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Eldaya RW, Fagan RJ, Dagher SA, Roy A, Dahiya S, Fuller GN, Wintermark M, Parsons MS, Huisman TAGM. Imaging Features of Primary Intracranial Sarcoma with DICER1 Mutation: A Multicenter Case Series. AJNR Am J Neuroradiol 2024; 45:626-631. [PMID: 38637027 DOI: 10.3174/ajnr.a8192] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/12/2024] [Indexed: 04/20/2024]
Abstract
Primary intracranial sarcoma, DICER1-mutant, is a rare, recently described entity in the fifth edition of the WHO Classification of CNS Tumors. Given the entity's rarity and recent description, imaging data on primary intracranial sarcoma, DICER1-mutant, remains scarce. In this multicenter case series, we present detailed multimodality imaging features of primary intracranial sarcoma, DICER1-mutant, with emphasis on the appearance of the entity on MR imaging. In total, 8 patients were included. In all 8 patients, the lesion demonstrated blood products on T1WI. In 7 patients, susceptibility-weighted imaging was obtained and demonstrated blood products. Primary intracranial sarcoma, DICER1-mutant, is a CNS neoplasm that primarily affects pediatric and young adult patients. In the present case series, we explore potential imaging findings that are helpful in suggesting this diagnosis. In younger patients, the presence of a cortical lesion with intralesional blood products on SWI and T1-weighted MR imaging, with or without extra-axial blood products, should prompt the inclusion of this entity in the differential diagnosis.
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Affiliation(s)
- Rami W Eldaya
- From the Department of Neuroradiology (R.W.E., S.A.D., G.N.F., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard J Fagan
- Department of Radiology (R.J.F., T.A.G.M.H.), Baylor College of Medicine, One Baylor Plaza - BCM360, Houston, Texas
| | - Samir A Dagher
- From the Department of Neuroradiology (R.W.E., S.A.D., G.N.F., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Angshumoy Roy
- Department of Pathology (A.R.), Texas Children's Hospital, Houston, Texas
- Department of Pathology & Immunology (A.R.), Baylor College of Medicine, Houston, Texas
| | - Sonika Dahiya
- Department of Pathology and Immunology (S.D.), WA University School of Medicine, St Louis, MO, USA
| | - Gregory N Fuller
- From the Department of Neuroradiology (R.W.E., S.A.D., G.N.F., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas
- Departments of Anatomical Pathology (G.N.F.), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Max Wintermark
- From the Department of Neuroradiology (R.W.E., S.A.D., G.N.F., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Matthew S Parsons
- Mallinckrodt Institute of Radiology (M.S.P.), Washington University School of Medicine, St Louis, Missouri
| | - Thierry A G M Huisman
- Department of Radiology (R.J.F., T.A.G.M.H.), Baylor College of Medicine, One Baylor Plaza - BCM360, Houston, Texas
- Edward B. Singleton Department of Radiology (T.A.G.M.H.), Texas Children's Hospital, Houston, Texas
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Eldaya RW, Calle S, Wong FC, Learned KO, Wintermark M. Parathyroid carcinoma: Imaging features of initial presentation and recurrence. A single center experience. Neuroradiol J 2024; 37:92-106. [PMID: 37934201 PMCID: PMC10863576 DOI: 10.1177/19714009231212361] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Parathyroid carcinoma is the rarest endocrine neoplasm with very few published data discussing its imaging appearance with primary focus on ultrasound imaging features. We present our 23 years institutional experience to highlight multimodality imaging evaluation at presentation and at recurrence. MATERIAL AND METHODS Retrospective chart review of clinical and pathological diagnosis of parathyroid carcinoma patients presented for initial or recurrent disease management at M.D. Anderson Cancer Center between the period of January 2000 and February 2023 was performed. Imaging findings on US, CT, PET/CT, and technetium-99m sestamibi were analyzed for initial and local recurrent parathyroid carcinoma. We further assess patterns of distant recurrence and its location. RESULTS Twenty three patients with pathological and clinical diagnosis of initial (14 patients) or recurrent parathyroid carcinoma (14 patients) were included in this study. US findings of parathyroid carcinoma were larger lesions, increased/irregular vascularity, and non-circumscribed margins. Multiphasic CT findings of parathyroid carcinoma included an arterially enhancing lesion that is hypoenhancing relative to the thyroid and demonstrates no washout on delayed imaging. Highly suggestive findings for recurrent disease included a hypoechoic solid nodule (91.67%) with increased vascularity on ultrasound (81.8%) with corresponding enhancement on CT. CONCLUSION Parathyroid carcinoma is a rare malignancy often diagnosed after surgical resection. We provided CT and US imaging features that are helpful in suggesting the diagnosis of parathyroid carcinoma and detection of early local recurrence.
