Hungarian Radiology

[Radioguided localization of the non-palpable breast lesions and sentinel lymph nodes]

MONOKI Erzsébet1, VARGA Erika1, SZABÓ Tünde1, TARJÁN Tibor2, PETRI István3, ZS. TÓTH Endre4, BAGDI Enikő5, KRENÁCS László5

OCTOBER 20, 2007

Hungarian Radiology - 2007;81(05-06)

[INTRODUCTION - As the result of mammographic screening of breast cancer, the incidence of surgically removable, non-palpable breast lesions is increasing. The study is aimed to demonstrate the use of radioisotope and gamma-probe for identifying the sentinel lymph node and the intraoperative radioguided localization of occult breast lesions. PATIENTS AND METHODS - 26 patients with nonpalpable breast lesions underwent radioisotope guided sentinel lymh node localization for staging purposes. In eight patients non-palpable breast lesions were localized with use of radioisotope method intraoperatively. RESULTS - All breast lesions were successfully localized pre- and intraoperatively. The combined radioisotope and blue-dye staining method increased the sensitivity of the procedure for identifying sentinel lypmh node. In case of 14 patients with negative sentinel node, the surgical dissection of axillary lymph nodes was avoided. CONCLUSION - Radioguided localization is a simple, quick and accurate technique for localization of nonpalpable breast lesions and sentinel lymph node, which is utilized for the up-to-date and correct oncological management of the breast cancer patients.]

AFFILIATIONS

  1. Dr. Bugyi István Kórház, Röntgenosztály
  2. Dr. Bugyi István Kórház, Izotópdiagnosztika
  3. Dr. Bugyi István Kórház, Általános Sebészet
  4. Szegedi Tudományegyetem, Általános Orvostudományi Kar, Patológiai Intézet, CIT
  5. Daganatpatológiai és Molekuláris Diagnosztikai Laboratórium, Bay Zoltán Alkalmazott Kutatási Közalapítvány, Biotechnológiai Intézet

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NAGY Gábor, VRECZENÁR László

[INTRODUCTION - The campomelic dysplasia is a disorder characterized by short and bowed lower limbs resulting in dwarfism. CASE REPORT - In the case of a 21-year-old primipara woman the second screening ultrasonography raised the suspicion of short and bowed lower limbs of the fetus, at the 19th week of the pregnancy. Repeated examinations proved the presence of short and bowed femurs and tibias and abnormal echogenecity of the bones. The upper limbs were almost normal in length. During the 19th week of pregnancy, after a genetic analysis in agreement of the parents the pregnancy was interrupted without any complication. Photography and Xray of the fetus confirmed the diagnosis. CONCLUSION - Fetal ultrasonography should include exact size measurement and observation of the shape of the long bones, making possible the early detection of limb anomalies. The anomaly being proven by positive genetic analysis the pregnancy can be interrupted at the parents' request.]

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[Jugulotympanic glomus tumor - 7-year follow up of a rare disease]

SEBŐ Nóra, LÁZÁR István, SZÍGYÁRTÓ Mária, SÍPOS Gyula

[INTRODUCTION - The jugulotympanic glomus tumor is rare pathology with slow progression and its treatment is difficult. We present the imaging and clinical findings of a case obtained during 7 year follow up period. CASE REPORT - A 77-year-old female patient was admitted in 2000 with slowly progressing swelling of the neck. A palpable soft, non-painful resistance was noted at the main neck vessel region. Angiography revealed a jugulo-tympanic glomus tumor and embolization of the feeders from the external carotid artery was also performed. The size of the tumor is decreased but a clinically silent floating thrombus appeared in the internal jugular vein. It was treated with LMWH. Three years later external carotid artery transsection and denudation was performed. Slow progression of the tumor toward the subclavian vein was detected without intracranial invasion, in 2004. Repeated angiography was performed in 2005, but embolization was not possible due to technical reasons. Irradiation was considered to diminsh clinical symptoms, however due to the old age of the patients and the risk of bleeding, the treatment was not performed. Symptomatic therapy has been applied. CONCLUSION - Jugulo-tympanic glomus tumor is one of the non-chromaffin paragangliomas. The clinical symptomps are dominated by the paresis of IX.-X.-XI. nerves. Semimalignant disease and metastases are rare. The course is mostly influenced by compression syndromes and intracranial spread. The therapy is mostly microsurgical but preoperative embolization is frequently done to decrease blood loss. Surgical therapy is recommended with prior embolization of the feeders in order to decrease the blood supply of the mass. If surgery cannot be carried out irradiation therapy is needed. Unfortunately, all of these procedures are seldom curatives because of natural course of the disorder and the high frequency of recurrencies.]

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