No abstract

Figure 1. Axial T 2-weighted magnetic resonance imaging of the inferior abdomen showing hyperintensity of the right inferior musculus gemellus.

Anomalous coronary arteries are rare congenital variations with cases ranging from asymptomatic to life-threatening. Given the wide variability of coronary anomalies, it is challenging to predict their clinical consequences. Here, we present the ‘malignant’ variant – interarterial course of the left coronary artery between the aorta and pulmonary trunk – given the highest risk of sudden cardiac death among the various coronary anomalies. Learning Objectives: 1. To describe the ‘malignant’ interarterial course of the left coronary artery and its association with sudden cardiac death 2. To present the various surgical options recommended to patients with this variant

Introduction and aim. We aimed to evaluate the usefulness of dynamic contrast-enhanced (DCE) MRI semiquantitative analysis values in focal liver lesions (FLL) to provide additional qualities that can be used in daily practice in the differential diagnosis of lesions. Material and methods. This retrospective study included 91 patients with liver masses on DCE-MRI. The sensitivity and specificity of time intensity curves (TIC) and semiquantitative analysis values were evaluated to differentiate benign and malignant lesions. Results. The study included 91 patients (376 lesions), aged between 28-81 years. Of the lesions, 303 were malignant and 73 were benign. In TIC semiquantitative analysis, it was found that “Tpeak” and “wash-out” rate values showed differences, especially in the differentiation of HCC, metastasis, and hemangioma. Area under curve, maximum relative enhancement, and “wash-in” and “wash-out” values of metastases and hemangiomas were different. Brevity of enhancement values of HSK, hemangiomas, and metastases were found to be different. The risk of malignancy was found to be high when the “wash-out” ratio was above 0.08 (sensitivity: 64.3%, specificity: 70.4%). Conclusion. We think that the 0.08 threshold value we found for the washout ratio with DCE-MRI semiquantitative analysis data will be useful in daily practice in the differentiation of malignant and benign FLL.

Intracardiac metastasis of the testicular cancer is very rare phenomenon. A 30-year-old-man with a history of testicular rhabdomyosarcoma and lung metastases was found to have an intracardiac filling defect in a surveillance computed tomography scan 3 years after the initial diagnosis. A cardiac magnetic resonance imaging study was performed for further evaluation and demonstrated a lobulated, heterogeneously enhancing mobile mass within the right ventricle attaching to the anterior papillary muscle. Patient underwent an open surgical resection of the cardiac mass that was confirmed metastasis of testicular rhabdomyosarcoma into the right ventricular papillary muscle and tricuspid valve. To our knowledge, this is the first report in the literature that describes metastasis to a papillary muscle and tricuspid valve from a testicular neoplasm.