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Affiliation(s)
- Rami W Eldaya
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Susana Calle
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Franklin C Wong
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Kim O Learned
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Max Wintermark
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
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Mallikarjun KS, Eldaya RW, Miller-Thomas MM, Orlowski HL, Parsons MS. Good Gone Bad: Complications of Chemotherapy, Immunotherapy, and Radiotherapy on the CNS. Curr Probl Diagn Radiol 2024; 53:133-149. [PMID: 37495483 DOI: 10.1067/j.cpradiol.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/24/2023] [Accepted: 06/28/2023] [Indexed: 07/28/2023]
Abstract
With recent advancements in cancer therapy, especially immunotherapy, overall survival of many cancers has increased and patient toxicity has been reduced. However, many complications of traditional cancer therapy are still prevalent and complications of novel therapies are just beginning to appear. The neuroradiologist may be the first to visualize signs of these complications on imaging. This article describes the notable imaging findings of several unique and characteristic complications of CNS cancer therapy, including toxicities of chemotherapies, immunotherapies, and radiotherapy. Complications of chemotherapeutic agents covered include methotrexate-induced and disseminated necrotizing leukoencephalopathy, and chemotherapy-induced myelopathy. Immunotherapy complications included are Tacrolimus-related Optic Neuropathy, Rituximab and Immune reconstitution inflammatory syndrome-associated Progressive Multifocal Leukoencephalopathy, Bevacizumab-associated late radiation-induced neurotoxicity, and Ipilimumab-induced hypophysitis. Lastly, radiation-induced neurotoxicities are covered, including myelopathy, radiation necrosis, cerebral atrophy, leukoencephalopathy, optic neuropathy, mineralizing microangiopathy, stroke-like migraine attacks, osteonecrosis, and vasculopathies. Neuroradiologists will increasingly encounter patients who have undergone treatment with more than 1 therapeutic modality, resulting in overlapping findings as well. Recognition of the common complications of these therapies on imaging is critical to minimizing the effects of these potential short- and long-term complications.
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Warren D, Koch C, Parsons MS, Pérez-Carrillo GJG, Eldaya RW. Head and Neck Sarcoma Tumor Board Survival Guide for Neuroradiologists: Imaging Findings, History, and Pathology. Curr Probl Diagn Radiol 2023; 52:275-288. [PMID: 36792427 DOI: 10.1067/j.cpradiol.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/12/2023] [Accepted: 01/18/2023] [Indexed: 01/28/2023]
Abstract
Sarcomas of the head and neck carry a poor prognosis as diagnosis is often delayed until a late stage of the disease. Accordingly, it is essential to be familiar with the clinical and imaging features of sarcomas to suggest an appropriate differential diagnosis for collaborating surgeons and pathologists. However, as there are only 1000-1500 cases in the United States annually, many radiologists lack experience with pertinent imaging findings of sarcoma and lack knowledge of both treatment and necessary follow-up. In this review, a brief discussion of WHO definitions and histopathology is included to decode information provided by pathologists. Finally, staging and treatments are illuminated to aid the radiologist with initial imaging staging and follow-up care. This review aims to increase the comprehensive knowledge of a neuroradiologist and further their value to the multidisciplinary tumor board.
