Tuesday, April 19, 2011

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

Sunday, April 10, 2011

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