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A man with a history of blind eye due to trauma 22 years earlier consulted at 53 years of age with a large conjunctival neoplastic lesion, compromising almost the entire temporal limbus, and reaching a size of approximately 16 mm on its larger diameter, in the conjunctiva. Management was started with topical and subconjunctival chemotherapy (interferon alpha-2b) in order to perform immunoreduction, but a dramatic response with total disappearance of the lesion was observed. In the follow-up time period of more than 7 years, there were no signs of recurrence.

Temporomandibular joint herniation (TJH) is a rare condition in which the contents of the temporomandibular joint herniate into the external auditory canal (EAC). The foramen of Huschke (FH), also known as the foramen tympanicum, is an anatomical defect in the anteroinferior aspect of the EAC bone, and persisting FH is thought to be one of the causes of TJH. We report a case of spontaneous TJH along with a review of the literature. A 42-year-old man with aural fullness visited our department for the examination of the temporomandibular joint and a potentially neoplastic lesion in March 2020. Computed tomography performed previously showed a soft tissue density with a bone defect in the anterior wall of the left EAC. Otoscopic examination revealed a dome-shaped raised mass in the anterosuperior wall of the left side of the EAC. The mass protruded when the mouth was closed and disappeared when the mouth was opened. The patient was diagnosed with left TJH based on the clinical and imaging findings. Due to the lack of clinical symptoms, we decided not to perform aggressive surgical treatment for TJH, but to follow up carefully with regular imaging examinations. Fifteen months have passed since the first visit, and the symptoms have not worsened. This case report shows that TJH presents with characteristic clinical and imaging findings. Therefore, understanding the pathophysiology of this disease is essential for oral and maxillofacial surgeons who deal with temporomandibular joint diseases on a daily basis.

Background Viral infection is the most common cause of salivary gland swelling as mumps which mainly affects the parotid glands. Sialolithiasis is another cause of obstruction of the salivary duct. A tumor is another cause of swelling. Around 70% of salivary gland tumors arise from the parotid glands. Benign lesions represent 57% of these tumors. Three to 5% of all tumors affecting the head and neck are represented in the salivary gland. Ultrasonography is considered a basic diagnostic tool in all salivary gland swellings. Our study is to evaluate the role of ultrasound in the evaluation of salivary glands swellings in comparison with a computed tomography scan. Results A total of 80 patients aged more than 1 year old with swellings affecting the salivary glands were collected from the out-patient clinic during the period from February 2020 to February 2021. All patients underwent ultrasonography and computed tomography examination of the neck. All submandibular gland lesions presented with sialolithiasis (40 cases) (100%), and 20 cases (50%) of parotid gland swellings presented as inflammation without stone (16 cases (40%) of acute inflammation and 4 cases (10%) with recurrent inflammation), while 4 patients only presented as sialolithiasis. Neoplastic lesions were diagnosed in 16 cases of the parotid gland group. Stones less than 3 mm were detected only by computed tomography in 5 patients (12.5%) of the submandibular group. Twenty-eight cases (70%) with stones ranged in size between 3 and 6 mm. Only 11 cases (27.5%) with stones ranged in size more than 6 mm. Of the 16 parotid swellings diagnosed with neoplastic lesions, 14 parotid cases (87%) showed well-defined margins by computed tomography and ultrasonography. Conclusions Sonography is the basic diagnostic tool in salivary glands swellings. Ultrasonography should be the initial imaging modality. Only in special cases, such as stones that could not be detected by ultrasonography or a neoplastic lesion in a deep location, or bone infiltration, computed tomography neck should be performed.

Introduction: Inflammation of the infrapatellar bursa results from various causes like trauma, infection and overuse. Superficial skin or soft tissue infection can also lead to occasional septic bursitis. Infrapatellar bursa has two parts, superficial and deep bursae. Superficial bursa inflammation reactive to adjacent superficial skin infection may occasionally lead to secondary bursitis. Case Presentation: We report a rare finding of acute right knee pain with extraordinary amount of fluid collection within superficial part of infrapatellar bursa in an elderly male patient. A secondary, septic and massive superficial infrapatellar bursitis was unusual in its appearance mimicking neoplastic lesion. Judicious use of clinical assessment and imaging helped to diagnose the condition. Conclusion: Early diagnosis and treatment of bursitis can ensure optimal outcome and it can be used to check further complications. Atypical presentation of any bursitis should be acknowledged and the judicious use of clinical assessment and imaging is critical for prompt diagnosis and treatment.

