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Fujii S, Inoue C, Yunaga H, Gonda T, Makishima J, Ochiai R, Yamaji D, Ozaki K. MR imaging findings of primary ovarian carcinoid: A novel finding of T1 hyperintense solid tissue. Radiol Case Rep 2024; 19:2816-2819. [PMID: 38689806 PMCID: PMC11059293 DOI: 10.1016/j.radcr.2024.03.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 05/02/2024] Open
Abstract
Ovarian carcinoid is a rare well-differentiated neuroendocrine tumor resembling those arising in the gastrointestinal tract. We present a case of ovarian carcinoid with magnetic resonance imaging (MRI) findings. A 50-year-old woman with genital bleeding and severe constipation was referred to our hospital. On MR imaging, a left ovarian tumor showed iso to high signal intensity on T1-weighted images (T1WI), relatively low signal intensity on T2WI, and slightly high signal intensity on diffusion-weighted images. Additionally, the tumor demonstrated early and delayed strong contrast enhancement on dynamic contrast-enhanced images. The tumor was pathologically diagnosed with ovarian strumal carcinoid. High signal intensity on T1WI should be recognized as the MRI findings in ovarian carcinoids.
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Affiliation(s)
- Shinya Fujii
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Chie Inoue
- Department of Radiology, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Hiroto Yunaga
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Takuro Gonda
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Jun Makishima
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Ryoya Ochiai
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Daisuke Yamaji
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kanae Ozaki
- Department of Pathology, Faculty of Medicine, Tottori University, Yonago, Japan
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Shi L, Sun L. Colorectal adenocarcinoma with hepatic neuroendocrine carcinoma: A case report. Medicine (Baltimore) 2023; 102:e35428. [PMID: 37933070 PMCID: PMC10627708 DOI: 10.1097/md.0000000000035428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/14/2023] [Indexed: 11/08/2023] Open
Abstract
RATIONALE Primary hepatic neuroendocrine tumors are rarely reported and extremely blurry to diagnose, especially in the case of a confirmed diagnosis of colon cancer and a family history. Here we report such a case followed by our experiences and lessons. PATIENT CONCERNS A 62-year-old male with a family history of colon cancer has been recently admitted to our hospital, exhibiting multiple hepatic lesions when diagnosed as colon cancer, and all assistant examinations indicated the hepatic metastases. DIAGNOSES Liver puncture biopsy and immunohistochemistry confirmed hepatic neuroendocrine carcinoma, which was tended to primary hepatic tumor combining medical history. INTERVENTIONS AND OUTCOMES The patient refused the further treatment and dead of liver failure. LESSONS Hepatic neuroendocrine tumors exhibited no specific symptoms, signs or imaging manifestations, mainly relying on immunohistochemistry for diagnosis, which makes it difficult to be distinguished from other liver masses and metastatic tumors, especially interfered by a confirmed diagnosis of colon cancer and a family history. In this regard, more rigorousness is required in the diagnosis and treatment of liver tumors.
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Affiliation(s)
- Lingzi Shi
- Department of Gastrointestinal Surgery, Xi’an Jiaotong University School of Medicine Affiliated Honghui Hospital, Xi’an, China
| | - Li Sun
- Department of Gastrointestinal Surgery, Xi’an Jiaotong University School of Medicine Affiliated Honghui Hospital, Xi’an, China
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Le Chapelain O, Ho-Tin-Noé B. Intratumoral Platelets: Harmful or Incidental Bystanders of the Tumor Microenvironment? Cancers (Basel) 2022; 14:cancers14092192. [PMID: 35565321 PMCID: PMC9105443 DOI: 10.3390/cancers14092192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The tumor microenvironment (TME) is the complex and heterogenous ecosystem of solid tumors known to influence their growth and their progression. Besides tumor cells, the TME comprises a variety of host-derived cell types, ranging from endothelial cells to fibroblasts and immune cells. Clinical and experimental data are converging to indicate that platelets, originally known for their fundamental hemostatic function, also participate in tumor development and shaping of the TME. Considering the abundance of antiplatelet drugs, understanding if and how platelets contribute to the TME may lead to new therapeutic tools for improved cancer prevention and treatments. Abstract The tumor microenvironment (TME) has gained considerable interest because of its decisive impact on cancer progression, response to treatment, and disease recurrence. The TME can favor the proliferation, dissemination, and immune evasion of cancer cells. Likewise, there is accumulating evidence that intratumoral platelets could favor the development and aggressiveness of solid tumors, notably by influencing tumor cell phenotype and shaping the vascular and immune TME components. Yet, in contrast to other tumor-associated cell types like macrophages and fibroblasts, platelets are still often overlooked as components of the TME. This might be due, in part, to a deficit in investigating and reporting the presence of platelets in the TME and its relationships with cancer characteristics. This review summarizes available evidence from clinical and animal studies supporting the notion that tumor-associated platelets are not incidental bystanders but instead integral and active components of the TME. A particular emphasis is given to the description of intratumoral platelets, as well as to the functional consequences and possible mechanisms of intratumoral platelet accumulation.