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Affiliation(s)
- Daniel Warren
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO.
| | - Cameron Koch
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO
| | - Matthew S Parsons
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO
| | | | - Rami W Eldaya
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO
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Mallikarjun KS, Parsons MS, Nigogosyan Z, Goyal MS, Eldaya RW. Neuroimaging Findings in CHANTER Syndrome: A Case Series. AJNR Am J Neuroradiol 2022; 43:1136-1141. [PMID: 35798385 PMCID: PMC9575414 DOI: 10.3174/ajnr.a7569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/13/2022] [Indexed: 11/07/2022]
Abstract
Recently, a distinct clinicoradiologic entity involving cerebellar, hippocampal, and basal nuclei transient edema with restricted diffusion (CHANTER) on MR imaging was identified. Patients present in an unresponsive state following exposure to drugs of abuse. Very little information exists regarding this entity, particularly in the radiology literature. We identify and describe 3 patients at our institution with similar clinical and radiographic findings. Multifocal restricted diffusion in the brain is typically associated with poor outcomes. By contrast, CHANTER involves intraventricular obstructive hydrocephalus that, when treated, can lead to substantial recovery. This novel syndrome should be on the differential in patients who present in an unresponsive state after recent opioid use in the context of the above imaging findings. Additional diagnoses on the differential can include ischemic stroke, hypoxic-ischemic encephalopathy, "chasing the dragon," leukoencephalopathy, opioid-associated amnestic syndrome, and pediatric opioid-use-associated neurotoxicity with cerebellar edema.
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Affiliation(s)
- K S Mallikarjun
- From the Mallinckrodt Institute of Radiology (K.S.M., M.S.P., Z.N., M.S.G., R.W.E.), Washington University School of Medicine, Ringgold Standard Institution, St. Louis, Missouri
| | - M S Parsons
- From the Mallinckrodt Institute of Radiology (K.S.M., M.S.P., Z.N., M.S.G., R.W.E.), Washington University School of Medicine, Ringgold Standard Institution, St. Louis, Missouri
| | - Z Nigogosyan
- From the Mallinckrodt Institute of Radiology (K.S.M., M.S.P., Z.N., M.S.G., R.W.E.), Washington University School of Medicine, Ringgold Standard Institution, St. Louis, Missouri
| | - M S Goyal
- From the Mallinckrodt Institute of Radiology (K.S.M., M.S.P., Z.N., M.S.G., R.W.E.), Washington University School of Medicine, Ringgold Standard Institution, St. Louis, Missouri
| | - R W Eldaya
- From the Mallinckrodt Institute of Radiology (K.S.M., M.S.P., Z.N., M.S.G., R.W.E.), Washington University School of Medicine, Ringgold Standard Institution, St. Louis, Missouri.,MD Anderson Cancer Center, Diagnostic Imaging Division (R.W.E.), Houston, Texas
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Eldaya RW, Parsons MS, Rhea L, Sharma A. Delineation of Inner Annulus Fibrosus and Nucleus Pulposus on Routine T2-weighted MR Images. Spine (Phila Pa 1976) 2022; 47:954-960. [PMID: 35802121 DOI: 10.1097/brs.0000000000004241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 08/18/2021] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective study of 150 IVDs. OBJECTIVE Assessment of costume algorithm ability to delineate the IAF and NP on routine T2 images. SUMMARY OF BACKGROUND DATA Central hyperintense region on T2-weighted MR images of normal lumbar IVDs represents a combination of IAF and NP. Ability to identify NP as distinct from IAF can help improve our understanding of IVD morphology in-vivo. METHODS Sagittal T2-weighted TSE MR images of 150 lumbar IVDs from 25 patients were analyzed. MR images were processed using a custom algorithm that markedly increased the signal intensity of structures with inherent signal intensity within 2 defined intensity thresholds. Signal intensity and contrast-to- noise ratio between outer annulus fibrosus, IAF, and NP were assessed at baseline and after processing. To assess consistency of underlying T2 differences, similar analysis was done on 108 discs from 18 patients in whom additional sagittal T2-weighted STIR images were available. RESULTS Following image processing, apparent IAF and NP were rendered visible in 86% and 84.3% IVDs on T2-weighted TSE and STIR images respectively. While signal intensity of these 2 regions was inherently different (P< 0.001) before processing on TSE and STIR images, their visualization was facilitated by a significant increase (P<0.001) in contrast-to-noise ratio after processing. Nonvisualization of NP was associated with disc degeneration (P<0.001). CONCLUSION Inherent differences exist in signal intensities of normal NP and IAF on T2-weighted MR images. Accentuating these differences using image postprocessing techniques can render these 2 structures visible.