We present the case of a 47-year-old woman treated by radiochimotherapy for a glioblastoma which underwent a [68Ga]Ga-PSMA-11-PET/CT to distinguish postradiation changes from an evolutionary process. This demonstrated a weak homogeneous uptake surrounding the lesion. There was a focal and moderate uptake of a pseudo lytic skull diploe lesion near to the glioblastoma, finally attributed to a calvaria hemangioma. Calvaria hemangiomas are less frequent than vertebral hemangiomas and may demonstrate a modest PSMA uptake that one should keep in mind so as not to misinterpret the examination in patients followed for glioblastomas.

Background Colon capsule endoscopy (CCE) and CT colonography (CTC) are minimally invasive techniques for colorectal cancer (CRC) screening. Our objective is to compare CCE and CTC for the identification of patients with colorectal neoplasia among participants in a CRC screening programme with positive faecal immunochemical test (FIT). Primary outcome was to compare the performance of CCE and CTC in detecting patients with neoplastic lesions. Methods The VICOCA study is a prospective, single-centre, randomised trial conducted from March 2014 to May 2016; 662 individuals were invited and 349 were randomised to CCE or CTC before colonoscopy. Endoscopists were blinded to the results of CCE and CTC. Results Three hundred forty-nine individuals were included: 173 in the CCE group and 176 in the CTC group. Two hundred ninety individuals agreed to participate: 147 in the CCE group and 143 in the CTC group. In the intention-to-screen analysis, sensitivity, specificity and positive and negative predictive values for the identification of individuals with colorectal neoplasia were 98.1%, 76.6%, 93.7% and 92.0% in the CCE group and 64.9%, 95.7%, 96.8% and 57.7% in the CTC group. In terms of detecting significant neoplastic lesions, the sensitivity of CCE and CTC was 96.1% and 79.3%, respectively. Detection rate for advanced colorectal neoplasm was higher in the CCE group than in the CTC group (100% and 93.1%, respectively; RR = 1.07; p = 0.08). Both CCE and CTC identified all patients with cancer. CCE detected more patients with any lesion than CTC (98.6% and 81.0%, respectively; RR = 1.22; p = 0.002). Conclusion Although both techniques seem to be similar in detecting patients with advanced colorectal neoplasms, CCE is more sensitive for the detection of any neoplastic lesion. Trial registration ClinicalTrials.gov Identifier: NCT02081742. Registered: September 16, 2013.

Background The aim of this study is to investigate the role of PET/CT imaging with the 68Ga-labeled PSMA-ligand in the follow up assessment of post-operative and post-therapeutic cases of prostate cancer. All data were collected and analyzed retrospectively, enrolling 30 patients (their age range from 53 to 80 years with a mean age 67.8). The patients had been referred to a private imaging center for their assessment by 68Ga-labeled PSMA-ligand PET/CT. Results By 68Ga-labeled PSMA-ligand PET/CT, prostatic recurrent/residual neoplastic lesion was depicted in 23 (76.6%) patients, nodal metastases was present in 7 (23.3%) patients, and distant metastasis was present in 11 (36.6%) patients. The clinical and/or PSA level and/or radiological follow-up and/or the histopathological assessment for the patients served as a reference in the present study.The 68Ga-labeled PSMA-ligand PET/CT had sensitivity, specificity, positive predictive value, negative predictive value, and an overall accuracy (96.5%, 100%, 100%, 50%, and 96.6%) respectively. Conclusion 68Ga-labeled PSMA-ligand PET/CT is a very helpful tool for detection of prostatic cancer residual/recurrent lesions and restaging which can help in performing treatment plans and improve the clinical outcome and survival of the patients.

Background: Hepatocellular adenoma (HCA) is a hepatocyte derived neoplastic lesion with an increasing incidence and a strong association with oestrogen therapy. Laparoscopic resection has proven safe for small, non-ruptured lesions whilst its use for large adenomas (≥10 cm) and cases of haemorrhage requires further investigation. Methods: All patients undergoing liver resection for HCA at the Royal Brisbane Hospital between January 2003 and April 2018 were analysed. Ethics approval was obtained. Results: Thirty-three laparoscopic and three open resections were performed in 35 patients, all female, with a median age of 35 years (range 14–75). Nine laparoscopic resections were performed for large adenomas (≥10 cm) and 17 laparoscopic resections were performed for adenomas of intermediate size (5–9.9 cm). Only one conversion to open surgery was required for an intermediate sized tumour. Haemorrhage, either intratumoural, intraparenchymal or free intraperitoneal was the indication for resection in six of the 33 laparoscopic cases. Median operative time was 143 and 266 min for laparoscopically resected intermediate and large lesions, respectively. The median length of stay was 5 days (range 4–9) and no major complications were observed in the laparoscopic group. β-catenin mutation was seen in four of nine large adenomas whereas the inflammatory subtype constituted 11 of 17 intermediate sized lesions. Conclusion: Laparoscopic surgery has been demonstrated to be safe for the resection of HCA in this group of patients. Importantly, haemorrhage and/or large size were not barriers to laparoscopic resection.

