Background: Microcystic adnexal carcinoma (MAC) is a rare cutaneous neoplasm, with a high rate of local recurrences. Objective: A series of MAC was analyzed and compared to previously published cases. Methods: Seven cases of MAC were identified in the register of the institution. Medical and pathological records were reviewed. Results: The primary MAC were located on the face in all patients, and 85% were initially misdiagnosed. The mean follow-up duration was 108 months. The recurrence rate was high: 4 patients developed recurrences. In 3 patients, the course of the disease was severe: one of them developed pathologically proven lung metastasis. Conclusion: The present study and review of the literature confirm the clinically aggressive evolution of MAC and its rare ability to give rise to metastasis. Long-term clinical follow-ups with imaging investigations are mandatory.

A total of 24 cases of hepatic alveolar echinococcosis (HAE) due to Echinococcus multilocularis was assessed by US and CT. The diagnosis was confirmed in all cases by immunologic and histologic study. Both US and CT patterns of HAE showed changes of liver morphology in both contour and size. Abnormal areas of parenchyma were nodular or in fields, irregular, heterogeneous, and basically echogenic. On CT these lesions were hypodense (30 to 40 HU) and did not show enhancement after administration of intravenous contrast medium. Clustered microcalcifications were encountered within the abnormal parenchymal fields in 50% of cases, and necrotized zones occurred in 40% of cases. Dilatation of intrahepatic bile ducts was commonly seen, especially on US; hilar involvement was frequent. Follow-up by both techniques can display increases of primary lesions, occurrence of new foci, and local or regional extensions. Precise evaluation of the lesions arising from correlative use of US and CT permits adequate therapeutic management.

Nineteen patients with histologically proved tumor thrombi of the inferior vena cava (IVC) secondary to abdominal neoplasms were studied with the use of ultrasonography (US) and computed tomography (CT). The primary neoplasms were renal cell carcinoma (13 cases), adrenal tumors (two cases), retroperitoneal tumors (two cases), and hepatic tumors (two cases). A positive diagnosis of tumor thrombus was achieved by both methods. The cranial extent of the tumor thrombus was better demonstrated by US studies, which showed echogenic endoluminal material within an enlarged IVC with a bulging anterior wall. On CT scans the tumor thrombus usually appeared as an endoluminal filling defect surrounded by a rim of contrast material. Tumor thrombus was better outlined by CT, particularly when it extended beyond the limits of the IVC wall, as in the retroperitoneal tumors. Neither method could accurately be used to predict IVC wall infiltration when the tumor thrombus remained within the confines of the IVC, nor could either method differentiate tumor from nontumor thrombi. US and CT are complementary in the preoperative assessment of tumor thrombus, and their use obviates the need for venacavography in many cases.

Fluid accumulations present in the lesser omental bursa and the greater peritoneal cavity simultaneously outline a pattern resembling a butterfly. This "butterfly sign" can contribute to a more accurate diagnosis in evaluation of acute pancreatic processes and, more generally, acute abdominal syndromes.

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