Neck Vessels: Carotid body tumor

What is it?

ajronline.org

Carotid body tumors (CBTs) are rare neoplasms that develop within the adventitia of the medial aspect of the carotid bifurcation. The carotid arteries are on either side of the neck and supply blood to the front aspect of the brain, which deals with thinking, speech, personality, sensory, and motor functions reside.   Carotid body tumors are also known as chemdectoma or paragangliaoma and are found in the upper portion of the neck.   Carotid body tumors can occur in children; however, these tumors are noted most commonly in the middle age portion of the population.  CBTs are noted to be inherited in 10-50% of the cases.




Forms of CBTs

The following 3 different types of carotid body tumors (CBTs) have been described in the literature:

• Familial
• Sporadic
• Hyperplastic

ajronline.org

"The sporadic form is the most common type, representing approximately 85% of carotid body tumors (CBTs)." "The familial type (10-50%) is more common in younger patients." "The hyperplastic form is very common in patients with chronic hypoxia, which includes those patients living at a high altitude (> 5000 feet above sea level), like those patients living in New Mexico, Peru, and Colorado."  ^"The hyperplastic form is also seen in patients with COPD or cyantoic heart disease."
(All information from:http://emedicine.medscape.com/article/1575155-overview#aw2aab6b2b1aa )


Treatments

medical.toshiba.com

Carotid body tumors are not deadly, but would need to be removed.  CBTs are aggressive and need to be removed multiple times surgically.  Surgery is not the only option because sometimes patients will also use radiation therapy to rid of the tumors. The turnout of surgery is very good; however, with every surgery case there is always a risk.



More information on this topic can be found at:
http://my.clevelandclinic.org/heart/disorders/vascular/carotid_body_tumors.aspx (or)
http://emedicine.medscape.com/article/1575155-overview#aw2aab6b2b1aa

Ashli

Soft Tissue Neck: Parathyroid adenoma

What is parathyroid adenoma?

smmhc.adam.com

Parathyroid adenoma is a benign tumor of the parathyroid glands, which are located in the neck.  Women over 60 are most likely to have parathyroid adenoma or also individuals with great radiation does to their head or neck can also develop parathyroid adenoma.  Parathyroid adenoma is due to a genetic problem and the most common is hyperparathyroidism.  The parathyroid glands in an individual's neck produce parathyroid hormone (PTH), which control calcium, Vitatmin D, and phosphorus levels within the blood and bone of the individual.  


Symptoms

Some patients may not have any symptoms and parathyroid adenoma maybe diagnosed accidentally after a routine blood test.  If a patient does have symptoms so of those may include:

• 
  Bone fractures
• Confusion
• Constipation
• 
  Kidney stones
• Lethargy
• Muscle pain
• Nausea
   (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002170/)

Tests and Treatments

CT image - endocrinesurgeon.co.uk

Blood tests are most commonly done to check the levels of parathyroid hormone, and urine tests are done to check for increased calcium in the urine.  Other tests consist of MRI of the neck, US of neck or kidneys, Bone density exam, or  CT of kidneys.  As far as treatments, surgery is the most common type unless you have hyperparathyroidism then you would have check-ups with your doctor.




More information regarding parathyroid adenoma can be found at:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002170/

Ashli House

CT/MRI-Cranial Nerves and Vessels: Moyamoya disease

What is it?

Moyamoya disease is a cerebrovascular disorder caused by blocked arteries near the basal ganglia.  It affects the Circle of Willis and surrounding arteries.    Moyamoya disease is very rare and progressive.  The disease was first discovered in the 1960's in Japan and primarily affects children, but can occur in adults.  Moyamoya means "puff of smoke" in Japanese. Moyamoya disease has a strong family history and  an inherited genetic abnormality. 



Symptoms

medscape.org

Symptoms vary with children and adults.  The first symptoms of children are often times stroke or TIAs.  Children have muscle weakness, paralysis of one size, or sometimes seizures.  Most adults experience a hemorrhagic stroke due to constant blood clots in the affected brain vessels. 

