Unknown Cases from the Participants Case 1: 1
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
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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
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 1 2 3 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
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
CASE # 4 F 52. RIGHT SUPRACLAVICULAR FOSSA MASS. MH: NO RELEVANT. 8
DIFF DX? SARCOMA MALIGNANT NERVE SHEATH TUMOR. 56 YEARS OLD FEMALE. CASE #4. COMPANION CASE MH: HBP, LYMPHOMA (2006). END TREATMENT IN 2008. 2014 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
MRI # 1 CT # 1 MRI # 2 10
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
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
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
10/23/2016 11/15/2016 Case 11: DDx? Case 11: Vestibular schwannoma with acute hemorrhage Answer on next slide 10/23/2016 11/15/2016 Case 12: Vestibular schwannoma with acute hemorrhage 14
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
Case 4 Case 4 Answer on next slide Left petrous apex plasmacytoma Next case 16
Case 5 Answer on next slide Case 5 Case 6 Lyme dz Cn 5 and oculomotor Initial 8 8 2016 17
Initial 8 8 2016, no PNT 10 28 2017, resection cavity 10 28 2017, 10 28 2017, Case 6 Answer on next slide Case 6 Perineural spread to trigeminal from GBM 18
Case 15: 19
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Case 15: DDx? Case 15: Answer on next slide Case 15: Neurofibroma Case 16: Carotid Space Lesion 22
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