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Affiliation(s)
- Rami W Eldaya
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO.,Department of Radiology, Barnes- Jewish Hospital South, St. Louis MO.,Department of Radiology, St. Louis Children's Hospital, St. Louis MO
| | - Matthew S Parsons
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO.,Department of Radiology, Barnes- Jewish Hospital South, St. Louis MO.,Department of Radiology, St. Louis Children's Hospital, St. Louis MO
| | - Lee Rhea
- Department of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | - Aseem Sharma
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO.,Department of Radiology, Barnes- Jewish Hospital South, St. Louis MO.,Department of Radiology, St. Louis Children's Hospital, St. Louis MO
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Samara A, Gusman M, Aker L, Parsons MS, Mian AY, Eldaya RW. The Forgotten Phacomatoses: A Neuroimaging Review of Rare Neurocutaneous Disorders. Curr Probl Diagn Radiol 2021; 51:747-758. [PMID: 34607749 DOI: 10.1067/j.cpradiol.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/07/2021] [Accepted: 07/18/2021] [Indexed: 01/05/2023]
Abstract
Phakomatoses, or neurocutaneous syndromes, are a heterogeneous group of rare genetic disorders that predominantly affect structures arising from the embryonic ectoderm, namely the skin, eye globe, retina, tooth enamel, and central nervous system. Other organs are also involved in some syndromes, mainly cardiovascular, pulmonary, renal, and musculoskeletal systems. Currently, more than sixty distinct entities belonging to this category have been described in the literature. Common phakomatoses include conditions like Neurofibromatosis and Tuberous sclerosis. Several review papers have focused on various aspects of these common conditions, including clinical presentation, genetic and molecular basis, and neuroimaging features. In this review, we focus on rare neurocutaneous syndromes: Melanophakomatoses (Ie, Neurocutaneous Melanosis, and Incontinentia Pigmenti), Vascular Phakomatoses (Ie, Ataxia Telangiectasia and PHACE Syndrome), and other conditions such as Cowden Syndrome, Basal Nevus Syndrome, Schwannomatosis, Progressive Facial Hemiatrophy, Gomez-Lopez-Hernandez Syndrome, Wyburn-Mason Syndrome, CHILD Syndrome, and Proteus Syndrome. We also review the neuroradiologic manifestations of these conditions as a guide for neurologists and neuroradiologists in their daily practice.
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Affiliation(s)
- Amjad Samara
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO..
| | - Mariya Gusman
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Loai Aker
- Department of Radiology, Hamad General Hospital, Doha, Qatar
| | - Matthew S Parsons
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Ali Y Mian
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Rami W Eldaya
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
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Samara A, Herrmann S, Ditzler MG, Raj KM, Orlowski HLP, Eldaya RW. External Ear Diseases: A Comprehensive Review of the Pathologies With Neuroradiological Considerations. Curr Probl Diagn Radiol 2021; 51:250-261. [PMID: 33485754 DOI: 10.1067/j.cpradiol.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/13/2020] [Accepted: 12/31/2020] [Indexed: 11/22/2022]
Abstract
The peripheral auditory system is subdivided into 3 compartments: the external, middle, and inner ear. Historically, the middle and inner ear have garnered more attention in the imaging literature, due to their intricate anatomy and complexity of pathologies. The external ear, however, has attained less recognition given its relatively straightforward anatomy and convenience of direct visual examination. The continued advancement in computed tomography and magnetic resonance imaging has expanded the role of radiology in the evaluation of the external ear lesions. The purpose of this article is to offer a comprehensive review of external ear pathologies, including congenital, inflammatory, infectious, traumatic, neoplastic, and rare disease entities and their imaging findings.
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Affiliation(s)
- Amjad Samara
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Stephen Herrmann
- Department of Radiology, Houston Methodist Hospital, Houston, TX
| | | | - Karuna M Raj
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Hilary L P Orlowski
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Rami W Eldaya
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO.
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Eldaya RW, Deolankar R, Orlowski HLP, Miller-Thomas MM, Wippold FJ, Parsons MS. Neuroimaging of Adult Lacrimal Drainage System. Curr Probl Diagn Radiol 2020; 50:687-702. [PMID: 32980207 DOI: 10.1067/j.cpradiol.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/01/2020] [Accepted: 08/21/2020] [Indexed: 11/22/2022]
Abstract
The lacrimal drainage system (LDS) pathology is frequently encountered in the ophthalmology setting but is rarely discussed in the radiology literature. This is even truer for adult LDS lesions despite increase utilization of computed tomography and magnetic resonance in imaging for diagnosis of LDS pathology. The purpose of this image rich review is to highlight common adult LDS pathologies and introduce the radiologist to rare disease entities affecting this pathology rich anatomical region with emphasis on imaging findings, clinical presentation, and differential generation.
