Monday, September 21, 2009

Osteosarcoma of Sternum

CT scan and MRI of 40 year old male came with swelling and pain in the sternum since 3 months shows large destructive soft tissue mass lesion in the body of sternum having osteoid matrix. The lesion is extending anteriorly in the subcutanesous region, psoteriorly in to mediastinum abutting large vessels. We can better appreciate the sternal destruction in SSD image. MR T2 weighted image shows hyperintense signal throughout the lesion. Histopathology proved to be osteosarcoma.

The primary sternal tumors are quite rare. The most commonly occurring malignant tumor in sternum is chondrosarcoma and occurrence of osteosarcoma in sternum is extremely rare. The most common tumors of sternum are the metastases of lung, renal or thyroidal malignancies. CT may show lytic, mixed or sclerotic pattern and it is observed as an expansile mass lesion with irregular borders, and the lesion invades bone marrow by destroying the cortex. MRI clearly demonstrates the extent of the lesion and characterization of the lesion.

Wednesday, September 9, 2009

Occular Metallic Foreign body

17 year old male CT coronal, axial and coronal bone window showing metallinc foreign body in the right globe adherent to lateral wall.
Metallic foreign body in another patient in right orbit on radiograph (arrow). CT scan axial section of the same patient showing foreign body just posterior to the limbus which is extra occular.

Intraocular foreign bodies (IOFBs) are rather variable in presentation, outcome, and prognosis. With increased awareness and advanced surgical techniques, the outcome and the prognosis for these potentially devastating injuries have substantially improved.

CT scans are the imaging study of choice for IOFB localization. A helical CT scan is the most efficient method to establish a diagnosis. Helical CT scans have a very high identification rate. With conventional CT scans, cuts of 0.5 mm are advised. With the advent of MDCT the role of radiologist has become easier in identification and diagnosis of occular foreign body. Plain x-ray is useful if a metallic IOFB is present and a CT scan is unavailable. MRI is generally not recommended for metallic IOFBs. Ultrasound is a useful tool in localizing IOFBs, and its careful use is possible even if the globe is still open; alternatively, intraoperative use after wound closure can be attempted. The ultrasound biomicroscope may help with IOFBs in the anterior segment.

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