Although secondary involvement of the broad ligament by malignant tumors arising elsewhere in the abdomen and pelvis is common, primary tumors in this location are rare. Tumors of the broad ligament can be of mesenchymal and mixed nature, such as leiomyoma, the most common neoplasm; epithelial tumors of Müllerian type, imposing a challenge to differentiate them from other adnexal masses; unique tumors from mesonephric origin; and tumor-like lesions. Most neoplasms in this region, whether benign or malignant, usually present clinically with vague symptoms and are often discovered during a routine gynecological examination. Suspicion of such location and knowledge of the potential range of lesions of this region may allow for planning minimally invasive surgical interventions. To be considered tumor from the broad ligament, it should not be connected with either the uterus or the ovary. Thus, the imaging approach to establish the differential diagnosis includes excluding an ovarian, uterine, or tubal origin by recognizing these separately and by rebutting imaging clues pointing to these origins. This pictorial essay reviews some of the imaging findings that may suggest such location and presents some of the possible differential diagnoses by means of illustrative confirmed cases.
The treatment of advanced non-small-cell lung cancer shifted with the development of molecular-targeted therapies, like the tyrosine kinase inhibitors. One example of tyrosine kinase inhibitors is crizotinib, an anaplastic lymphoma tyrosine kinase inhibitor, which targets an echinoderm microtubule-associated protein-like-4-anaplastic lymphoma kinase gene fusion. This mutation is found in only 2% to 7% of non-small-cell lung cancer cases. Although these new therapies have shown promising results, the occurrence of interstitial lung disease as a side effect could be problematic. As the diagnosis of drug-related-interstitial lung disease is difficult to make, computed tomography is an important diagnostic tool. The recognition of computed tomography manifestations of tyrosine kinase inhibitors -induced interstitial lung disease is the key for an early recognition and management of this pulmonary toxicity. We aim to raise awareness of tyrosine kinase inhibitors-induced interstitial lung disease, by reporting the first case of a Portuguese patient treated with crizotinib for non-small-cell lung cancer who developed drug-induced interstitial lung disease.
Emphysematous vaginitis represents a rare and self‐limited condition, which presents with vaginal discharge. Despite its benignity, it has some worrisome imaging features, which should be recognized in order to avoid unnecessary invasive procedures.
Solitary fibrous tumors were initially described in the pleural cavity and they were thought to have mesothelial origin. Nowadays, these tumors are known to have origin in the mesenchymal cells and they are ubiquitous with both pleural and extrapleural distribution. There are many extrapleural localizations, being the pelvis one of the rarest and the most challenging to diagnose. Usually, solitary fibrous tumors are clinically insidious and manifest as a slow-growing large tumor. At imaging, these tumors have different characteristics, and computed tomography and magnetic resonance play an important role in their diagnosis. Solitary fibrous tumors appear as heterogeneous enhancement on contrast-enhanced computed tomography, intermediate signal on T1-weighted images, hypointense on T2-weightes images and show intense heterogeneous enhancement in dynamic sequences. When they appear in the female pelvis, it is essential to recognize their radiological characteristics, in order to differentiate it from others tumors, like pure stromal ovarian tumors or Brenner tumors. This study reviews the female pelvis solitary fibrous tumors’ imaging findings and its differential characteristics from more common tumors, by describing illustrative confirmed cases.
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