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Gupta N, Hiremath S, Martinez-Rios C, Chakraborty S, Miller E. Pediatric Petrous Apex Lesions: A Radiological Classification and Diagnostic Algorithm. Can Assoc Radiol J 2022; 73:655-671. [PMID: 35253470 DOI: 10.1177/08465371221074880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The petrous apex (PA) is involved in a myriad of pathological conditions, some of which are exclusive in children. Diagnosis may be difficult due to vague clinical presentation, and local examination is challenging owing to its inaccessible location. This is further complicated by multiple unfused sutures and ongoing PA pneumatization in children. Cross-sectional imaging is vital for the evaluation of the PA lesions, due to their precarious location and proximity to the major neurovascular structures. Several classification systems have been proposed for these lesions based on their site of origin, solid or cystic appearance, surgical or non-surgical (no touch lesions) management, and benign or malignant nature. In this article, we emphasize the distinctive role of different cross-sectional imaging modalities in the diagnosis of pediatric PA lesions, with special attention to normal variants that should not be mistaken for pathology. We also propose a radiological classification and algorithmic approach to aid in the precise diagnosis and facilitate appropriate management of the various PA lesions in children.
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Affiliation(s)
- Neetika Gupta
- Medical Imaging Department, 27338Children's Hospital of Eastern Ontario (CHEO), Department of Radiology-University of Ottawa, Ottawa, ON, Canada
| | - Shivaprakash Hiremath
- Division of Neuroradiology, Department of Radiology, 6363The Ottawa Hospital Civic and General Campus, Ottawa, ON, Canada
| | - Claudia Martinez-Rios
- Medical Imaging Department, 27338Children's Hospital of Eastern Ontario (CHEO), Department of Radiology-University of Ottawa, Ottawa, ON, Canada.,Division of Neuroradiology, Department of Radiology, 6363The Ottawa Hospital Civic and General Campus, Ottawa, ON, Canada
| | - Santanu Chakraborty
- Division of Neuroradiology, Department of Radiology, 6363The Ottawa Hospital Civic and General Campus, Ottawa, ON, Canada
| | - Elka Miller
- Medical Imaging Department, 27338Children's Hospital of Eastern Ontario (CHEO), Department of Radiology-University of Ottawa, Ottawa, ON, Canada
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Jicman Stan D, Niculet E, Lungu M, Onisor C, Rebegea L, Bobeica C, Elisei AM, Anghel L, Tatu AL. Rare case of metachronous tumor: Nasopharyngeal and colorectal carcinoma. Exp Ther Med 2021; 22:1417. [PMID: 34707699 PMCID: PMC8543177 DOI: 10.3892/etm.2021.10852] [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: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
The study presents an unusual case of a patient with a personal history of a rectal malignant tumor in 2013, who after a period of 6 years, was diagnosed with an advanced nasopharyngeal carcinoma, locally and regionally invasive. It is possible that the colorectal malignant tumor affected the development of the nasopharyngeal carcinoma, or the other way around, depending on the presence of genetic instabilities. These two types of malignant tumors share a series of genes that can influence their progression, i.e., SPINK-6 and Bcl-2. The particularity of this case stems from the development of a metachronous tumor, a rectal adenocarcinoma and nasopharyngeal carcinoma, two malignant tumors with different patient prognosis and disease progression. Research needs to be continued on the multidisciplinary therapeutic management of nasopharyngeal cancer and the ways of identifying this cancer type in its early stages, considering that most patients come from a rural environment, have poor medical education, a number of comorbidities, and who frequently ignore the signs, symptoms and sometimes the treatment offered.
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Affiliation(s)
- Daniela Jicman Stan
- Department of Otorhinolaringology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Biomedical Doctoral School, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania.,Department of Pathology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania
| | - Mihaela Lungu
- Department of Neurology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.,Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
| | - Laura Rebegea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800010 Galati, Romania
| | - Alina Mihaela Elisei
- Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform 'Dunărea de Jos', ReForm-UDJG, 800010 Galati, Romania.,Research Centre in The Field of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, Department of Pharmaceutical Sciences, 'Dunărea de Jos' University of Galați, 800010 Galati, Romania
| | - Lucretia Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.,Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform 'Dunărea de Jos', ReForm-UDJG, 800010 Galati, Romania.,Department of Dermatology, 'Sfanta Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
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