Individuals may experience:

• speech deficits
• sensory and cognitive impairments
• disturbed consciousness
• involuntary movements
• vision problems

(http://www.ninds.nih.gov/disorders/moyamoya/moyamoya.htm)


Diagnosis & Treatments

Magnetic resonance imaging (MRI) or cat scan (CT) can be used to identify Moyamoya disease.  MRI exams are the gold standard because of the detail.  "There are several types of revascularization surgery that can restore blood flow to the brain by opening narrowed blood vessels or by bypassing blocked arteries" (http://www.ninds.nih.gov/disorders/moyamoya/moyamoya.htm). Children normally respond better to surgery than adults.  After surgery most patients have no more strokes or other problems related to the diease.  

medscape.org

More information:
http://www.ninds.nih.gov/disorders/moyamoya/moyamoya.htm
or
http://emedicine.medscape.com/article/1180952-overview

Ashli 

CT Sinus and Facial bones: Angiofibroma

What is it?

radpod.org

 

Angiofibroma is often known as a nasal tumor or  juvenile angiofibroma.  Juvenile angiofibroma is a growth on the back of the upper throat or nose, which is noncancerous. Juvenile angiofibroma is not very common and is often found in young boys.  The tumor contains blood vessels and causes bone damage.



Symptoms...

• Difficulty breathing through the nose
• Easy bruising
• Frequent or repeated nosebleeds
• Hearing loss
• Nasal discharge, usually bloody
• Prolonged bleeding
• Stuffy nose

(Info above: http://www.pennmedicine.org/encyclopedia/em_DisplayArticle.aspx?gcid=001572&ptid=1)

medscape.com

Diagnosis

Juvenile angiofibroma can be diagnosed by several different methods.  The doctor can simply diagnose by examining the patients upper throat.  Also, CT scan or MRI scan can diagnose a patient's juvenile angiofibroma.  






Treatment
 

medscape.com

Treatments vary with juvenile angiofibroma.  Sometimes angiofibroma grow larger and can cause different problems with patients.  An angiofibroma can block an airway or cause an individual to have regular nosebleeds.  Sometimes individuals do not even need treatment, but other severe cases of angiofibroma need treatment.  Sometimes surgery or embolization may be required.  Surgery will remove the tumor completely; however, removal can be a challenge because of the position of the tumor.  The tumor is not enclosed and will spread to other areas.  Embolization may be chosen because it is a procedure that can prevent bleeding within the tumor.  Embolization would be the first option, but if the procedure didn't work then surgery would be the last option.  Even after surgery the tumor can still return.





For more information on angiofibroma, please visit:
http://www.pennmedicine.org/encyclopedia/em_DisplayArticle.aspx?gcid=001572&ptid=1

Ashli 

Orbits: Brown's syndrome

What is Brown's syndrome?


Brown's syndrome is know as Superior Oblique Tendon Sheath syndrome.  Brown's syndrome was named after Dr. Harold W. Brown.  The syndrome consists of a mechanical problem in which the superior oblique muscle doesn't move freely.  Patients have trouble looking up and in with the affected eye. Brown's syndrome patients are 90% of the time affected in one eye and majority of the time it is the right eye that is affected. The figure below is just an image to show which muscle is affected.

http://www.aapos.org/faq_list/brown_syndrome

 

 

 

What causes Brown syndrome?
The cause of Brown's syndrome is unknown.  Heredity cases of Brown's syndrome are quite rare.  People 
 just seem to have Brown's syndrome randomly. "These abnormalities may include a reduced elasticity of the superior oblique muscle and tendon, a thickened tendon, a short and/or tight sheath, or fibrous adhesions (scarring) of the tendon" (http://www.aapos.org/faq_list/brown_syndrome).  Brown's syndrome can also be caused post-surgery around the upper portion of the eye, from blunt trauma to the upper corner of the eye area, or from inflammation. The picture below shows how people are affected by the syndrome.

Clinical Characteristics of Brown Syndrome

1." Vision and stereo acuity usually normal"

2. "Chin up face points to opposite side"

3."Deficient elevation in adduction"

4. "Usually some elevation limitation in straight upgaze and in abduction"

5. "Widened palpebral fissure on adduction"

6. "May or may not have downshoot of involved eye in adduction"

7. "May be acquired"

8. "May be intermittent with or without pain"

(all info above from:  http://www.cybersight.org/bins/volume_page.asp?cid=1-3-4-18 ) 

Axial section of T1 contrast MRI  (http://webeye.ophth.uiowa.edu/eyeforum/cases/50-Acquired-Brown-Syndrome-Ethmoid-Mucocele.htm)

 

 

Treatment 

Treatment of Brown's syndrome varies with the severity of the disease. Occasionally Brown's syndrome cures itself.  Nonsurgical and surgical advise is given for differently acquired Brown's syndrome.  Nonsurgical treatment is recommended for patient that acquired Brown's syndrome after traumatic accidents or newly developed cases.  Patients with inflammation from Brown's syndrome will sometimes receive corticosteroids or take anti-inflammatory medications.  "Surgical treatments are recommended if any of the following are present: eye turns down when looking straight ahead, significant double vision, compromised bincocular vision or pronounced abnormal head position" (http://www.aapos.org/faq_list/brown_syndrome).