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Song S, Koh Y. Primary Hepatic Neuroendocrine Tumor Arising at a Young Age: Rare Case Report and Literature Review. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2022; 79:35-40. [PMID: 35086971 DOI: 10.4166/kjg.2021.139] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023]
Abstract
Neuroendocrine tumors (NETs) are low-grade malignancies arising from neuroendocrine cells. Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare and difficult to differentiate from other liver tumors, such as hepatocellular carcinoma (HCC) or cholangiocarcinoma. A 22-year-old male presented with intermittent abdominal pain. A preoperative imaging study revealed a 5.1cm-sized heterogeneously enhancing mass in S6 of the liver, suggesting HCC. Laparoscopic right hepatectomy was performed, and a well-demarcated brown solid mass was found. The pathology report revealed a neuroendocrine tumor of the liver. 18F-fluorodeoxyglucose-positron emission tomography/computed tomography was performed postoperatively to exclude extrahepatic lesions, and no lesions were found. This is a rare case of PHNET that developed at a young age and was misdiagnosed as HCC preoperatively. This suggests that PHNET should be considered one of the differential diagnoses when a non-specific enhanced hepatic tumor is found, even when the patient is young.
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Affiliation(s)
- Sanghwa Song
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Yangseok Koh
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
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Rao YY, Zhang HJ, Wang XJ, Li MF. Primary hepatic neuroendocrine tumor — 18F-fluorodeoxyglucose positron emission tomography/computed tomography findings: A case report. World J Clin Cases 2021; 9:6450-6456. [PMID: 34435011 PMCID: PMC8362580 DOI: 10.12998/wjcc.v9.i22.6450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/11/2021] [Accepted: 06/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary hepatic neuroendocrine tumors (PHNETs) are rare hepatic tumors. Their diagnosis, which is based on radiological findings, is difficult.
CASE SUMMARY We present a case of PHNET in a 79-year-old man with no clinical symptoms. Computed tomography (CT) and 2-Deoxy-2-[fluorine-18] fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) were performed for further evaluation. A hypoattenuating mass with rim-like enhancement in segment 6 of the liver was detected on contrast-enhanced CT imaging. Increased uptake was also observed on 18F-FDG PET/CT. Histopathological and immunohistochemical examinations, which revealed a grade 2 neuroendocrine tumor (NET), confirmed the diagnosis.
CONCLUSION Diagnosing PHNET is challenging, and must be distinguished from other liver tumors. Metastatic NETs should be excluded.
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Affiliation(s)
- Yan-Ying Rao
- Department of Radiology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou 350000, Fujian Province, China
| | - He-Jun Zhang
- Department of Pathology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou 350000, Fujian Province, China
| | - Xiao-Jiang Wang
- Department of Pathology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou 350000, Fujian Province, China
| | - Min-Feng Li
- Department of Radiology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou 350000, Fujian Province, China
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Doan NV, Duc NM, Ngan VK, Anh NV, Khuyen HTK, Nhan NT, Giang BV, Thong PM. Hypovascular pancreatic neuroendocrine tumor with hepatic metastases: A case report and literature review. Radiol Case Rep 2021; 16:1424-1427. [PMID: 33912257 PMCID: PMC8063702 DOI: 10.1016/j.radcr.2021.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 11/23/2022] Open
Abstract
Hypovascular pancreatic neuroendocrine tumors are uncommon pancreatic tumors and commonly misdiagnosed as pancreatic ductal adenocarcinoma or chronic mass-forming pancreatitis. The liver is the organ most commonly affected by neuroendocrine tumor metastases but hepatic neuroendocrine tumor metastases are quite difficult to discriminate from other hepatic metastases and primary hepatic tumors. We describe a case of a 47-year-old man with incidentally detected multiple hepatic lesions on ultrasound. On further imaging technique including computed tomography and magnetic resonance imaging, the patient had an abnormal hypoenhancing lesion at the pancreatic tail and multiple hyperenhancing hepatic metastases that were diagnosed as hypovascular pancreatic well-differentiated neuroendocrine tumor Grade 2 with multiple hypervascular hepatic metastases after liver biopsy and surgery. Neuroendocrine tumor is a rare etiology among hypoenhancing pancreatic tumors, and must be considered to discriminate from pancreatic adenocarcinomas in cases there are multiple hyperenhancing hepatic metastases on the arterial phase without typical washout on the portal venous phase.
