Giant cell tumor is the sixth most frequent primary bone neoplasm, affecting long bone metaphysis, most frequently in young adults. On radiological images, this tumor appears as a lytic, well-defined, eccentric lesion. The authors report a case of benign giant cell tumor in a patient who presented with lung metastases five years after undergoing resection of the primary tumor.

Keywords: Giant cell tumor, Benign, Metastasis

The present study reports the case of a 46-year-old female patient complaining of mild premenstrual pain and increase in the volume of the periumbilical region. The condition progressed with a gradual increase of the pain intensity. Ultrasonography, computed tomography and magnetic resonance imaging were performed. Biopsy of tissue collected during exploratory laparotomy confirmed the diagnosis of leiomyomatosis peritonealis disseminata.

Keywords: Leiomyomatosis peritonealis disseminata, Oral contraceptive method, Computed tomography, Magnetic resonance imaging

The nasopharynx is located in the upper aerodigestive tract. Its roof is formed by the basisphenoid, basiocciput and the anterior aspect of the first two cervical vertebrae, in front of the clivus. The lateral walls are formed by the margins of the superior constrictor muscle and the pharyngobasilar fascia, pharyngeal recess, torus tubarius and pharyngeal opening of auditory tube. The inferior margin of the nasopharynx is a horizontal plane passing through the hard palate and palatopharyngeal muscle. Anteriorly, it is in direct continuity with the nasal cavity through the posterior choanae. It is approximately 2.0 cm in anteroposterior diameter and about 4.0 cm in craniocaudal extent. Squamous cell carcinoma accounts for about 70% to 98% of nasopharyngeal malignant lesions found in adults. This tumor presents a high incidence in Asians, most frequently in men, and is the third most frequent cancer in women. The clinical presentation of this disease depends on the size and site of the lesion, with small-sized lesions being asymptomatic. Computed tomography and magnetic resonance imaging play essential and complementary roles in the staging and treatment of patients with nasopharyngeal cancer.

Keywords: Computed tomography, Nasopharynx, Tumor, Carcinoma

Surgery and radiation therapy are de main treatments for head and neck cancer. The side effects of the interaction of ionizing radiation on the tissues include dermatitis, mucositis, xerostomia, candidiasis, dysgeusia, dysphagia, caries, trismus, osteoradionecrosis. OBJECTIVE: To assess dental condition of the patients using a protocol which allows avoiding or reducing the effects of radiation in the tissues of the oral cavity. MATERIALS AND METHODS: Dental follow-up was performed before, during and up to 180 days after radiation therapy in 12 patients submitted to surgery and radiation therapy or radiation therapy alone. RESULTS: The proportion of effects such as dermatitis, mucositis, dysgeusia, and dysphagia increased from the second week of the treatment until the end of the administrations. There was a clear decrease at the end of the treatment which was close to baseline values after 180 days. The reduction of xerostomia was slower and less effective. No case of caries, trismus, and osteoradionecrosis were observed during the assessment period. CONCLUSION: Regular dental follow-up associated with preventive measures such as prophylactic management of dental and oral diseases, adequate hygiene, mouth-washing with bicarbonate water and chamomile tea, and topic fluorine application contributed to improve the recovery conditions of patients with cancer of head and neck submitted to radiation therapy.

Keywords: Oral sequels, Odontology, Radiotherapy

OBJECTIVE: To observe digital sucking or hand sucking habits in fetuses using ultrasound, to identify pregnancy related factors that influence its appearance and to evaluate the persistence of digital sucking after delivery. MATERIALS AND METHODS: Two ultrasound examinations were performed in 55 pregnant women with 20-24 and 25-32 weeks of pregnancy. Questionnaires were used to evaluate the factors related to pregnancy. In order to verify the persistence of digital sucking, visits to the newborns were performed one week after delivery. RESULTS: Digital sucking was detected in 35 of the 55 fetus studied. Digital sucking in fetuses was not associated with the health status of the pregnant women and the level of pregnancy acceptance. The Q Cochran test showed no relationship between the observation of digital sucking in the fetuses and the development of sucking habit in the newborns. CONCLUSION: Ultrasound is an effective method to observe digital sucking in the fetus. There is no association between prenatal digital sucking and the development of sucking habits after delivery.

