Advanced fumarate hydratase-deficient renal cell carcinoma responding to combination immune checkpoint inhibitors.

Fumarate hydratase deficient (FHdef) renal cell carcinoma (RCC) is rare, highly aggressive and is believed to arise mostly in the setting of hereditary leiomyomatosis RCC (HLRCC) syndrome with a germline mutation of fumarate hydratase (FH) gene. There is currently little evidence regarding the most effective systemic treatment for advanced FHdef RCC. We present three cases of metastatic FHdef RCC, all achieving tumor response with combination immunotherapy ipilimumab and nivolumab (Ipi/Nivo).

18F-FDG PET, contrast CT and MRI to comprehensively diagnose and assess rare perineural spread of squamous cell carcinoma to the greater auricular nerve.

We present a case of a 78-year-old male with a primary parotid squamous cell carcinoma which spread via the left facial, trigeminal and greater auricular nerves. The patient presented with left facial droop and paraesthesia. Initial MRI scans demonstrated involvement of the trigeminal and facial nerves with no sign of a primary lesion.

Mammography as a screening tool for diabetes.

Background: This large retrospective study investigates the relationship between breast arterial calcifications (BAC) identified on screening mammography and the presence of DM, thereby evaluating the utility of screening mammography as an additional screening tool for diabetes.

Materials And Methods: The screening mammograms of 1000 women were prospectively evaluated for BAC; women with a prior history of DM or CAD were excluded. This screening group was compared with all diabetic women who had undergone routine mammographic screening at our institution.

Vascular calcifications on screening mammography identify women with increased risk of coronary artery disease and diabetes.

Background: Mammographic breast arterial calcifications (BAC) have been reported in women with diabetes and coronary artery disease (CAD). This prospective study further investigates the clinical significance of BAC, CAD, and diabetes.

Methods: Women undergoing screening mammography were prospectively evaluated for mammographic BAC.

Mammography as a screening tool for coronary artery disease.

Background: The leading cause of death in women over 40 y old is coronary artery disease (CAD) followed by cancer. This large retrospective study investigates the relationship between mammographic benign arterial calcifications (BAC) and a history of CAD to determine if mammography is a suitable screening tool for CAD.

Methods: To determine the incidence of BAC in our general screening population, we prospectively studied 1000 consecutive women undergoing screening mammography.

Focal hepatic activity during ventilation-perfusion scintigraphy due to systemic-portal shunt due to superior vena cava obstruction from histoplasmosis-induced fibrosing mediastinitis.

A 59-year-old woman with a history of fibrosing mediastinitis secondary to histoplasmosis diagnosed on mediastinoscopy presented with dyspnea. A ventilation-perfusion scan demonstrated decreased perfusion to the entire right lung. In addition, the perfusion images demonstrated focal abnormal activity in part of the liver.

Differentiating adrenal adenomas from nonadenomas using (18)F-FDG PET/CT: quantitative and qualitative evaluation.

Rationale And Objectives: We sought to assess the ability of (18)F-fluoro-2-deoxy-d-glucose (FDG) PET/CT to distinguish adrenal adenomas from nonadenomas in patients with suspected malignancy.

Methods: Fifty-nine adrenal masses were evaluated with coregistered (18)F-FDG PET (PET/CT). Two reviewers independently graded uptake of (18)F-FDG by visual inspection of the adrenal mass in comparison to liver and background.

Use of [18F]fluorodeoxyglucose positron emission tomography in evaluating locally recurrent and metastatic adrenocortical carcinoma.

Context: Adrenocortical carcinomas are uncommon, and their evaluation by [(18)F]fluorodeoxyglucose positron emission tomography (FDG PET) has not been well evaluated.

Objective: The purpose of this study was to examine the potential utility of FDG PET in the detection of recurrent or metastatic adrenocortical carcinoma.

Design: In patients with known adrenocortical carcinoma who underwent FDG-PET imaging for suspected recurrence or metastasis, FDG activity was compared with other imaging findings, clinical features, and the presence or absence of disease as confirmed by resection, biopsy, or clinical follow-up.

Differentiation between carcinoid and sarcoid with F-18 FDG PET and In-111 pentetreotide.

A patient who presented with weight loss and recurrent left lower lobe pneumonia was diagnosed with endobronchial carcinoid. Chest CT scan demonstrated extensive mediastinal and hilar lymphadenopathy suggesting stage IIIB disease, but radionuclide imaging with In-111 pentetreotide and F-18 FDG PET diagnosed 2 distinct pathologic processes based on functional differences between neuroendocrine tumors (expressing somatostatin receptors) and sarcoidosis (intensely FDG-avid). The possible association of carcinoid with sarcoidosis and sarcoid-like reactions in regional lymph nodes should always be considered, and the staging process should include both anatomic and functional imaging and biopsy confirmation of suspected metastatic lesions.

Amiodarone-induced hyperthyroidism in a patient with functioning papillary carcinoma of the thyroid and extensive hepatic metastases.

Thyroid hormone producing thyroid carcinoma is an uncommon cause of thyrotoxicosis. A patient with extensive hepatic metastases from well-differentiated carcinoma is presented. Administration of amiodarone for atrial fibrillation led to the development of hyperthyroidism.

Mediastinal histoplasmosis: F-18 FDG PET and CT findings simulating malignant disease.

We describe the computed tomography and F-18 FDG PET findings of a patient with extensive mediastinal nodal enlargement resulting from histoplasmosis. This patient with known metastatic melanoma presenting for restaging was initially considered to have widespread mediastinal and cervical metastases on the basis of the imaging findings. Bronchoalveolar lavage fluid and transbronchial lymph node biopsy were consistent with histoplasmosis.

Renal infarction secondary to a subcapsular haematoma following percutaneous renal biopsy.

We present the case of post-biopsy subcapsular haematoma leading to infarction of the kidney. This is a very uncommon complication of percutaneous renal biopsy. The radiological findings in this case are shown, highlighting the sonographic finding of the renal interlobar arteries having reversed flow in diastole in connection with very high resistance because of compression by a subcapsular haematoma.

Pigmented villonodular synovitis and giant cell tumor of the tendon sheath: scintigraphic findings in 10 cases.

The purpose of this report was to determine the pattern of thallium (T1-201) uptake in pigmented villonodular synovitis (PVNS) and giant cell tumor of the tendon sheath (GCTTS) and to evaluate for features that might help to distinguish these lesions from malignant disease. Scintigraphic images from patients subsequently found to have pigmented villonodular synovitis confirmed by histopathologic analysis were assessed. The patients had been evaluated with T1-201 scintigraphy for a suspicious musculoskeletal lesion.