For more information on Brown's syndrome, please visit:

http://www.aapos.org/faq_list/brown_syndrome
http://www.cybersight.org/bins/volume_page.asp?cid=1-3-4-18

Ashli

Pituitary: Macroadenoma

What is it?

Macroadenoma is a benign growth of more than 10 mm in size in the pituitary gland.  A microadenoma is different because it is a growth of less than 10 mm in size.  The image below shows the differences in sizes of the macroadenomas or microadenomas. 

radonc.ucla.edu

 

Macroadenomas are not as common as microadenomas.  There are several types of pituitary macroadenomas depending on if they produce hormones or not.  A functioning pituitary macroadenoma makes one or more pituitary hormones; whereas, a nonfunctioning pituitary macroadenoma does not make hormones.  Each type of pituitary macroadenoma can have different symptoms depending on the hormones produced in the individual.  For example, functioning pituitary macroadenoma include:

• "Prolactin-producing macroadenomas"
• "Growth hormone-producing macroadenomas"
• "ACTH-producing macroadenomas"
• "Thyroid hormone-producing macroadenomas" 

(http://endocrine-system.emedtv.com/pituitary-macroadenoma/pituitary-macroadenoma-p2.html)

 Symptoms

The symptoms of macroadenoma can range from simple to complex.  Some symptoms could be headaches, vomiting, or dizziness. Symptoms vary because of the size of the macroadenoma.  If the macroadenoma grow larger, it could possibly press on certain parts of the brain.  A macroadenoma could press on the optic nerve, which could cause vision problems. Symptoms also vary depending on the hormones produced by the macroadenoma. Hormones tumors could cause hyperthyroidism, Cushing syndrome, or hyperprolactinemia.

radiopaedia.org

 

Diagnosis/Treatments

Diagnosis could be concluded by the tests listed:

 

• "Blood tests to measure hormone levels"
• "Computed tomography (CT) scans"
• "Magnetic resonance imaging (MRI) scans"
• "Petrosal sinus samplings"
• "Eye exams." 

(http://endocrine-system.emedtv.com/pituitary-macroadenoma/pituitary-macroadenoma-p3.html)

Pituitary macroadenoma treatment options vary based on:

 

• "The type of pituitary macroadenoma (see Types of Pituitary Tumors)"
• "The symptoms of its hormone activity"
• "How far the macroadenoma has spread into the brain"
• "The patient's age and overall health." 

(http://endocrine-system.emedtv.com/pituitary-macroadenoma/pituitary-macroadenoma-p3.html)

Treatments for a pituitary macroadenoma can include radiation therapy, surgery, and drug therapy.f

mayfieldclinic.com

If you would like any additional information on macroadenoma go visit:

-http://emedicine.medscape.com/article/123223-overview
-http://endocrine-system.emedtv.com/pituitary-macroadenoma/pituitary-macroadenoma-p3.html

Ashli House

 

 

 

IAC/Temporal Pathology: Otosclerosis

Otosclerosis

What is it?

I wanted to research Otosclerosis because I had no idea as to what it was.  I didn’t realize how many individuals were affected by Otosclerosis.  Otosclerosis is an abnormal growth of the bone in the middle ear which causes hearing loss in people.  I always assumed individuals had loss of hearing because of loud noises but there are several reasons which affect hearing loss.  The cause of Otosclerosis is unknown, but is thought to be passed down in families.  The most common cause of middle ear hearing loss in young adults is Otosclerosis.  It normally begins in early adulthood and affects both ears.  Often times, women are affected by Otosclerosis more commonly than men.

squidoo.com

Symptoms/ Tests

Some different symptoms and tests can help diagnose a patient with Otosclerosis.  According to Pub Med Health, some symptoms are: 

·         “Hearing loss may occur slowly at first but continue to get worse.”

·         “You may hear better in noisy environments that quiet ones.”

·         “Ringing in the ears (tinnitus) may also occur.”

(http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002031/)

The main tests used to diagnose Otosclerosis are a hearing test and a CT of the temporal bone. 

Possible Treatments

Treatments vary with Otosclerosis.  Some patients can take medications such as calcium or vitamin D to prevent or slow their hearing loss.  A hearing aid can help in hearing loss but will not cure Otosclerosis.  Surgery is another option that can cure or prevent hearing loss from getting worse.  A total replacement of the stapes with prosthesis is stapedectomy.  If surgery is unsuccessful then the patient may have to learn to cope with deafness.  Complications include complete deafness, infection, dizziness, pain, or nerve damage. 

audiologyonline.com

 

imaging.consult.com

If you want to learn more about Otosclerosis, here is a link:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002031/

Ashli