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Body composition, currently evaluated by computed tomography scan, is related to poor evolution and severity of Crohn's disease (CD). Few MRI studies have been performed, yet it is the most commonly used imaging modality for the surveillance of the disease. Evaluate the feasibility of MRI body composition measurement and compare the variation according to the activity of the disease. A cohort of 132 consecutive patients was studied. The visceral adiposity index (VAI), subcutaneous adiposity index (SAI) and skeletal muscle index (SMI) were measured. Patients were divided into 2 groups according to disease activity. Sarcopenic status was defined according to the cut off value (SMI < 38.9 cm2/m2 in women and < 54.4 cm2/m2 in men). MRI measurements of body composition parameters were feasible and reproducible. After adjustment, sarcopenia was more common (2.07 [1.02; 4.27], p = 0.046), and the SMI (−4.90 [−9.36; −0.431], p = 0.032) was lower in active disease. The SAI was lower (−14.7 [−29.8; 0.258], p = 0.054) in active disease. The VAI tended to be higher with active disease (3.91 [−3.50; 11.9], p = 0.34), and the VAI/SAI+VAI ratio was higher (9.40 [4.72; 14.1], p <0.001). Assessment of body composition is feasible and reproducible in routine MR and parameters are related to disease activity. [ABSTRACT FROM AUTHOR]

Abstract Background The long-term management of perianal Crohn's disease for patients on anti-TNF-α therapy remains challenging. Aim To evaluate the long-term course and complications of patients with perianal fistulas treated with anti-TNF-α based on their clinical remission and healing on MRI. Methods Patients were evaluated clinically and by MRI. Deep remission was defined as clinical remission associated with the absence of contrast enhancement and T2 hyperintensity on MRI. Flare-free survival, surgery and hospitalizations were compared based on the presence or not of deep remission. Results Forty-eight consecutive patients were included with a median follow-up of 62 months after anti-TNF-α first administration. Deep remission was observed in 16 patients (33.4%). For patients in deep remission, the median time to any perianal event was 116 months (95–130) versus 42 months (8–72) in patients with pathological MRI (p < 0.001). Sixteen patients (50%) with pathological MRI had perianal surgery versus 2 (12.5%) in the deep remission group (p < 0.05). The mean duration of cumulative hospital stays was 0.75 ± 0.52 days in the deep remission group versus 19.7 ± 7.4 in the pathological group (p < 0.05). Conclusions Higher flare-free survival and lower rates of surgery and hospitalization were found in patients achieving deep remission. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Solitary fibrous tumour (SFT) of the larynx is a rare benign mesenchymal tumour of adults. The diagnosis is based on a combination of histological and immunohistochemical signs. Case report: The authors report the case of a patient with chronic laryngeal dysphonia and dyspnoea related to supraglottic SFT. Discussion/Conclusion: The main challenge of surgery is to ensure healthy resection margins to avoid recurrence while preserving the functions of the upper aerodigestive tract. Surgery is the treatment of choice and provides an excellent prognosis. Long-term clinical follow-up is required to detect rare recurrences. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Kidney cancer, and especially clear cell carcinoma, has an unpredictable clinical course, with metastatic potential that is variable over time and in location. Six percent of atypical locations are ENT. The three most frequent sites are the thyroid, sinus and parotid gland. Case report: We report two rare locations: the base of the tongue, and the sphenoid sinus. Discussion: First-line treatment is surgical, due to low radiosensitivity, with radiation therapy as a possible second line. Functional impact is a prime issue, to avoid functional mutilation. Conclusion: Such metastases may sometimes occur years after the discovery of the primitive renal tumor; any history of kidney cancer should, therefore, be noted in patients with suspect ENT lesions. [Copyright &y& Elsevier]

Summary: Introduction: Cervical subcutaneous emphysema and pneumomediastinum are often secondary to trauma, surgery or infection. More rarely, they can be spontaneous with no identified cause, but forced Valsalva manoeuvres are a known predisposing factor. Any forced effort with a closed glottis, such as sneezing, can cause rupture of the mucosa leading to the formation of cervical subcutaneous emphysema and pneumomediastinum. Case report: The authors report the case of a 30-year-old man with cervical subcutaneous emphysema complicated by pneumomediastinum due to fistula of the piriform sinus following sneezing while simultaneously obstructing both nostrils. Discussion/Conclusion: Rupture of the mucosa of the piriform sinus is an extremely rare complication of this type of manoeuvre. This condition requires management in hospital due to the risk of infection with cervical cellulitis progressing to mediastinitis. Simultaneously obstructing both nostrils during sneezing is a dangerous manoeuvre that should be avoided. [ABSTRACT FROM AUTHOR]