Mehmet Beyazal

Primary Alveolar Soft Part Sarcoma of the Scapula

Alveolar soft part sarcoma (ASPS) is an unusual soft tissue malignity, occurring in less than 1% of sarcomas and typically found in the head and neck tissues in children or, in adults, in the deep soft tissues of the lower extremities. In this report, we present a 33-year-old male with primary ASPS in the right scapular bone and discuss the radiologic features of this tumor in the context of the current literature.

Herlyn-Werner-Wunderlich Syndrome: Merits of Sonographic and Magnetic Resonance Imaging for Accurate Diagnosis and Patient Management in 13 Cases

STUDY OBJECTIVE To review the main sonographic and magnetic resonance imaging manifestations of Herlyn-Werner-Wunderlich syndrome, characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis, and to discuss the value of techniques for its diagnosis and treatment. PARTICIPANTS Thirteen patients with Herlyn-Werner-Wunderlich syndrome referred to our department with acute abdomen were identified for the period from 2009-2012. DESIGN Retrospective chart review. SETTING Two tertiary academic centers. INTERVENTIONS None. MAIN OUTCOME MEASURES The evaluation of the clinical features, ultrasonography and magnetic resonance imaging findings, and the treatment protocols. RESULTS Ultrasonographic evaluation of didelphic or double uterus in 10 and bicornuate-bicollis uterus in 3 patients with hematocolpos or hematometrocolpos associated with agenesis of the ipsilateral kidney revealed the diagnosis. In 10 patients, magnetic resonance imaging provided extra information. In 1 patient, a 25-week pregnancy was additionally detected and follow-up was suggested. Seven patients underwent surgical excision of the septum and drainage of the obstructed vagina. Total hysterectomy and hemicolpectomy were performed in 1 patient with 2 children suffering from severe chronic pelvic pain due to pelvic inflammatory disease. CONCLUSIONS Despite its rarity, accurate diagnosis and morphologic description of Herlyn-Werner-Wunderlich syndrome with radiologic modalities are of importance in relieving the clinical complaints by enabling the suitable surgical treatment to be identified.

Submandibular Lateral Ectopic Thyroid Tissue: Ultrasonography, Computed Tomography, and Scintigraphic Findings

Ectopic thyroid can be encountered anywhere between the base of tongue and pretracheal region. The most common form is euthyroid neck mass. Herein, we aimed to present the findings of a female case with ectopic thyroid tissue localized in the left submandibular region. A 44-year-old female patient, who underwent bilateral subtotal thyroidectomy four years ago with the diagnosis of multinodular goiter, was admitted to our hospital due to a mass localized in the left submandibular area that gradually increased in the last six months. Neck ultrasonography, contrast-enhanced computed tomography, and scintigraphic examination were performed on the patient. On thyroid scintigraphy with Tc-99m pertechnetate, thyroid tissue activity uptake showing massive radioactivity was observed in the normal localization of the thyroid gland and in the submandibular localization. The focus in the submandibular region was excised. Pathological examination of the specimen showed normal thyroid follicle cells with no signs of malignancy. The submandibular mass is a rarely encountered lateral ectopic thyroid tissue. Accordingly, ectopic thyroid tissue should also be considered in the differential diagnosis of masses in the submandibular region.

Computed tomography and magnetic resonance imaging findings of primary bladder angiosarcoma: a case report.

Primary bladder angiosarcomas are extremely rare but aggressive tumors. Due to the small number of cases (less than 30) reported to date, the information about natural tumor progression, optimal treatment procedure and prognosis are limited. Also, published reports of bladder angiosarcoma have not adequately featured imaging findings. Herein we report computed tomography and magnetic resonance imaging findings of a 20-year-old male with primary angiosarcoma of the bladder.

A Case Report of Acute Acalculous Cholecystitis and Acute Hemorrhagic Cystitis due to Salmonella Typhi

Acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi are a rare condition. A 24-year-old female patient was admitted to our clinic with abdominal pain, nausea, fever, headache, urinary burning, and bloody urine. Based on clinical, laboratory, and radiological evaluations, the patient was diagnosed with acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi. The patient was treated with intravenous ceftriaxone for two weeks. After the treatment, the patients clinical and laboratory findings improved. Acute acalculous cholecystitis due to Salmonella Typhi concomitant with acute hemorrhagic cystitis is very rare and might be difficult to diagnose. Infectious agents such as Salmonella Typhi should be considered when acute acalculous cholecystitis and acute hemorrhagic cystitis are detected in adult patients with no underlying diseases.

Solitary paraganglioma of the hypoglossal nerve: A case report with magnetic resonance imaging findings

Patient: Female, 58 Final Diagnosis: Solitary paraganglioma of the hypoglossal nerve Symptoms: Neck pain Medication: — Clinical Procedure: Surgical resection Specialty: Otolaryngology Objective: Rare disease Background: Paragangliomas are rare neuroendocrine tumors originating in the neural crest. Only a few cases of hypoglossal paraganglioma have been reported in the published literature. The localization of hypoglossal paragangliomas close to the carotid artery precludes determination of tumor origin preoperatively. Case Report: A 58-year-old female patient was admitted due to neck pain. During physical examination, a significant mass could not be palpated in the upper left part of the neck, despite sensitivity during palpation. Atrophy and left deviation of the left half of the tongue was observed. MRI of the neck revealed a lesion located superior to the carotid bifurcation between the left internal carotid artery and external carotid artery. There was atrophy in the left half of the tongue. The neck mass displaced the left internal carotid artery anteriorly and medially. The operation was performed with left lateral cervical access. This lesion, which derived from the hypoglossal nerve, was excised. Following histopathological evaluation, the lesion was diagnosed as paraganglioma. Conclusions: Hypoglossal paraganglioma is quite rare and there are no established criteria for preoperative diagnosis. Hypoglossal paraganglioma must be considered to determine treatment options if a lateral neck mass and ipsilateral tongue atrophy are present at the level of the 12th cranial nerve tract.