Keywords: Fetal ultrasound, Obstetric ultrasound, Oral habits, Digital sucking, Malocclusion

The authors report a case of a two year-old girl with an extrarenal Wilms' tumor in the retroperitoneum. Abdominal plain films, intravenous urography, abdominal ultrasound and computed tomography examinations showed a retroperitoneal mass adjacent to the right kidney. The patient underwent surgery with complete resection of the mass. The diagnosis of Wilms' tumor was confirmed by histopathological study. Extrarenal Wilms' tumor is an extremely rare malignancy which is almost always presented in medical literature as a case report. The tumor may arise in the retroperitoneum, uterus and ovaries, inguinal groove, testes, skin, and even in the thorax. The exact mechanism of occurrence of this tumor in extrarenal tissues has not yet been established. The diagnosis relies on histopathological study, generally after surgical intervention.

Keywords: Extrarenal Wilms' tumor, Retroperitoneum, Radiology

Magnetic resonance imaging and computed tomography are important additional methods for the diagnosis of oral cavity diseases. The technical aspects of both methods are discussed including their advantages and limitations. The anatomy of the oral cavity is reviewed as well as some characteristics of squamous cell carcinoma, which is the most frequent neoplasia in this region.

Keywords: Oral cavity, Computed tomography, Magnetic resonance imaging

The authors report a case of intraabdominal desmoplastic small round cell tumor in a 21-year-old male patient who presented with abdominal pain, right lower limb thrombosis and obstructive loss of renal function. Initial investigation showed a large lobulated intraabdominal soft tissue mass with internal cystic cavities, located posteriorly to the bladder and causing obstruction of ureteral flow, compression of the right iliac vein and partial occlusion of the rectum. Involvement of intraperitoneal and retroperitoneal nodes was also seen. Ultrasound, computed tomography and magnetic resonance imaging findings, as well as surgical and histopathology macroscopical, microscopical and immunohistochemistry findings are described.

Keywords: Desmoplastic small cell tumor, Desmoplastic tumor

Undifferentiated embryonal sarcoma of the liver is a rare disease that affects predominantly children over five years of age. The most common macroscopic finding is a large hepatic mass with a greater solid component and smaller cystic areas. However, computed tomography tends to overestimate the cystic components of the lesion and consequently ultrasonography is considered a more reliable technique for evaluating the texture of the tumor. Imaging methods can help to rule out nonneoplastic diseases such as liver abscesses and hematomas, and to establish the extent of the lesions. The diagnosis of undifferentiated embryonal sarcoma can be correctly inferred when imaging findings, the age of the patient and serum alpha protein levels are concurrently analyzed. The authors report a case of undifferentiated embryonal sarcoma in a 10-year-old girl and discuss the imaging findings features and differential diagnosis.

Keywords: Sarcoma, Tumor, Liver

The authors report a rare case of granular cell tumor in the left medial rectus muscle of a seven-year-old boy. Clinical, pathologic and radiologic findings of the present case are described and a brief literature review is undertaken.

Keywords: Orbit; Granular cell tumor.

OBJECTIVE: To estimate extracranial doses on eyes, thyroid, chest and pelvis in patients submitted to radiosurgery with 6 MV linear accelerator. MATERIALS AND METHODS: The present study evaluated 11 patients, 7 of them with primary, and 4 with secondary brain tumors. In the latter group, 2 patients had two lesions. Thermoluminescent dosimeters were utilized to estimate the extracranial dose. Radiosurgery cones ranges between 1.50 and 3.75 cm and doses between 1300 and 2000 cGy. RESULTS: Mean patients' age was 52 years, and 63.6% of them were women and 36.4%, men. Lesion locations were the following: right acoustic nerve (1), frontal (2), parietal (5), right occipital (1), cerebellum (2) and parasagittal (2). Mean received doses were the following: 5.1 cGy between the eyes; 4.8 cGy in the right eye; 6.5 cGy in the left eye; 4.2 cGy in the thyroid; 1.65 cGy in the chest; and 0.45 cGy in the pelvis. CONCLUSION: The results demonstrate that that although the eye doses do not exceed the tolerance limits for occurrence of lens opacity, it is important that the risks associated with radiation doses are taken into consideration by radiotherapists in the planning of cranial radiosurgery procedures.

