sábado, 19 de enero de 2013

CASE 30: Mid 30's female patient with abdominopelvic mass

This case is a contribution from the Radiology Department of one of the most prestigious hospitals in Guatemala called Centro Médico.

It was a female patient with history of a growing mass felt on the lower abdomen that has been progressively becoming painful associated with swelling of the left leg. At physical exam, presents varicose veins on the swollen left leg.  She has no other disease to our concern. She was brought to the Department with a previous Doppler ultrasound that showed a vascular mass so we conducted an AngioMR to discard AVM.

Here are the relevant images (click to enlarge):


Axial Fat Sat parallel to mass level

Axial Fat Sat perineum

Axial Fat Sat lower level

Axial Fat Sat distal thigh


T2

T2

T2

T2

Post Gad

Post Gad

T1 coronal

Post Gad Coronal

Later on I'll post the angio...but with these findings and history is almost definitive the diagnosis. Feel free to comment.

3 comentarios:

  1. Have you considered posting your cases on Radiopaedia.org? I would encourage you to do so, you have great cases. :)

    ResponderEliminar
  2. I've just opened my account and will start posting shortly. Thank you so much!

    ResponderEliminar
  3. When you saw a AVM so large, one of the differential diagnosis should be Klippel–Trénaunay–Weber syndrome, often simply Klippel–Trénaunay syndrome (KTS) and sometimes angioosteohypertrophy syndrome and hemangiectatic hypertrophy is a rare congenital medical condition in which blood vessels and/or lymph vessels fail to form properly. The three main features are nevus flammeus (port-wine stain), venous and lymphatic malformations, and soft-tissue hypertrophy of the affected limb. Other DXDIFERENTIAL SX PROTEUS, less common OSLER WEBER RENDU.

    DR. MARCO A. CABRERA

    ResponderEliminar