Background Contrast-enhanced ultrasound (CEUS) has been used as an additional imaging technique in order to clarify testicular findings. CEUS is easy and fast to perform, overcomes the limitations of B-mode US. Objective To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the assessment of unclear testicular pathologies. Methods CEUS examinations of 45 patients with unclear testicular pathologies between 2012 and 2018 were analyzed retrospectively. Examinations were performed using B-mode, colour Doppler (CCDS) and CEUS after injection of contrast agent (SonoVue®, Bracco) and interpreted by an experienced radiologist (EFSUMB level 3). Reference standard was defined as histopathological report and clinical course. Results Overall 19 patients presented with a neoplastic lesion, whereas 14 were malignant. Matched to the histopathological report and clinical follow up, CEUS represented a sensitivity of 93% (95% -CI, 69-99), a specificity of 94% (95% -CI, 80-98), a positive predictive value (PPV) of 87% (95% -CI, 62-96) and a negative predictive value (NPV) of 97% (95% -CI, 83-99). Conclusion CEUS is an accurate additional tool to differentiate between testicular alterations when B-mode US and CCDS are uncertain. CEUS may provide additional information and detect early enhancement in small tumor lesions when CCDS comes to its limit.

Introduction: Kidneys are involved in variety of pathological processes. Renal diseases are an important cause of morbidity worldwide. Chronic pyelonephritis and its variants still continue to be the leading cause of nephrectomies in developing country like India. In some developed countries, neoplastic lesion is the commonest indication for nephrectomy. Aim: The study is carried out to study the frequency of various neoplastic and non-neoplastic lesions in nephrectomy specimens and to study histomorphological features in a teaching hospital. Materials and Methods: The t otal of 50 nephrectomy cases were studied. Detailed clinical finding were collected from case sheets. Detailed gross findings and histomorphological features were studied. Results: Out of 50 lesions 35 were non neoplastic and 15 were neoplastic. Out of 35 nephrectomy lesions, 32 cases were of chronic pyelonephritis and males (n=18) were commonly affected than female (n=14). Out of 15 neoplastic lesions majority(n=12) were renal cell carcinoma and most commonly (n=12) involved males. Conclusion: In developing country like India pyelonephritis is the commonest cause of nephrectomy. Better treatment modalities of inflammatory lesions of kidney in the develop ing countries will reduce the rate of nephrectomies. Keywords: Kidney, Carcinoma, Chronic, Pyelonephritis.

Epstein-Barr virus (EBV) has been associated with about 9% of all gastric carcinomas, but its role in gastric carcinogenesis remains unclear since there is lack of evidence of EBV presence in pre-neoplastic lesions of gastric mucosa. This study intends to determine the prevalence of EBV in gastric dysplasia and superficial neoplasia to clarify whether EBV infection is an early or late event in gastric cancer development. This retrospective study included a total of 242 gastric lesions from 199 consecutive patients who were referred for endoscopic resection. The histological classification of lesions includes 137 low- and high-grade dysplasia and 105 superficial carcinomas. EBV infection was investigated by EBER-ISH. Results showed that EBV was not detected in any epithelial cells of any case with dysplasia or superficial carcinomas, although we observed the presence of a small number of EBV-infected lymphocytes in 2.1% of all lesions. These results showed that EBV is not present in gastric dysplasia neither in superficial carcinomas suggesting that EBV carcinogenesis is a late event in well/moderately differentiated gastric carcinogenesis., Joana Ribeiro was granted with a PhD Scholarship (SFRH/BD/107740/2015) from FCT-Fundação para Ciência e Tecnologia.

The present study emphasizes on the diagnostic value of Orthopantomography and different appearances of pathologies in panoramic radiographs. Orthopantomography (OPG) has proved its work in dentistry for many years, which often offers a valuable alternative beyond the supplementary evidence provided by routine radiological techniques. It is concluded that OPG is of great value when you are suspecting multiple dental pathology & either maxillary or mandibualr cystic or neoplastic lesion. In case of trauma it is mandatory for complete evaluation as well as pre & post-operative evaluation.

