Rhabdomyosarcoma is the most common soft tissue sarcoma of childhood and adolescence. Gross dissemination as multifocal solid masses to unusual sites such as breasts are rare, as we encountered in this case.In this report, we will be highlighting a rare case of disseminated rhabdomyosarcoma that presented as compressive thoracic myelopathy with bilateral multiple breast masses; which was diagnosed after radiological and histopathologic examination.

AIMS AND OBJECTIVESTo study the pattern of brain involvement in acute hepatic encephalopathy in patients with chronic liver disease and correlate the extent of involvement on magnetic resonance imaging with serum ammonia and clinical severity. MATERIALS AND METHODSThirty patients with clinical or radiological evidence of chronic liver disease who presented with acute onset neuropsychiatric symptoms with a clinical diagnosis of acute hepatic encephalopathy. A detailed history was taken. Status of chronic liver disease confirmed, serum ammonia values estimated and magnetic resonance imaging done within 7 days of admission. The anatomic pattern of involvement in FLAIR and DWI (comparison with ADC maps) noted. The initial clinical severity (assessed by West Haven grade) and serum ammonia values were recorded and correlated with extent of involvement in magnetic resonance imaging. The patients were followed up for 21 days from the day of MRI to get an idea about inpatient or outpatient status; however, no clinical or radiological end points were evaluated. OBSERVATION AND RESULTSOn FLAIR and DWI, there were abnormalities in PLIC (73.3%, 60%), thalamus (63.3%, 53.3%), PVWM (26.7%, 16.7%) and IC (36.7%, 23.3%). There was significant correlation (P<0.05) for PVWM (P=0.001, 0.002) and IC (P=0.005, 0.009) involvement with clinical severity on FLAIR and DWI. There was no significant correlation for PLIC (P=0.371, 0.162) and thalamic (P=0.252, 0.92) involvement. All the patients showed elevated serum ammonia values and a period of inpatient stay >21 days. CONCLUSIONThe constellation of anatomic involvement in the appropriate clinical setting is suggestive of acute hepatic encephalopathy. Involvement of PVWM and IC indicated a higher grade of initial clinical severity.

BACKGROUNDContrast-enhanced MR imaging of breast characterises the lesion more accurately than mammography or sonography. This contributes to the distinction between benign and malignant lesions. Multifocal and contralateral lesions can also be better detected by MR imaging. Aims-To differentiate benign from malignant breast lesions that have been detected on MRI by analysing qualitative lesion characteristics. To compare and correlate the radiological diagnosis with the final histopathological diagnosis. MATERIALS AND METHODSA prospective study on 41 cases was conducted in the Department of Radiodiagnosis, Govt. Medical College, Kozhikode during the period of Aug. 2009 to July 2010 who were undergoing MR imaging of breast for characterisation of lesions. Morphological parameters of the lesions were correlated with the final histopathological diagnosis. RESULTS 66.6% of benign lesions showed well-defined (Oval, round, lobulated) shape while none of the malignant lesions demonstrated this. Irregular shape was observed in all the malignancies. Smooth margin was observed in 66.7% of benign lesions while illdefined margin like irregular & spiculated constituted 70% and 25% respectively in malignancies. None of the malignant lesions showed smooth margin. CONCLUSIONWell-defined shape and smooth margin were characteristic of benign lesions. Spiculated margin was highly specific for malignancy. Both irregular and spiculated margin had a high predictive value for malignancy. Submission 23-03-2017, Peer Review 12-05-2017, Acceptance 19-05-2017, Published 25-05-2017. Corresponding Author: Juvaina Puthiyakam, Assistant Professor, Department Radiodiagnosis, Government Medical College, Kozhikode. E-mail: juvaina.faiz@gmail.com DOI: 10.14260/jemds/2017 2. To compare and correlate the radiological diagnosis with the final histopathological diagnosis. KEYWORDS MATERIALS AND METHODS Study DesignDescriptive study; Diagnostic test evaluation. Study SettingAll patients undergoing MR imaging of breast at Dept. of Radiodiagnosis, Govt. Medical College, Kozhikode for characterisation of breast lesions detected clinically, by x-ray mammography or by ultrasonography. Study Period August 2009 to July 2010Study Method 41 cases of breast lesions were evaluated with MRI. Morphologic parameters like shape and margin were studied.Final histopathological report of all the lesions were compared and correlated with MRI findings.

BACKGROUND Ovarian cancer is one of the leading causes of death, 5 th among the other causes of cancer related in women. Accurate diagnosis and staging helps in tailoring the management and also reducing the unnecessary burden of surgeries. Aim-To assess the accuracy of CT evaluation in diagnosis of ovarian tumours and their differentiation into benign and malignant categories. MATERIALS AND METHODS Seventy-nine patients who were clinically diagnosed as adnexal mass and were suggested CECT examination for the same were evaluated in Department of Radiodiagnosis during March 2015 to September 2016. The results of CECT were correlated with postsurgical HPR diagnosis. RESULTS CECT was proved to have 87.1% sensitivity and 92.5% specificity in distinguishing benign and malignant tumours. Premenopausal age group had higher incidence of benign pathology, whereas postmenopausal group had higher incidence of malignant pathology. CONCLUSION CECT evaluation can be a choice of investigation in initial evaluation of ovarian tumours due to its diagnostic accuracy and easy availability.

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