Keywords: Brain tumor; Radiotherapy; Radiosurgery; Dosimetry.

Inflammatory myofibroblastic tumors rarely affect the urinary tract or children, and frequently mimic malignancy on imaging studies. According to the recent literature, only 35 cases of such bladder tumors in children have been reported. The authors present the case of a child with a bladder myofibroblastic tumor with favorable progression following complete surgical resection.

Keywords: Bladder tumor; Inflammatory myofibroblastic tumor; Computed tomography.

A congenital ranula is a rare cystic malformation seen in the oral cavity. This pseudocyst is normally located in the sublingual space between the mylohyoid muscle and the lingual mucosa. A 24-year-old woman, gravida 3, para 2, at 29 weeks' gestation was referred to our institution because of polihydramnios and large oral mass.

Keywords: Prenatal diagnosis; Ultrasound; Oral tumor; Ranula.

OBJECTIVE: To evaluate the accuracy of computed tomography for local and lymph node staging of Wilms' tumor. MATERIALS AND METHODS: Each case of Wilms' tumor was evaluated for the presence of abdominal lymph nodes by a radiologist. Signs of capsule and adjacent organ invasion were analyzed. Surgical and histopathological results were taken as the gold standard. RESULTS: Sensitivity was 100% for both mesenteric and retroperitoneal lymph nodes detection, and specificity was, respectively, 12% and 33%, with positive predictive value of 8% and 11% and negative predictive value of 100%. Signs of capsular invasion presented sensitivity of 87%, specificity of 77%, positive predictive value of 63% and negative predictive value of 93%. Signs of adjacent organ invasion presented sensitivity of 100%, specificity of 78%, positive predictive value of 37% and negative predictive value of 100%. CONCLUSION: Computed tomography tumor showed low specificity and low positive predictive value in the detection of lymph node dissemination. The absence of detectable lymph nodes makes their presence unlikely, and likewise regarding the evaluation of local behavior of tumors.

Keywords: Computed tomography; Wilms' tumor; Staging.

OBJECTIVE: To determine whether an interim ¹⁸F-fluoride positron-emission tomography/computed tomography (PET/CT) study performed after the third cycle of radium-223 dichloride (²²³RaCl₂) therapy is able to identify patients that will not respond to treatment. MATERIALS AND METHODS: We retrospectively reviewed 34 histologically confirmed cases of hormone-refractory prostate cancer with bone metastasis in patients submitted to ²²³RaCl₂ therapy. All of the patients underwent baseline and interim ¹⁸F-fluoride PET/CT studies. The interim study was performed immediately prior to the fourth cycle of ²²³RaCl₂. The skeletal tumor burden—expressed as the total lesion fluoride uptake above a maximum standardized uptake value of 10 (TLF₁₀)—was calculated for the baseline and the interim studies. The percent change in TLF₁₀ between the baseline and interim studies (%TFL₁₀) was calculated as follows: %TFL₁₀ = interim TLF₁₀ − baseline TLF₁₀ / baseline TLF₁₀. End points were overall survival, progression-free survival, and skeletal-related events. RESULTS: The mean age of the patients was 72.4 ± 10.2 years (range, 43.3–88.8 years). The %TLF₁₀ was not able to predict overall survival (p = 0.6320; hazard ratio [HR] = 0.753; 95% confidence interval [CI]: 0.236–2.401), progression-free survival (p = 0.5908; HR = 1.248; 95% CI: 0.557–2.797) nor time to a bone event (p = 0.5114; HR = 1.588; 95% CI: 0.399–6.312). CONCLUSION: The skeletal tumor burden on an interim ¹⁸F-fluoride PET/CT, performed after three cycles of ²²³RaCl₂, is not able to predict overall survival, progression-free survival, or time to bone event, and should not be performed to monitor response at this time.

Keywords: Sodium fluoride; Positron-emission tomography/methods; Tomography, X-ray computed/methods; Prostatic neoplasms; Radium-223; Bone neoplasms/diagnostic imaging; Tumor burden.