Introduction: Tumors of salivary glands constitute 3% of neoplasms of the body. Clinical signs and symptoms usually occur in tumors at advance stages. Dynamic-contrast-enhanced and diffusion-weighted MR sequences have been described as useful diagnostic tools in other locations. Our goal is to evaluate the utility of these techniques for parotid tumors.
Material and methods:We retrospectively reviewed the Parotid tumors operated by our department whit Dynamic-contrast-enhanced and diffusion-weighted MR sequences between 2012 and 2015. We correlate the results with the final histopathological diagnosis.Results: From 44 parotid tumors studied, Warthin tumors were the most common (43%). They showed high enhancement and high washout in perfusion series, so as low ADC values. Pleomorphic adenomas (41%) are hyperintense tumors in T2, with moderate constant enhancement in perfusion and high Apparent Diffusion Coefficient values. It is not possible to establish consistent results for malignant tumors given their underrepresentation in this sample.
Conclusion:Advanced MRI techniques contribute to the differential diagnosis of parotid tumors. Perfusion is useful in diagnosis of Warthin tumors and Pleomorphic adenomas. There is greater overlap in other tumors, for which diffusion-weighted MR sequences can help in discriminating malignancies. Both malignancies and Warthins show low Apparent Diffusion Coefficient values.
La fístula linfática cervical se produce por daño iatrogénico del conducto torácico en cirugías de cabeza y cuello. Ante la sospecha de una fístula linfática se debe iniciar rápidamente un manejo nutricional y seguimiento estrecho, ya que pueden tener consecuencias graves como inmunosupresión, compromiso metabólico y necrosis cutánea con exposición e incluso ruptura carotídea. A continuación se presenta el caso de un paciente con fístula linfática cervical que precisó reintervención quirúrgica para lograr el cese de la fístula.
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