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Introduction: Primary choriocarcinoma of the colon is an extremely rare neoplasm which has a poor prognosis. Only 18 cases have been previously reported in English medical literature. Here we present a case of primary rectal choriocarcinoma with a good response to chemotherapy and review the literature on this uncommon tumor. Case report: A 36-year-old woman presented with abdominal pain and vaginal bleeding. Abdominal magnetic resonance imaging revealed 6.9 × 5.3 × 6.4 cm hypervascular mass posterior to uterus very close to rectum. Beta-human chorionic gonadotropin (β-hCG) level was markedly elevated. Low anterior resection of the rectum with lymph node dissection and total abdominal hysterectomy with bilateral salpingo-oophorectomy were performed. Pathologic diagnosis was reported as colonic choriocarcinoma with a focal component of adenocarcinoma. Post-operative magnetic resonance imaging detected multiple metastatic lesions throughout the liver. The patient was treated with systemic chemotherapy using bleomycin, etoposide and cisplatin (BEP protocol). After three cycles, β-hCG level decreased to normal and magnetic resonance imaging showed regression of liver metastasis. However, the patient died of respiratory failure due to bleomycin toxicity and pneumonia accompanied by rapid disease progression. Discussion: This is an extremely rare case of primary rectal choriocarcinoma. Due to poor prognosis of the disease, it seems very important to start prompt treatment to improve patient's survival. [ABSTRACT FROM AUTHOR]

OBJECTIVE This study is a comparison of contoured diagnostic images derived from computed tomography (CT) and magnetic resonance imaging (MRI) by both a radiation oncologist (RO) and a radiologist (R) using volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) techniques. METHODS CT and MRI sections of 16 patients were contoured by the RO and the R. Planning target volume (PTV) criteria assessed were conformity index (CI), homogeneity index (HI), volume covered by 98% isodose line (V 98%) and maximum dose (Dmax). In critical organs, 40 Gy organ area volume (V40), 65 Gy organ area volume ( V65), and Dmean criteria were evaluated. Paired samples t-test was used for statistical analysis. RESULTS PTV and critical organs were compared. MRI PTV and bladder volume drawn by R were lower. Comparison of CT images revealed IMRT plans were superior in terms of Dmax and CI, while V40 and Dmean values for rectum and bladder were lower in MRI-based VMAT plans. In MRI plans, IMRT was superior in terms of PTV, Dmax, CI, V65, and Dmean for critical organs; however, critical organs were well preserved with both planning techniques. CONCLUSION There was some difference between contouring of the R and the RO, which was reflected in the treatment plans. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of our study was to determine apparent diffusion coefficients (ADCs) of focal liver lesions on the basis of respiratory triggered diffusion-weighted single-shot echo-planar MR imaging (DWI-SS-EPI) sequence and to evaluate whether ADC measurements can be used to characterize lesions. Patients and Methods: One hundred and eighteen patients with 134 focal liver lesions [35 cysts, 48 hemangiomas, 4 focal noduler hyperplasias (FNH), 31 metastases, 14 hepatocellular carsinomas (HCCs), 1 fibrolamellar carsinoma, 1 cholangiocellular carcinoma; mean size 18.4 mm; range 10-140 mm] were examined on a 1.5-T system using respiratory triggered DWI-SS-EPI (b-values: 50, 400, 800 s/mm2). Results: Results were correlated with characteristic MRI findings, histopathologic data and follow-up imagings. The ADCs of different lesion types were compared and lesion differentiation using optimal thresholds for ADCs was evaluated. Mean ADCs (x10-3 mm2/s) were 2.15, 1.57, 1.16, 1.08, 1.03 for cysts, hemangiomas, FNHs, metastases and HCCs, respectively. Mean ADCs differed significantly for all lesion types except metastases, HCCs and FNHs. Overall, 88.5% of lesions were correctly classified as benign or malignant using a treshold value of 1.20x10-3mm²/s. Conclusion: Measurements of the ADCs of focal liver lesions on the basis of a respiratory triggered DWI-SS-EPI sequence may constitute a useful supplementary method for lesion characterization. [ABSTRACT FROM AUTHOR]

Acute leukemias are the most common childhood cancer in all age groups. Acute myeloid leukemias (AML) constitute about 15-20% of acute leukemias. Fatigability, pallor, fever, and bleeding are the most common presenting symptoms of AML. Hepatosplenomegaly and lymphadenopathy are commonly encountered during physical examination. In rare instances eruptions due to skin involvement and localized tumor masses (myeloid sarcoma)may be found. Myeloid sarcoma is especially seen in AML-M2 subtype. By cytogenetic analysis, in AML-M2 subtype t(8;21) is often seen and it is more probable to find inversion 16 in AML-M4Eos subtype. Herein, we present a 15-year-old girl whose initial symptom was abdominal pain for three days and her pathological sign was a large abdominal mass which was verified by imaging studies and diagnosed as myeloid sarcoma by biopsy. On bone marrow examination, she had diagnosis of AML-M2 and by cytogenetic analysis inversion 16 was positive. She was treated with AML-BFM 2004 protocol and she is being followed up in remission on her ninth month of the maintenance therapy. [ABSTRACT FROM AUTHOR]

To investigate the acute inflammatory and structural changes of sacroiliitis as auxiliary findings on magnetic resonance enterography (MRE) and their presence on closely timed conventional magnetic resonance imaging of the sacroiliac joint (SI joint MRI). We screened axial spondyloarthritis patients for the simultaneous presence of MREs and SI joint MRIs. Two blinded radiologists evaluated SI joint MRIs and MREs on two separate occasions. We used the Assessment of SpondyloArthritis International Society (ASAS)/Outcome Measures in Rheumatology Network (OMERACT) definitions for SI joint MRI. We implemented previously published standard definitions for osteitis, erosion, sclerosis, and fatty infiltration of SI joint in MREs that contain T1w and T1w post-gadolinium sequences. SI joint MRI and MRE images were present in 43 patients. The median time between the two modalities was 14 (0–89) days. Twelve patients had ASAS-defined positive SI joint MRI. Radiologist-1 and radiologist-2 detected osteitis on MRE in nine and eight out of these 12 patients, respectively. The two radiologists detected ankylosis and fatty metaplasia with a complete agreement and sclerosis with an almost perfect agreement. Both radiologists agreed on erosions on SI joint MRI in the same 10 cases. Radiologists did not identify acute inflammatory or structural changes on MRE in patients with a negative SI joint MRI for these lesions. Along with intestinal findings, additional reporting of acute inflammatory and structural changes of the SI joint on a MRE is valuable and may alert physicians to the presence of previously not diagnosed axial spondyloarthritis. • Acute inflammatory and structural changes of the SI joint may readily be available on MRE. • MRE may alert physicians to the presence of previously undiagnosed axial spondyloarthritis. • MRE reveals important radiologic data on the presence of sacroiliitis. [ABSTRACT FROM AUTHOR]