Unknown Cases from the Participants
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1 Unknown Cases from the Participants Case 1: 1
2 Case 1: Case 1: DDX? Answer on next slide Case 1: MS V5 Neuropathy Case 2: Case 2: 76 year old woman Ultrasound for multinodular goiter finds suspicious nodule located in level II A right nodes place 2
3 3
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5 Case 2: DDx? Case 2: 76 year old woman Ultrasound for multinodular goiter finds suspicious nodule located in level II A right nodes place FNA of the thyroid nodule benign FNA of level II nodule BMT CT and MR multiple nodules, right parapharyngeal and level II/III Case 2: Answer on next slide Case 2: Multiple benign mixed tumors? Case 3: FERNANDO MARTÍN FERRARO 5
6 CASE #1 1.F 71. Subclavian steal Sme?. Upper limbs ABP asimmetry. 2.F 72. Convulsive status. 3.F 45. Persistent fever. 3 DIFFERENT PATIENTS 3 DIFFERENT PATHOLOGIES SIMILIAR SINONASAL FINDINGS 1.F 71. Subclavian steal Sme?. Upper limbs ABP asimmetry. 2.F 72. Convulsive status. 3.F 45. Persistent fever. DON T FORGET CHROME INTOXICATION! CASE #2 COCAINE NASAL MUCOCUTANEUS LESHMANIASIS WEGENER M 26. PERSISTENT HEADACHE. AVM? 6
7 DIFF DX RHABDO ADENOID CYSTIC CA LYMPHOMA SCCA NSP SCCA CASE #3 M 75. DIPLOPIA AND TRISMUS. PREVIOUS HISTORY OF PATHOLOGY IN THE PINNA (5 YEARS AGO) 7
8 CASE # 4 F 52. RIGHT SUPRACLAVICULAR FOSSA MASS. MH: NO RELEVANT. 8
9 DIFF DX? SARCOMA MALIGNANT NERVE SHEATH TUMOR. 56 YEARS OLD FEMALE. CASE #4. COMPANION CASE MH: HBP, LYMPHOMA (2006). END TREATMENT IN FUNCTIONAL IMPOTENCE (RIGHT SUPERIOR EXTREMITY). MRI # 1 INTERPRETED AS RELAPSING 48 HS BEFORE ENTERING THE HOSPITAL INTENSE HEADACHE + LEFT FACIAL PALSY CT # 1 MRI # 2 9
10 MRI # 1 CT # 1 MRI # 2 10
11 OUR CASE LYMPHOMA DIFFERENTIAL DIAGNOSIS PATCHY AND DIFFUSE REPLACEMENT OF HUMERUS BONE MARROW. ISOINTENSE SOFT TISSUE THAT PRESENTS ENHACEMENT POSTCONTRAST. LOCALLY SPREADING WITH COMPROMISE OF NEURO- VASCULAR STRUCTURES OF THE SKULL BASE. LYMPHOMA. SARCOID. IDIOPATIC INFLAMATORY PSEUDOTUMOR. METS. TB. MEDICAL HISTORY. ++ RESTRICTED DIFFUSION. PAQUIMENINX INVOLVEMENT. DESMOID TUMOR / DESMOPLASTIC FIBROMA BENIGN AND UNCOMMON SOFT TISSUE TUMOR WITH MEDIUM MALIGNANCY POTENCIAL. LOCALLY AGRESSIVE. ASSOCIATION WITH TRAUMA AND SYNDROMES SUCH AS GARDNER S. VARIABLE PRESENTATION ON IMAGES. IgG4? 11
12 CASE # 5 F 47. LEFT SUPRACLAVICULAR FOSSA MASS. MH: NO RELEVANT. LEVATOR CLAVICLE MUSCLE ANATOMIC VARIANTE (2-3% OF THE POPULATION). PROXIMAL INSERTION: TRANSVERSE PROCESSES OF THE UPPER CERVICAL VERTEBRAE. LEVATOR CLAVICLE MUSCLE DISTAL INSERTION: LATERAL/MIDDLE PORTON OF THE CLAVICLE. PALPABLE LUMP. 12
13 CASE #1. SINONASAL INVOLVEMENT DIFFERENT PATHOLOGIES WITH SIMILAR SINONASAL INVOLVEMENT. CASE#2. NSP MASS RF LYMPH NODES. PERIVASCULAR/PERINEURAL SPREAD. CASE #3. MELANOMA PAROTID GLAND: NODAL STATION. CONNECTION VII-V: AURICULOTEMPORAL NERVE CASE #4. DESMOID TUMOR. SOFT TISSUE LESION LOCALLY AGRESSIVE. RETROPERITONEUM, MESENTERIUM, ABDOMINAL WALL, SUPRACLAVICULAR FOSSA, SKULL BASE IgG4?. CASE #5. LEVATOR CLAVICLE MUSCLE. COMPARISON WITH THE OTHER SIDE. COMPARISON WITH OTHER STRUCTURES. EVALUATE SURROUNDING FAT. Case 11: 57 y/o male with PMH of AIDS and platelet count of 16k with acute onset left hearing loss MRI IAC performed 11/15/2016 MRI IAC performed 10/23/2016 (performed 23 days prior) 13
14 10/23/ /15/2016 Case 11: DDx? Case 11: Vestibular schwannoma with acute hemorrhage Answer on next slide 10/23/ /15/2016 Case 12: Vestibular schwannoma with acute hemorrhage 14
15 Case 3 66 y.o male left submandibular mass Case 3 Case 3 66 y.o male left submandibular mass Answer on next slide 66 y.o male left submandibular mass IgG4 disease Case 4 15
16 Case 4 Case 4 Answer on next slide Left petrous apex plasmacytoma Next case 16
17 Case 5 Answer on next slide Case 5 Case 6 Lyme dz Cn 5 and oculomotor Initial
18 Initial , no PNT , resection cavity , , Case 6 Answer on next slide Case 6 Perineural spread to trigeminal from GBM 18
19 Case 15: 19
20 20
21 21
22 Case 15: DDx? Case 15: Answer on next slide Case 15: Neurofibroma Case 16: Carotid Space Lesion 22
23 Schwannoma? Low ADC Values? 3T: ADC 0.66 X 10-3 mm 2 /s Renal Cell Carcinoma Met Case 16: Unknown Cases from the Participants 23
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