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Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

A case of a 32-year-old female with a known diagnosis of Turner syndrome who presented with complaints of chronic progressive right-sided facial pain and sinus pressure and who was afebrile. On physical examination, there was eye proptosis on the right and significant increased fullness in the right infraorbital and maxillary regions. Computed tomography and magnetic resonance imaging demonstrated a large expansile space-occupying lesion in the right maxillary area that histologically turned out to be a giant cell reparative granuloma. The lesion was completely removed, and of interest, the patient was followed up both clinically and on imaging for 10 years with no signs of recurrence. A discussion on this entity, as well the clinical and imaging differential diagnoses, is discussed.

This is a case of a 32-year-old female with a known diagnosis of Turner syndrome who presented with complaints of chronic progressive right-sided facial pain and sinus pressure, and who was afebrile. On physical examination, there was eye proptosis on the right and significant increased fullness in the right infraorbital and maxillary regions. Computed tomography and magnetic resonance imaging demonstrated a large expansile space-occupying lesion in the right maxillary area, that histologically turned out to be a giant cell reparative granuloma. The lesion was completely removed and of interest, the patient was followed up both clinically and on imaging for 10 years with no signs of recurrence. A discussion on this entity, as well the clinical and imaging differential diagnoses, is carried out.

Background: The use of smart pump technology has shown to be profitable in the intensive care unit (ICU) because it avoids costs from prevented medication errors and allows for savings on disposables and medications by establishing standardized concentrations and dosing units. Objective : The objective of the study is to evaluate the economic impact of the implementation of smart infusion pumps in the consumption of intravenous (IV) solutions in an ICU. Methods: A retrospective observational study was conducted with a pre-post design. The study occurred in the adult ICU of the Hospital Juárez de México. The pattern of consumption of IV solutions (sodium chloride 9%, Hartmann's solution, dextrose 5% and 10%, sodium chloride 0.9% with dextrose 5%) was analyzed preimplementation and postimplementation of 50 Plum A+™ pumps with Hospira MedNet™ security software. Using the TreeAge Pro 2016 software, deterministic and probabilistic analyses were carried out (10 000 Monte Carlo simulations) to confirm the robustness of the annual consumption comparison and the associated expenses before and after implementing smart technology. Results : The implementation of the smart pumps reduced the annual consumption of IV solutions to 8994 units (18%) and 3649 liters (22.3%). In the first year, MXN$55 850.97 were saved. From an institutional perspective and with a probability of 0.63, the use of MedNet™ technology proved to be a lower cost alternative (17.1% saved) with respect to the conventional infusion systems. Conclusion : The implementation of smart infusion pumps allows savings, specifically for the IV solutions used in ICU., Competing Interests: Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Erika Palacios-Rosas, Isaac F. Soria-Cedillo, Fabiola Puértolas-Balint, Rebecca Ibarra-Pérez, Sergio E. Zamora-Gómez, Elizabeth Lozano-Cruz, Marcos A. Amezcua-Gutiérrez, and Lucila I. Castro-Pastrana have no conflicts of interest that are directly relevant to the content of this article.

Few cases of primary mucosal melanoma of the larynx have been documented in the literature, so only a limited amount of data exists regarding its diagnosis and treatment. The prognosis is poor, as patients often present at a late stage with regional or distant metastases. We describe the case of a 66-year-old man who presented with hoarseness and dysphagia. Laryngoscopy identified a dark discoloration of the supraglottic larynx and incomplete mobility of the right vocal fold; an excisional biopsy confirmed the diagnosis. We discuss the epidemiology, clinical features, diagnosis, interpretation of imaging findings, and management of this rare malignant melanoma.

Imaging of the submandibular glands can provide vital information about malignant neoplastic processes. One of these modalities, fluorine-18 fluorodeoxyglucose-positron-emission tomography/computed tomography (FDG-PET/CT), has become very important in the detection of malignancies because it provides functional and metabolic information as well as anatomic localization. However, there are several pitfalls associated with FDG-PET/CT in terms of salivary gland imaging. For example, a normal increase in the uptake of radiotracer might be mistaken for a neoplastic process. Other routine findings may include normal physiologic uptake in some structures, benign tumors and medical conditions, and iatrogenic abnormalities. We review a case in which compensatory hypertrophy of a submandibular gland was suspected to be a possible malignancy.