ObjectiveArtificial intelligence (AI) may reduce underdiagnosed or overlooked upper GI (UGI) neoplastic and preneoplastic conditions, due to subtle appearance and low disease prevalence. Only disease-specific AI performances have been reported, generating uncertainty on its clinical value.DesignWe searched PubMed, Embase and Scopus until July 2020, for studies on the diagnostic performance of AI in detection and characterisation of UGI lesions. Primary outcomes were pooled diagnostic accuracy, sensitivity and specificity of AI. Secondary outcomes were pooled positive (PPV) and negative (NPV) predictive values. We calculated pooled proportion rates (%), designed summary receiving operating characteristic curves with respective area under the curves (AUCs) and performed metaregression and sensitivity analysis.ResultsOverall, 19 studies on detection of oesophageal squamous cell neoplasia (ESCN) or Barrett's esophagus-related neoplasia (BERN) or gastric adenocarcinoma (GCA) were included with 218, 445, 453 patients and 7976, 2340, 13 562 images, respectively. AI-sensitivity/specificity/PPV/NPV/positive likelihood ratio/negative likelihood ratio for UGI neoplasia detection were 90% (CI 85% to 94%)/89% (CI 85% to 92%)/87% (CI 83% to 91%)/91% (CI 87% to 94%)/8.2 (CI 5.7 to 11.7)/0.111 (CI 0.071 to 0.175), respectively, with an overall AUC of 0.95 (CI 0.93 to 0.97). No difference in AI performance across ESCN, BERN and GCA was found, AUC being 0.94 (CI 0.52 to 0.99), 0.96 (CI 0.95 to 0.98), 0.93 (CI 0.83 to 0.99), respectively. Overall, study quality was low, with high risk of selection bias. No significant publication bias was found.ConclusionWe found a high overall AI accuracy for the diagnosis of any neoplastic lesion of the UGI tract that was independent of the underlying condition. This may be expected to substantially reduce the miss rate of precancerous lesions and early cancer when implemented in clinical practice.

Central giant cell granuloma in the mandibula: clinical, radiological and histopathological study in 2 clinical cases. Central giant cell granuloma (CGCG) is a benign and proliferative lesion of the jaw, with an unknown etiology. It is widely considered to be a neoplastic lesion. The current etiology of GCGC is still unclear, although local inflammation, bleeding, and trauma have been suggested. The biological behavior of CGCG of the jaw varies from resting to aggressive with destructive expansion. The incidence in the general population is very low, and patients are generally under 30 years of age females. In this study, we report two cases of GCGC in 8-year-old and 13 year old girls treated surgically

A partial or complete resolution of the neoplastic lesion, either spontaneously or in the presence of therapy that is considered inadequate to exert significant influence on the growth of the neoplastic lesion, is considered a spontaneous regression. This phenomenon is extremely rare in lung neoplasms. A close follow up with imaging along with bronchoscopy and a biopsy of the lesion is essential, as they may have potential for distant spread even during radiological regression. Here, we report a case of a partial resolution of a bronchial carcinoid tumor that had a high mitotic activity and was resected.

Almost any colorectal superficial neoplastic lesion can be treated by endoscopic resection (ER) but very little is known about outcomes of ER leaving circumferential or near-circumferential mucosal defects. We report the outcomes of ER leaving ≥ 75% circumferential mucosal defects performed in a western expert centre. Five hundred eighty-seven ERs of large colorectal lesions ≥ 20 mm were grouped according to the extent of the mucosal defect and comparisons made between those with

Aim of this case report is to present a rare case of primary malignant melanoma of brain stem at the region of medulla oblongata mimicking as cavernoma. 40-year-old male presented with vertigo, headache, dizziness for 1 month. MRI showed pear shaped T1 hyperintense lesion at medulla oblongata and predominantly hypointense on T2 with focal area of hemorrhage. Lesion showed diffuse enhancement on postcontrast images. On plain CT lesion was Hyperdense. It was initially reported as Cavernoma. Surgical excision of lesion was done with per-op findings of solid, dark maroon colored lesion with hemorrhage. Histopathology showed neoplastic lesion with abundant melanin pigment deposition. The lesion was finally diagnosed as Malignant neoplasm with features favoring Malignant Melanoma.

