No abstract

Klippel-Trenaunay syndrome (KTS) is characterized by port-wine hemangiomas, deep venous system abnormalities, superficial varicosities, and bony and soft-tissue hypertrophy. When associated with an arteriovenous fistula, it has been termed Klippel-Trenaunay-Parkes-Weber syndrome. It is imperative that both the radiologist and surgeon be aware of this entity, as incomplete evaluation and inappropriate surgery may be devastating. Radiological workup includes phlebography, angiography, and conventional radiography of the involved extremities. Surgery should be performed only to relieve deep venous obstruction (if present) or to correct inequality in the lengths of legs. Removal of superficial varicosities is contraindicated because it will worsen existing symptoms. Five cases of KTS are presented and the literature reviewed.

Eleven cases of sonographically detected metastatic disease to the gallbladder are reported. This paper represents the first comprehensive review of the ultrasonographic findings in this not infrequently encountered disease process. Four distinctive sonographic diagnostic patterns have evolved and are described. The suspicion of metastatic tumors in the gallbladder should be raised, particularly in the presence of focal gallbladder wall thickening in association with nonshadowing intraluminal soft tissue masses. In contrast to primary carcinomas of the gallbladder, cholelithiasis usually is absent. The differential diagnosis, which includes various benign conditions of the gallbladder, is discussed.

Scrotal ultrasound examinations of 23 male adults and children with the diagnosis of lymphoproliferative disease (LPD) were performed. Diagnoses included acute lymphoblastic leukemia (ALL) (six patients); acute myelogenous leukemia (AML) (one patient); chronic lymphocytic leukemia (CLL) (nine patients); non‐Hodgkin's lymphoma (four patients); Hodgkin's lymphoma (three patients). Sonography‐biopsy correlation was 100% in identifying testicular infiltrates. Nine of ten patients with testicular involvement had bilateral disease. Six patients had nonpalpable disease correctly identified by sonography. Ultrasound has great potential value as a screening modality for testicular biopsy in ALL and for detecting subclinical or nonpalpable disease in adults with LPD.

We report 4 cases of peripelvic extravasation caused by tumor obstruction of the ureter. A urinoma developed in 3 of the 4 cases. Review of the literature reveals only 5 previously reported cases of peripelvic extravasation secondary to tumor obstruction of the urinary tract. We discuss the mechanics of peripelvic extravasation and urinoma formation, and conclude that tumor obstruction of the ureter must be considered in all cases of peripelvic extravasation.