Left cervical aortic arch with aneurysm and obstruction: three-dimensional computed tomographic angiography and magnetic resonance angiographic appearance

Cervical arch is a rare congenital anomaly presumed to result from persistence of the third aortic arch and regression of the normal fourth arch. Rather rare is cervical aortic arch associated with aneurysm and obstruction, with eight known cases reported. Definitive diagnosis with a noninvasive imaging modality is desirable and very important to prevent the need for disaster intervention. We present two cases of a pulsatile mass in the left supraclavicular region. Three-dimensional computed tomographic angiography and magnetic resonance angiography clearly showed a left-sided cervical aortic arch (Haughton type D) with arch aneurysm and coarctation (pseudocoarctation).

A multifunctional, provisional, implant-retained fixed partial denture

This article describes the modification of a procedure for fabricating a laboratory-processed, metal-reinforced, acrylic resin provisional restoration that becomes an implant-retained fixed partial denture. The modification involves the incorporation of patrix and matrix components into a cast metal framework. The prosthesis can be used as an alternative to a removable radiologic stent and surgical guide. It can function as a surgical guide during implant placement and help retract the buccal mucogingival flap during implant placement. The prosthesis also can be used as an aid in locating the implant during stage II surgery. Finally, the pontics can be converted into an implant-supported provisional restoration immediately after the implant prosthetic components are attached to the uncovered implants.

Breast cancer detection using magnetic resonance imaging in breasts injected with liquid silicone

Two patients who had received silicone injections in their breasts several years ago presented with breast complaints. Excluding cancer in these patients was very difficult. Mammograms were very difficult to interpret, as were the physical findings. Carcinoma was successfully detected by magnetic resonance imaging. When women who underwent the injudicious injection of silicone reach the cancer-prone age, the examining physicians should have a greater awareness of the detection and management of carcinoma coexistent with silicone mastopathy. We think that MRI is potentially valuable in the evaluation of the breast lesions; it plays an important role in the detection of breast cancer in breasts augmented with liquid silicone.

[Colpocephaly: report of a case]

A 43-year-old G12P4 mother delivered, at 35 weeks of gestation, a girl with a birth weight of 1980 g. Since her last pregnancy 20 years ago, she had had 8 subsequent abortions. Amniocentesis was done at the 18th week of gestation and revealed negative findings. Because of maternal age, the baby was delivered by cesarean section. The family history was not pertinent. After birth, the baby was noted to have a large head girth (34.5 cm) with widened anterior fontanel and mild frontal protrusion. The neurosonography showed symmetric dilatation of the frontal horns and temporal horns of the lateral ventricles, hyperechodensity in the periventricular wall, absence of corpus callosum and cavum septum pellucidum, and a large communicating pear-shaped ventricular cavity on the posterior coronal view. The brain CT scan demonstrated evidence of extreme dilatation of the occipital horns of the lateral ventricles and prominence of the subarachnoid spaces in the supra-Sylvian fissures. Based on these findings, the baby was diagnosed as a case of colpocephaly. Patients with colpocephaly usually have moderate to severe mental retardation, motor deficits, visual abnormalities and seizures. They need speech and physical therapies as early as possible. Therefore, if early diagnosis is confirmed by fetal sonography before the 5th month of gestation, this congenital brain malformation can be prevented by therapeutic abortion.