Paragangliomas are uncommon tumors that arise from the parasympathetic neuroectodermal ganglionic cells and have been described in numerous anatomic locations, most commonly in the abdomen. Head and neck paragangliomas are classified into carotid body (most common), vagal, and jugulotympanic types. Computed tomography is the initial imaging modality of choice for the preoperative assessment of the extent of paragangliomas. Magnetic resonance imaging and selective angiography provide more detail of the surrounding tissues and vasculature. Surgical resection is the treatment of choice.

We present a case of diffuse sphenoid bone cavernous hemangioma in a 22-year-old primigravid woman. Her disease first manifested clinically as progressively decreasing vision in her left eye during her third trimester of pregnancy. We also discuss the known causes and some theoretical causes of cavernous hemangioma enlargement during pregnancy.

Infectious diseases of the central nervous system vary in frequency in different locations in America and Europe. What is common in Brazil can be a sporadic presentation in Europe. Cooperative work gathering experiences from neuroradiologists working in various places can be achieved and will help to identify uncommon cases that can present in our daily practice.

Most intrathoracic goiters are located in the anterior mediastinum, frontal to the recurrent laryngeal nerve and anterolateral to the trachea. Posterior mediastinal goiters account for only 10 to 15% of all intrathoracic goiters and arise from the posterolateral portion of the thyroid gland. We present a case involving a 59-year-old man with history of gradual-onset dyspnea who was referred to us for evaluation of a large mediastinal mass. He had undergone bilateral thyroid lobectomy for a cervical goiter 10 years previously, with no subsequent complications. Contrast-enhanced computed tomography demonstrated a large, well-circumscribed mass extending paratracheally from the thoracic inlet to the posterior mediastinum. The mass was removed via a transcervical and transthoracic approach.

Aneurysms of the petrous portion of the internal carotid artery (ICA) are rare. Their etiology is usually congenital, traumatic, or mycotic. Depending on the size and location of the aneurysm, the direction of its growth, and the specific adjacent structures involved, patients may or may not present with signs and symptoms. When signs and symptoms do manifest, they may include headaches, epistaxis, a vascular retrotympanic mass with hemotympanum and/or otorrhagia, pulsatile tinnitus, hearing loss, vertigo, and Horner syndrome or Raeder paratrigeminal neuralgia. We describe the imaging aspects of the case of a 27-year-old man who presented with a 5-day history of unilateral symptoms secondary to a lesion located in the area of the right foramen lacerum. The lesion proved to be an aneurysm of the petrous portion of the ICA. We discuss the anatomic, imaging, and otologic aspects of ICA aneurysms in this location.

Most retropharyngeal abscesses, including iatrogenic cases, are caused by trauma. Nontraumatic retropharyngeal abscesses usually occur secondary to infection of the retropharyngeal lymph nodes. Because these particular nodes usually disappear by the age of 4 or 5 years, a nontraumatic retropharyngeal abscess in an adult is extremely rare. When they do occur in adults, they are generally seen in immunocompromised patients and in intravenous drug abusers. Left untreated, a retropharyngeal abscess can lead to rare and fatal complications such as cervical osteomyelitis, epidural abscess, and discitis. Retropharyngeal abscesses can be diagnosed with a thorough history of risk factors, an examination for neurologic deficits, and radiologic studies, particularly magnetic resonance imaging. Treatment involves intravenous antibiotic therapy and surgical drainage. During follow-up, it is important to closely monitor the results of clinical neurologic examinations and weekly determinations of the C-reactive protein level and erythrocyte sedimentation rate in order to assess the response to therapy. We report 4 cases of nontraumatic retropharyngeal abscess complicated by cervical osteomyelitis and epidural abscess that were seen in New Orleans within 3 years of Hurricane Katrina, which struck the U.S. Gulf Coast in August 2005.