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Affiliation(s)
- Ngo-Van Doan
- Department of Radiology, Vinmec Times City International Hospital, Ha Noi, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam.,Department of Radiology, Children's Hospital 2, Ho Chi Minh City, Vietnam.,Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Vuong Kim Ngan
- Department of Radiology, Vinmec Times City International Hospital, Ha Noi, Vietnam
| | - Nguyen-Van Anh
- Department of Radiology, Vinmec Times City International Hospital, Ha Noi, Vietnam
| | - Hoang-Thi Kim Khuyen
- Department of Radiology, Vinmec Times City International Hospital, Ha Noi, Vietnam
| | - Nguyen-Thi Nhan
- Department of Radiology, Vinmec Times City International Hospital, Ha Noi, Vietnam
| | - Bui-Van Giang
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam
| | - Pham Minh Thong
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam
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Abstract
Primary hepatic neuroendocrine neoplasms (PHNENs) represent a kind of rare liver tumor and its clinical features and prognosis remain unclear. This study aims to reveal the long-term therapeutic outcome of PHNEN and to present its prognostic feature.A retrospective designed, single-center study containing 22 patients with PHNENs receiving surgical resections was done. Clinical data were reviewed and long-term follow-up was updated. Survival analysis was tried to find the prognostic factors.Nine patients recurred (recurrence rate = 40.9%) and 6 patients died on the disease. The actual 1-, 3-, and 5-year recurrence-free survival rate were 86.4%, 63.6%, and 52.9%, respectively. The 1-, 3-, and 5-year overall survival rate were 95.5%, 81.8%, and 64.7%, respectively. Median overall survival for group G1, G2, and G3 were 69, 67, and 42 months, respectively.Patients with PHNEN can have a long survival after radical surgical resection, especially when the tumor proliferative grade exhibits lower (G1/2).
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Affiliation(s)
| | - Qian Zhao
- Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Shanghai, China
| | | | - Feng Xie
- Department of Hepatobiliary Surgery
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Meng XF, Pan YW, Wang ZB, Duan WD. Primary hepatic neuroendocrine tumor case with a preoperative course of 26 years: A case report and literature review. World J Gastroenterol 2018; 24:2640-2646. [PMID: 29962820 PMCID: PMC6021771 DOI: 10.3748/wjg.v24.i24.2640] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/12/2018] [Accepted: 05/26/2018] [Indexed: 02/06/2023] Open
Abstract
Primary hepatic neuroendocrine tumor (PHNET) is an extremely rare liver tumor. Patients often have no clinical symptoms or have only non-specific symptoms, such as abdominal pain and abdominal mass. The clinical manifestations, disease development, treatment methods, and treatment outcomes of PHNET vary greatly among cases. Here we report a case of PHNET with a confirmed 26-year survival before surgery. The patient was a 56-year-old female. A large right hepatic mass was detected when the patient was 30 years old. The tumor could not be removed during exploratory laparotomy, and constriction of the right hepatic artery and biopsy were conducted. Pathological results indicated a diagnosis of benign tumor, but a confirmed diagnosis was not reached. Twenty-six years after the patient had been living with the tumor, she sought treatment again because of tumor progression. After systematic evaluation of the resectability, the tumor was resected. Based on the examination results of the gastrointestinal tract and lungs, intraoperative examination results, pathological findings, and long-term follow-up results, the diagnosis of PHNET was confirmed. This case represents the longest reported survival time for a PHNET patient before removal of the tumor.
