CGRP receptor expression in human pulp tissue is significantly increased during inflammatory phenomena such as acute irreversible pulpitis.

Objectives To evaluate the feasibility of contrast-enhanced mammography (CEM)-guided biopsy at Hospital del Mar, a Spanish university hospital. Methods We retrospectively reviewed all consecutive women with a suspicious enhancing finding eligible for CEM-guided biopsy, who were prospectively enrolled in a pre-marketing clinical validation and feasibility study (October 2019 to September 2021). CEM-guided biopsy is a stereotactic-based procedure that, by using intravenous iodinated contrast media administration and dual-energy acquisition, provides localisation of enhancing lesions. All the biopsies were performed using a vacuum-assisted device. We collected procedural characteristics (patient position and type of approach), and histopathological results. Feasibility endpoints included success (visualisation of the enhancing lesion, post-procedural biopsy changes and clip placement), procedural time, number of scout acquisitions and complications. Results A total of 66 suspicious enhancing lesions (18.0% foci, 44.0% mass, 38.0% non-mass enhancement; median size 8.5 mm) in 64 patients (median age 59 years, mostly minimal [48.4%] or mild [32.8%] background parenchymal enhancement) were referred for CEM-guided biopsy in the study period. The success rate was 63/66 (95.4%). Amongst successful procedures, patients were most frequently seated (52/63, 82.5%) and the preferred approach was horizontal (48/63, 76.2%). Median total time per procedure was 15 min. Median number of acquisitions needed before targeting was 2 (range 1–4). Complications consisted of hematoma (17/63, 27%) and vasovagal reaction (2/63, 3.2%). At histology, the malignancy rate was 25/63 (39.7%). Conclusion In this first patient series, CEM-guided breast biopsy was feasible, with success and complication rates similar to those previously reported for magnetic resonance guidance. Key points • CEM may be used to guide biopsy of enhancing lesions through a stereotactic-based procedure combined with intravenous iodinated contrast media administration and dual-energy acquisition. • In this first patient series (n = 64), the success rate of CEM-guided biopsy was above 95%, the only complications were hematoma (22.2%) and vasovagal reaction (3.2%), and median total time per procedure was 15 min. • CEM-guided biopsy is feasible and could potentially be a widely available biopsy technique for enhancing-only lesions.

Carcinoma de células renales;Neoplasias del colon sigmoide; Adenocarcinoma; Neoplasias primarias múltiples; Hallazgos incidentales; Nefrectomía ResumenObjetivo: Presentar el caso clínico, el manejo posterior y los resultados histopatológicos de un paciente masculino de 67 años de edad con diagnóstico de adenocarcinoma de colon sigmoide, metástasis en hígado y tumor renal izquierdo, el último como hallazgo incidental en imágenes prequirúrgicas. Método: Descripción del caso y revisión sistemática de la literatura sobre reportes de casos análogos.Resultados: Se realiza nefrectomía abierta izquierda, sigmoidectomía y metastasectomía hepática por laparotomía, en el mismo tiempo quirúrgico en el Hospital Universitario de la Samaritana, Bogotá. Conclusión: El carcinoma de células renales y adenocarcinoma de colon como tumores primarios múltiples sincrónicos representan una entidad clínica conocida, de baja incidencia. Usualmente detectado de manera incidental como hallazgo durante la estadificación del cáncer de colon, en pacientes previamente asintomáticos. El manejo recomendado es quirúrgico, de preferencia en el mismo tiempo operatorio por laparotomía, sin embargo, se han descrito casos abordados por laparoscopia sin morbimortalidad.

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