We report a case of fetal pericallosal lipoma occurring at the anterior interhemispheric fissure and associated with agenesis of the corpus callosum. During targeted prenatal ultrasonography at 26 weeks' gestation, the lesion was seen as a highly echogenic mass. MR imaging performed at 35 weeks' gestation and during the postnatal period revealed a pericallosal fatty mass and agenesis of the corpus callosum.
Adult ; Brain Neoplasms/*diagnosis/ultrasonography ; Corpus Callosum/*abnormalities ; Female ; Fetal Diseases/*diagnosis/ultrasonography ; Gestational Age ; Human ; Infant, Newborn ; Lipoma/*diagnosis/ultrasonography ; *Magnetic Resonance Imaging ; Pregnancy ; *Ultrasonography, Prenatal

Several different tumors in different tissues(including the central nervous system, heart, kidney, liver, bone, and soft tissues) are found to be associated with tuberous sclerosis. In the brain, this tumor characteristically arises from the floor of the lateral ventricle and often occluded the foramen of Monro. Cardiac tumor is among the earliest signs of tuberous sclerosis and occurs in over half of affected patients, but symptomatic primary heart tumors are rare in newborn. Thus, early detections are rare in asymptomatic cases. We experienced a case of tuberous sclerosis, in a 2-day-old female newborn who presented with dilatation of lateral ventricle detected by fetal ultrasonography. Diagnosis was confirmed by brain MRI and echocardiogram demonstrated multiple cardiac tumor. Brief review and related literatures were also presented.
Brain ; Central Nervous System ; Cerebral Ventricles ; Diagnosis ; Dilatation ; Female ; Heart ; Heart Neoplasms* ; Humans ; Hydrocephalus* ; Infant, Newborn ; Kidney ; Lateral Ventricles ; Liver ; Magnetic Resonance Imaging ; Tuberous Sclerosis* ; Ultrasonography, Prenatal

Primary tumors of the heart are rare in infancy and childhood and are most often benign. The most common cardiac tumors are rhabdomyoma, fibroma, and myxoma. Rhabdomyomas occur as single or usually multiple nodules embedded in chamber walls. They may remain clinically unimportant or even regress but also cause mechanical obstruction, heart failure, or arrhythmias. It is generally accepted that 50% of cardiac rhabdomyoma are associated with tuberous sclerosis. We experienced two cases of fetal cardiac tumor which were detected by prenatal ultra sound. One case was multiple cardiac rhabdomyomas diagnosed in 37 weeks of gestation. After birth, brain MRI was performed and tuberous sclerosis was diagnosed. The other case was 1.2 cm sized single hyperechoic mass in the left ventricle. Postnatal echocardiography confirmed the prenatal diagnosis.
Arrhythmias, Cardiac ; Brain ; Echocardiography ; Fetus ; Fibroma ; Heart ; Heart Failure ; Heart Neoplasms* ; Heart Ventricles ; Magnetic Resonance Imaging ; Myxoma ; Parturition ; Pregnancy ; Prenatal Diagnosis ; Rhabdomyoma ; Tuberous Sclerosis ; Ultrasonography*

A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.
Adenocarcinoma ; Aged ; Biopsy ; Brain ; Diagnosis ; Emergencies ; Endoscopy ; Humans ; Leg ; Magnetic Resonance Imaging ; Neoplasm Grading ; Neoplasm Metastasis ; Pathology ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Spinal Cord Compression ; Spine ; Ultrasonography

Fever of unknown origin (FUO) is caused by infections (30-40%), neoplasms (20-30%), collagen vascular diseases (10-20%), and numerous miscellaneous diseases (15-20%). The literatures also reveal that 5-15% of FUO cases defy diagnosis, despite extensive studies. Diagnostic advances continuously modify the spectrum of FUO-causing diseases. Modern imaging techniques (e.g., ultrasound, CT scan, MRI) enable early detection of abscesses and solid tumors that used to be difficult to diagnose. But the correct diagnosis can be delayed because the tumor, such as rare hematologic malignancy, is difficult to be detected by various imaging studies. Intravascular lymphomatosis (IVL) is a rare form of non-Hodgkin's lymphoma and generally fatal disease characterized by extensive proliferation of neoplastic mononuclear cells within the lumina of blood vessels. The prognosis is usually extremely poor, with rapid death despite chemotherapy. The diagnosis is most frequently made after biopsy of skin or brain but is often established post mortem. Most patients with IVL present with FUO and nonspecific cutaneous and neurologic manifestations. Peripheral nerve system or pulmonary involvements are not common as initial menifestations. We report a case of intravascular lymphomatosis, presenting as FUO with peripheral polyneuropathy. We made early diagnosis of IVL by video-assisted thoracoscopic lung biopsy. She is improving with good performance after the 4th cycle of chemotherapy till now.
Abscess ; Biopsy ; Blood Vessels ; Brain ; Collagen ; Diagnosis ; Drug Therapy ; Early Diagnosis ; Fever of Unknown Origin* ; Fever* ; Hematologic Neoplasms ; Humans ; Lung ; Lymphoma ; Lymphoma, Non-Hodgkin ; Neurologic Manifestations ; Peripheral Nerves ; Polyneuropathies* ; Prognosis ; Skin ; Tomography, X-Ray Computed ; Ultrasonography ; Vascular Diseases

Fever of unknown origin (FUO) is caused by infections (30-40%), neoplasms (20-30%), collagen vascular diseases (10-20%), and numerous miscellaneous diseases (15-20%). The literatures also reveal that 5-15% of FUO cases defy diagnosis, despite extensive studies. Diagnostic advances continuously modify the spectrum of FUO-causing diseases. Modern imaging techniques (e.g., ultrasound, CT scan, MRI) enable early detection of abscesses and solid tumors that used to be difficult to diagnose. But the correct diagnosis can be delayed because the tumor, such as rare hematologic malignancy, is difficult to be detected by various imaging studies. Intravascular lymphomatosis (IVL) is a rare form of non-Hodgkin's lymphoma and generally fatal disease characterized by extensive proliferation of neoplastic mononuclear cells within the lumina of blood vessels. The prognosis is usually extremely poor, with rapid death despite chemotherapy. The diagnosis is most frequently made after biopsy of skin or brain but is often established post mortem. Most patients with IVL present with FUO and nonspecific cutaneous and neurologic manifestations. Peripheral nerve system or pulmonary involvements are not common as initial menifestations. We report a case of intravascular lymphomatosis, presenting as FUO with peripheral polyneuropathy. We made early diagnosis of IVL by video-assisted thoracoscopic lung biopsy. She is improving with good performance after the 4th cycle of chemotherapy till now.
Abscess ; Biopsy ; Blood Vessels ; Brain ; Collagen ; Diagnosis ; Drug Therapy ; Early Diagnosis ; Fever of Unknown Origin* ; Fever* ; Hematologic Neoplasms ; Humans ; Lung ; Lymphoma ; Lymphoma, Non-Hodgkin ; Neurologic Manifestations ; Peripheral Nerves ; Polyneuropathies* ; Prognosis ; Skin ; Tomography, X-Ray Computed ; Ultrasonography ; Vascular Diseases