Shu Chiang Hsieh

Malignant transformation of an ovarian mature cystic teratoma: Computed tomography findings

IntroductionThe malignant transformation of an ovarian mature cystic teratoma is rare. We presented such a case of a 46-year-old woman with characteristic computed tomography (CT) findings.Case report The patient had suffered from fullness and tenderness of the lower abdomen for one year. A high serum CA-125 level was noted. Computed tomography images showed a left adnexal mass with fat, calcification and soft tissue components, and areas of invasion through the teratoma wall.OutcomeThe histologic diagnosis was compatible with a squamous cell carcinoma arising from a mature cystic teratoma of the ovary.

Inflammatory pseudotumor of the spleen: CT and MRI findings.

We report the CT and MRI findings of an inflammatory pseudotumour of the spleen, which is an extremely rare benign inflammatory lesion. CT scans obtained 1 h after contrast administration and T2-weighted MRI images clearly demonstrated the central fibrosis and peripheral granuloma of this lesion.Inflammatory pseudotumors rarely occur in the spleen. We report such a case with characteristic computed tomography (CT) and magnetic resonance imaging (MRI) findings. A CT scan showed an isodense nodular mass with gradual mild enhancement on delayed-phase contrast-enhanced images. MRI showed a mass with isointense signal on T1-weighted images and hypointense signal on T2-weighted images. The tumor mass showed progressive inhomogeneous enhancement on gadolinium-enhanced images. The patient received splenectomy, and histologic diagnosis was compatible with inflammatory pseudotumor.

MRI of hemangiopericytoma in the sacrum

Osseous hemangiopericytoma is rare. We present a case of a 30-year-old woman with low-back pain with radiation to the left buttock for 1 month. Magnetic resonance imaging (MRI) showed a tumor mass with areas of serpentine signal void pattern in the sacrum suggestive of a vascular tumor. Neither calcifications nor layered blood serum were noted. Histological diagnosis was compatible with osseous hemangiopericytoma.

DIAGNOSIS OF INFLAMMATORY PSEUDOTUMOUR OF THE URINARY BLADDER AIDED BY DYNAMIC COMPUTED TOMOGRAPHY

A 36-year-old man suffered from intermittent gross haematuria for one week. Urine culture and cytology were negative. Intravenous urography showed an intravesical fi lling defect. Dynamic CT scan of pelvis showed a nodular mass arising from the right anterior wall of the urinary bladder. Unenhanced CT image shows a high-density clot within bladder (Fig.1A). Dynamic CT scan shows early and persistent enhancement of the outer part of the tumour (Fig.1B, C). At surgery, there was a large caulifl ower-like tumour in the right anterior wall of the bladder. Histological fi ndings revealed proliferation of spindle cells arranged in fascicles (Fig.1D). Marked myxomatous change and red cell extravasation were noted. Immunohistochemical study showed that the spindle cells were focally positive for cytokeratin and negative for smooth muscle actin. This was consistent with a diagnosis of infl ammatory pseudotumour of the bladder. No local recurrence was seen six months after surgery.

Malignant fibrous histiocytoma of the heart: a case report

Malignant fibrous histiocytoma (MFH) in the heart is rare.We present a case of a 38-year-old woman with histologically confirmed MFHs in the left atrium, liver and bone.The patient presented with shortness of breath and right shoulder pain. A plain radiograph showed an osteolytic lesion at the neck of the humerus on the right side. A computed tomography (CT) scan of the chest showed a lobulated tumour occupying the cardiac left atrium and a large heterogeneously enhancing mass in the liver and osteolytic metastasis in the thoracic spine.The patient underwent complete resection of the cardiac tumour, and histology showed a high-grade pleomorphic sarcoma – an MFH. Biopsy of the lesions on the right shoulder and in the liver also showed the same histologic diagnosis.