Objetivo: realizar un estudio descriptivo sobre Cáncer Colorrectal en Cova da Beira Portugal y el valor pronóstico de BCL2 en asociación con la localización del tumor, Estadificación TNM, y tipo histológico. Materiales y Métodos: se realizó un estudio en 29 pacientes que tuvieron cirugía curativa para la escisión de Cáncer Colon Rectal (CCR) en Centro Hospitalario Cova da Beira con el objetivo de verificar si la presencia de la oncoproteína BCL2 en células neoplásicas es un factor predictivo del pronóstico, verificando también si es predictivo de la estadificación TNM, localización y diferenciación celular en el Cáncer Colon Rectal. Resultados: los hallazgos de este estudio coinciden con lo reportado en la literatura, se encontró que la incidencia del CCR es mayor en hombres que en mujeres, el riesgo de la enfermedad aumenta con la edad y la localización más frecuente de lesión neoplásica es en la porción izquierda del colon, con un total de 26 casos (89,65%). Además, se encontró asociación estadística de la expresión de BCL2 con el pronóstico y con la diferenciación histológica. Conclusión: a pesar de las limitaciones de este estudio, los datos hallados guardan relación con lo reportado en la literatura y establecen una asociación estadística de la expresión de BCL2 con el pronóstico y con la diferenciación histológica.

Cemento-ossifying fibroma (COF) is a benign tumor classified under fibro-osseous lesions characterized by the proliferation of fibrous tissue associated with the presence of osteoid or cementicle-like masses. COF of bony origin is highly neoplastic in nature compared to their soft tissue counterparts which are relatively rare. The authors here present a case report of COF arising from the left upper lip in a 10-year-old female patient. The lesion was initially asymptomatic, slow-growing in nature, and later turned painful over a period of eight months. A medical CT was taken to elicit a calcified mass seen at the left subcutaneous plane of the upper lip. The lesion was surgically treated by complete excision under local anaesthesia and sutured. Follow-up was done for a period of one year to assess for recurrence which was not evident in this case. This case report, being a peculiar case of COF arising from the soft tissue of the upper lip, describes the clinical presentation, diagnostic imaging, histopathological evidence, and brief surgical management of the lesion.

Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. The aim of this review is to focus on first-line, second-line, and maintenance therapies as well as follow-up of women with VLS. With numerous controversies, we decided to conduct a scoping review on this subject. A review protocol was developed, and the Knowledge Resource Services website was used to run a search of articles pertaining to VLS with keywords “Vulvar,” “Vulval,” and “Lichen Sclerosus.” The search was limited to published data from the last 10 years, i.e., July 2009 onward, and researches published in English language. A total of 338 articles pertaining to VLS were obtained. Out of this, 62 were original articles related to management of VLS. Effective treatments such as high-potency topical steroids are now the standard of care and first-line treatment. Follow-up may be done every three to six months for the first two years and then at least yearly to ensure adequacy of treatment and encourage compliance. Long-term follow-up in specialist clinics is recommended for women who have persistent complaints, thickened skin, or history of neoplastic lesion. Monitoring young patients yearly is recommended as there are chances of recurrence.

Synchronous pancreatobiliary tumors are exceptionally found and high suspicion is needed in order to prevent overlooking of a synchronous neoplastic lesion. We report a rare case of a patient initially diagnosed of a 2 cm pancreatic cyst by nuclear magnetic resonance and diagnosed 11 months later of a synchronic pancreatobiliary tumor (pancreatic adenocarcinoma and an invasive ampullary adenocarcinoma) by an endoscopic ultrasonography.

The Paris classification has been widely used as a macroscopic classification of superficial neoplastic lesion in colon (Fig. 2.1) [1]. In brief, it is divided into polypoid and non-polypoid (superficial) lesion. In this classification, the height of the 0-Is lesion is clearly defined in each organ. As for neoplasia in the columnar epithelium (Barrett’s esophagus, stomach and colon), 0-Is lesion is determined to be higher than 2.5 mm (the height of the closed biopsy forceps). On the other hand, regarding neoplasia in the squamous cell epithelium, 0-Is lesion is determined to be higher than 1 mm. The reason for this is based on the fact that esophageal squamous carcinoma higher than 1 mm shows high frequency of submucosal invasion.

A collision tumor is a neoplastic lesion comprised of two or more distinct cell populations that maintain distinct borders. Collision tumors, which are rare but well documented, can be composed of two benign tumors, a benign and malignant tumor, and two malignant tumors. Although case reports and reviews on specific types of collision tumors exist, a cohesive source discussing these tumors is lacking. We critically reviewed the literature by analyzing case reports and retrospective studies in order to evaluate the following regarding collision tumors: definitions, types, pathogenesis, diagnosis, and management. Reports of these tumors are infrequent but not insignificant, and accurate classification and diagnosis will lead to better patient outcomes.