PsA and in normal-weight RA or PsA control subjects. Results were expressed as Odds Ratios (ORs) with pertinent 95% Confidence Intervals (95%CIs). Results We included 17 studies (10 on RA and 7 on PsA) comprising a total of 6693 patients (1562 with PsA and 5131 with RA) in the analysis. The MDA achievement rate was significantly lower in obese patients than in normal-weight subjects (OR 0.447, 95% CI 0.346–0.577, p < 0.001, I2 = 62.6%, p < 0.001). Similarly, overweight patients showed a significantly lower prevalence of MDA achievement than normal-weight subjects (OR 0.867, 95% CI 0.757–0.994, p = 0.041, I2 = 64%, p = 0.007). Interestingly, the effect of obesity on MDA was confirmed when we separately analyzed data on patients with RA and patients with PsA. In contrast, when we evaluated the effect of overweight, our results were confirmed for PsA but not for RA. A meta-regression analysis showed that follow-up duration, age, male sex, and treatment duration are covariates significantly affecting the effect of obesity/overweight on MDA achievement. Conclusions The results of our meta-analysis suggest that obesity and overweight reduce the chances to achieve MDA in patients with rheumatic diseases receiving treatment with traditional or biologic disease-modifying antirheumatic drugs. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1194-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roberta Lupoli
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Paolo Pizzicato
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Antonella Scalera
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Pasquale Ambrosino
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Manuela Amato
- Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Rosario Peluso
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Matteo Nicola Dario Di Minno
- Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Via Sergio Pansini 5, 80131, Naples, Italy.
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Di Minno MND, Iervolino S, Zincarelli C, Lupoli R, Ambrosino P, Pizzicato P, Di Minno A, Pappone N, Peluso R. Cardiovascular effects of Etanercept in patients with psoriatic arthritis: evidence from the cardiovascular risk in rheumatic diseases database. Expert Opin Drug Saf 2015; 14:1905-13. [DOI: 10.1517/14740338.2015.1111870] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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