Metastasis of Testicular Yolk Sac Tumor to Cauda Equina

Primary germ cell tumors may spread to the lung, liver, brain, and bone hematogenously. However, spinal metastasis is extremely rare. A case with yolk sac tumor (YST) and cauda equina metastasis was presented in a 2-year-old boy. Two months prior to admisssion, he underwent left radical orchiectomy for testicular YST. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed spinal and cauda equina involvement. This is the first report of metastasis of testicular YST to cauda equina in a child.

Tinnituslu hastalarda 3 boyutlu T2 ağırlıklı manyetik rezonans görüntüleme ile serebelopontin kenardaki vasküler değişikliklerin değerlendirilmesi

Amac: Serebelopontin kose (CPA) vaskuler ve noral yapilarin anatomik etkilesimleri isitsel-vestibuler semptomlarla iliskili oldugu dusunulmektedir. Manyetik rezonans goruntuleme, bu karmasik anatomik bolgeyi degerlendirmek icin tercih edilen bir yontem haline gelmistir. Bu calismada, 3-boyutlu T2 agirlikli MRI ile tinnitus hastalarda CPA’da vaskuler loop varyasyon iliskisini degerlendirmeyi amacladik. Materyal ve Metod: Bu calismada, aciklanamayan tinnitus olan ve kulak MRI tetkiki yapilan 149 hasta yer almistir. Hastalarin tinnitusu olan kulaklari calisma grubunu, sikâyet olmayan kulaklari kontrol grubunu olusturdu. Cift tarafli tinnitusu olanlar iki taraf ayri ayri olarak calisma grubuna dâhil edildi. MRI taramalari, CPA’da vaskuler varyasyon varligina iliskin olarak degerlendirildi. Bulgular: Sol tarafta tinnitusu olan hastalarda Tip 1 (CPA duzeyinde) (p=0.001) ve Tip A (vestibuloklear ve/veya fasial ile temas) (p<0.001) vaskuler loop anlamli derecede yuksekti. Sag tarafta tinnitusu olan hastalarda, sadece Tip A vaskuler loop anlamli derecede yuksekti (p=0.005). Cift tarafli tinnituslu hastalar icin sag kulakta Tip 2 vaskuler loop (internal akustik kanali proksimal [IAC]) (p=0.035) ve sol kulakta Tip A vaskuler loop(p<0.001) anlamli derecede yuksekti. Sonuc: Bu calisma, 3D T2W MRI kullanilarak tinnitus etyolojisini arastiran en buyuk olcekli calismadir. CPA ve IAC’deki vaskuler loop sikligi oncelikle tani teknigine baglidir. Bulgularimiz, vaskuler varyasyon nedenlerin yuksek cozunurluklu goruntuleme yontemleri kullanilarak daha net gosterilebilecegini gosterdi. Buna gore, tedavi secenekleri etiyolojinin aydinlatilmasiyla daha iyi belirlenebilir.

Evaluation of vascular variations at cerebellopontine angle by 3D T2WI magnetic-resonance imaging in patients with vertigo

BACKGROUND Vascular loops of the anterior-inferior cerebellar artery (AICA) at the cerebellopontine angle (CPA) are considered related to auditory-vestibular symptoms. Clinical association of these anatomical aberrations, which can be grouped together as vascular compression syndromes, is controversial. Magnetic resonance imaging (MRI) is widely used to visualize this anatomical region, given its high sensitivity and specificity. OBJECTIVE To elucidate the clinical relationship of vertigo symptoms with vascular loop compression syndrome by evaluating the neurovascular contacts of the vestibulocochlear nerve (VCN) and AICA at the CPA and internal auditory canal via high-resolution MRI. METHODS The study included 417 patients (178 with vertigo and 239 without vertigo) undergoing MRI for various clinical causes. MRI scans were assessed to study the presence of vascular abnormalities at the CPA. RESULTS According to our findings, type 1 vascular variation was observed most frequently in both sides. MRI findings were similar for the patients with and without vertigo. CONCLUSIONS Identifying the prevalence of the vascular loops of the AICA primarily depends on diagnostic technique, and our results identified a slightly higher prevalence than those of previous studies, which might be partly related to the high-sensitivity of 3-dimensional T2-weighted MRI.

The Efficacy of Magnetic Resonance Imaging for the Diagnosis of Superior Semicircular Canal Dehiscence

OBJECTIVE This study aimed to evaluate the efficacy of magnetic resonance imaging (MRI) for diagnosing superior semicircular canal dehiscence (SSCD). MATERIALS AND METHODS The radiological records of patients who were admitted to our clinic with complaints of otologic and neuro-otologic symptoms between October 2014 and December 2015 were retrospectively reviewed. Among these patients, those who underwent both computed tomography and MRI and were reported to have SSCD in the temporal bone on at least one side were included in the study group. MRI records of patients with a confirmed diagnosis were then assessed for the presence of SSCD. RESULTS The left and right semicircular canals of 52 patients were evaluated in this study. The sensitivity and specificity of MRI in the diagnosis of SSCD was 89.06% and 90%, respectively. The positive and negative predictive values were 93.44% and 83.72%, respectively. CONCLUSION The use of multiplanar reformats and angulation techniques during MRI assessment of patients with neuro-otologic symptoms can improve the diagnostic process for patients with SSCD. This may allow early diagnosis of the disease by using just one imaging method, which would also reduce the costs per patient during the diagnosis period.