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Affiliation(s)
- Rami W Eldaya
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO.
| | - Rahul Deolankar
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Hilary L P Orlowski
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | | | - Franz J Wippold
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Matthew S Parsons
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
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Samara A, Eldaya RW. Ocular and brain imaging findings in Peters' anomaly: A case report and literature review. Radiol Case Rep 2020; 15:863-866. [PMID: 32382368 PMCID: PMC7200615 DOI: 10.1016/j.radcr.2020.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/08/2020] [Revised: 03/23/2020] [Accepted: 04/07/2020] [Indexed: 11/28/2022] Open
Abstract
Peters’ anomaly is a rare congenital eye condition characterized by anterior segment dysgenesis and commonly presents as unilateral or bilateral corneal opacity in the early neonatal period. Peters’ anomaly is often associated with congenital brain and skull abnormalities, which are frequently overlooked. In this paper, we present a case of a 5-day-old female neonate with Peters’ anomaly, and review the literature for similar reports that describe associated brain imaging findings. In our case, imaging studies show abnormalities involving the anterior segments of both globes with absent intracranial manifestations. Although Peters’ anomaly is a condition of interest for ophthalmologists, radiological studies should be performed, and neuroradiologists should be aware of the imaging findings associated with this rare entity.
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Affiliation(s)
- Amjad Samara
- Department of Psychiatry, Washington University School of Medicine, 4525 Scott Ave, St. Louis, MO 63110, United States
| | - Rami W Eldaya
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
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Samara A, Nepute J, Lu HC, Perrin RJ, Eldaya RW. Calvarial Langerhans cell histiocytosis in an Adult: Typical imaging findings in an atypical age group. Radiol Case Rep 2019; 14:1478-1482. [PMID: 31641396 PMCID: PMC6796621 DOI: 10.1016/j.radcr.2019.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/19/2019] [Accepted: 09/08/2019] [Indexed: 12/18/2022] Open
Abstract
Langerhans Cell Histiocytosis (LCH) is a rare disorder characterized by neoplastic proliferation of Langerhans-type dendritic cells. LCH is most frequently encountered in the pediatric populations, and involvement of the skeletal system is a common manifestation. Herein, we report a case of LCH presented as an isolated skull lesion in a 66-year-old patient. This presentation has never been reported in the literature at this advanced age and suggests that, despite being exceptionally rare, clinicians should consider LCH in the differential diagnosis of skull lesions in the elderly with classical radiological appearance.
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Affiliation(s)
- Amjad Samara
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jordan Nepute
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Hsiang-Chih Lu
- Division of Neuropathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Richard J Perrin
- Division of Neuropathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Rami W Eldaya
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
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Eldaya RW, Paulino AC, Blanco AI, Chiang S, South M, Lehane D, Teh BS. Preservation of adrenal function after successful stereotactic body radiation therapy of metastatic renal cell carcinoma involving the remaining contralateral adrenal gland. Pract Radiat Oncol 2011; 2:270-273. [PMID: 24674163 DOI: 10.1016/j.prro.2011.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 11/04/2011] [Accepted: 11/10/2011] [Indexed: 12/31/2022]
Affiliation(s)
- Rami W Eldaya
- University of Texas Medical Branch, Galveston, Texas
| | - Arnold C Paulino
- Department of Radiation Oncology, The Methodist Hospital/The Methodist Hospital Research Institute, Houston, Texas
| | - Angel I Blanco
- Department of Radiation Oncology, The Methodist Hospital/The Methodist Hospital Research Institute, Houston, Texas
| | - Stephen Chiang
- Department of Radiology (Nuclear Medicine), The Methodist Hospital/The Methodist Hospital Research Institute, Houston, Texas
| | - Michael South
- Department of Radiation Oncology, The Methodist Hospital/The Methodist Hospital Research Institute, Houston, Texas
| | - Daniel Lehane
- Department of Academic Medicine, The Methodist Hospital, Houston, Texas
| | - Bin S Teh
- Department of Radiation Oncology, The Methodist Hospital/The Methodist Hospital Research Institute, Houston, Texas.
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