Gerald T. Kangelaris

Limited Utility of Routine Surveillance MRI Following Chemoradiation for Advanced-Stage Oropharynx Carcinoma

Objectives. To determine the utility of routine surveillance MRI in detecting locoregional recurrence following definitive chemoradiation in advanced-stage oropharynx carcinoma. Methods. We identified patients with Stage III-IV oropharynx carcinoma who were treated with chemoradiation between April 2000 and September 2004 and underwent longitudinal followup care at our institution. Patient charts were retrospectively reviewed for findings on MRI surveillance imaging, clinical signs and symptoms, and recurrence. Results. Forty patients received a total of 229 surveillance MRI scans with a minimum follow-up of three years (mean of 5.6 scans per patient). Six patients experienced false-positive surveillance studies that resulted in intervention. Four patients experienced recurrent disease, two of whom had new symptoms or exam findings that preceded radiographic identification of disease. Surveillance MRI scans identified recurrent disease in two asymptomatic patients who were salvaged, one of whom remains free of disease at follow-up. The overall sensitivity and specificity of the MRI surveillance program were 50 and 83 percent, respectively. The mean charge to each patient for the surveillance program was approximately

Role of Ultrasound in Thyroid Disorders

10,000 annually. Conclusion. In oropharyngeal cancer patients who have been treated with chemoradiation, an imaging surveillance program utilizing MRI produces limited opportunity for successful salvage.

Detection of Occult Melanoma by Preoperative Positron Emission Tomography–Computed Tomography and Intraoperative Ultrasonography

Thyroid ultrasonography has established itself as a popular and useful tool in the evaluation and management of thyroid disorders, both malignant and benign. Although its use has traditionally been the domain of radiologists, surgeons and endocrinologists are increasingly integrating this technology into their daily clinical and operative practice. This article provides an overview of the relevant uses and indications for ultrasound in various thyroid diseases, describes characteristic ultrasound findings in these diseases, and reviews the relevant literature and guidelines concerning its uses.

Comparison of L-strut preservation in endonasal and endoscopic septoplasty: a cadaveric study

Background: 18F-Fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) has become a common imaging modality for detecting metastatic melanoma. However, the identification of lesions intraoperatively can be difficult. Objective/Methods: We describe an innovative multimodality approach to tumor localization using preoperative PET-CT and intraoperative ultrasonography and describe cases in which this technique was used. Results: The use of these two modalities together enabled resection of multiple occult metastatic lesions in the patients presented. Conclusion: The use of this multimodality approach will be important in ensuring that all known metastatic disease sites are resected and represents an important concept in the setting of metastatic melanoma resection.

Pilomatricoma masquerading as metastatic squamous cell carcinoma

Preservation of an adequate cartilaginous L‐strut to prevent complications of septoplasty has been long recognized as critical. However, no previous study has examined the dimensions of the L‐strut that remain after septoplasty. We hypothesized that differences in exposure and visualization between endoscopic and endonasal techniques would result in differences in preserved L‐strut dimensions. We designed this study to determine L‐strut dimensions after performance of septoplasty with endonasal and endoscopic technique.

Prognostic Factors for Minimally Invasive Follicular Thyroid Carcinoma

We present a case of a 58-year-old woman with a posterior neck mass who underwent fine-needle aspiration of the lesion, with initial cytopathologic evaluation being consistent with metastatic squamous cell carcinoma. However, following excisional biopsy of the tumor, histopathologic evaluation revealed a pilomatricoma. Appreciation of the difficulty in cytologic classification of this benign tumor and its propensity for confusion with more aggressive tumors may help prevent unintended and unnecessary invasive procedures as a result of erroneous diagnoses.