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Affiliation(s)
- Xiang-Fei Meng
- Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Ying-Wei Pan
- Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhan-Bo Wang
- Department of Pathology, Chinese PLA General Hospital, Beijing 100853, China
| | - Wei-Dong Duan
- Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China
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Pirozzolo G, Cona C, Rizzo M, Shala F, Berisha S, Recordare A. Long term recurrence in primary liver neuroendocrine tumor: Report of a single case and review of literature. Ann Hepatobiliary Pancreat Surg 2018; 22:159-163. [PMID: 29896578 PMCID: PMC5981147 DOI: 10.14701/ahbps.2018.22.2.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/17/2017] [Accepted: 01/14/2018] [Indexed: 11/17/2022] Open
Abstract
Primary liver neuroendocrine tumors (PLNETs) are rare tumors of the liver. They share some common characteristics with neuroendocrine tumors (NETs) of the extrahepatic bile ducts, such as slow rise, hormonal, and histological features. Nevertheless, they possess some peculiarities and the major feature is the difference in the metastatic potential between PLNETs and NETs. PLNETs have less metastatic potential compared with NETs, which is the main factor based on which differential diagnosis between the two groups is achieved. There exists few reports disease's long-term outcome, especially about the recurrences management. We report the case of a 52-year-old woman admitted to hospital for jaundice and presence of liver mass. She underwent extended right hepatectomy and subsequently, PLNET was revealed. After 9 years, a new mass was discovered in the remnant liver, far from the resection line, and was surgically removed. Histological examination confirmed a PLNET recurrence. The patient is alive and doing well after a year of surgery. We conducted a review of the literature on recurrent PLNETS. Five papers followed our inclusion criteria and included 10 patients. Clinical presentation was mostly nonspecific in included cases and no carcinoid syndrome was reported. Median overall survival and median disease-free survival periods were 22 and 5 months, respectively. The primary disease was treated with surgical resection in all the included cases and recurrent diseases were mostly treated with non-surgical techniques (mainly transarterial chemoembolization). In conclusion, more studies should be conducted in order to have significant data about this uncommon neoplasm. Finally, considering the lack of data on long-term outcome, a long and accurate follow-up should be considered.
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Affiliation(s)
- Giovanni Pirozzolo
- General and Emergency Surgery Department, Angelo Hospital, Venice, Italy
| | - Camilla Cona
- General and Emergency Surgery Department, Angelo Hospital, Venice, Italy.,University of Padua, Padova, Italy
| | - Maurizio Rizzo
- General and Emergency Surgery Department, Angelo Hospital, Venice, Italy
| | - Fazli Shala
- General Surgery Department, Regional Hospital Peja, Peja, Kosovo
| | - Sadri Berisha
- General Surgery Department, Regional Hospital Peja, Peja, Kosovo
| | - Alfonso Recordare
- General and Emergency Surgery Department, Angelo Hospital, Venice, Italy
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Baxi AJ, Chintapalli K, Katkar A, Restrepo CS, Betancourt SL, Sunnapwar A. Multimodality Imaging Findings in Carcinoid Tumors: A Head-to-Toe Spectrum. Radiographics 2017; 37:516-536. [PMID: 28287937 DOI: 10.1148/rg.2017160113] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Carcinoid tumors are a rare biologically heterogeneous group of neuroendocrine tumors with a spectrum ranging from benign indolent to aggressive metastatic tumors. They belong to the category of amine precursor uptake and decarboxylase tumors, or apudomas. The most common sites for primary locations are the gastrointestinal and respiratory tracts; however, any organ can be involved. The clinical presentation depends on location, aggressiveness, production of biologically active amines and peptides, paraneoplastic syndromes, and tendency for metastasis. Their reported age-adjusted incidence has increased in recent years, partly due to improved detection at radiologic imaging and endoscopy. Not a ll neuroendocrine cell tumors are carcinoids. Numerous systems have been proposed regarding their nomenclature and classification. Cross-sectional and functional imaging plays an important role in diagnosis, lesion characterization, and staging. Awareness of nomenclature, classification, common sites of involvement, and imaging presentation are pivotal for making the diagnosis. Knowledge of the diverse clinical, pathologic, and radiologic spectrum of carcinoid tumors involving various organs of the body is important for diagnosis and patient management. ©RSNA, 2017.
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Affiliation(s)
- Ameya Jagdish Baxi
- From the Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7800, San Antonio, TX 78229-3900 (A.J.B., K.C., A.K., C.S.R., A.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (S.L.B.)
| | - Kedar Chintapalli
- From the Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7800, San Antonio, TX 78229-3900 (A.J.B., K.C., A.K., C.S.R., A.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (S.L.B.)
| | - Amol Katkar
- From the Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7800, San Antonio, TX 78229-3900 (A.J.B., K.C., A.K., C.S.R., A.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (S.L.B.)
| | - Carlos S Restrepo
- From the Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7800, San Antonio, TX 78229-3900 (A.J.B., K.C., A.K., C.S.R., A.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (S.L.B.)
| | - Sonia L Betancourt
- From the Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7800, San Antonio, TX 78229-3900 (A.J.B., K.C., A.K., C.S.R., A.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (S.L.B.)
| | - Abhijit Sunnapwar
- From the Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7800, San Antonio, TX 78229-3900 (A.J.B., K.C., A.K., C.S.R., A.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (S.L.B.)
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