RESUMEN
Eighteen patients who had elevated serum calcium and parathormone levels were prospectively studied with intravenous digital subtraction angiography (DSA). Intravenous DSA of the neck and mediastinum was performed in the anteroposterior, the left anterior, and the right anterior oblique projections. The study was considered positive if an abnormal blush or blood supply was noted. Upon operation, 14 patients were confirmed to have parathyroid adenomas, of whom five had positive preoperative DSA examinations. Four patients were followed medically (three negative DSA, one positive DSA). A positive intravenous DSA may be useful to guide neck explorations for parathyroid adenomas; however, the low sensitivity of the study may limit its screening potential.
Asunto(s)
Adenoma/diagnóstico por imagen , Angiografía Cerebral , Neoplasias de las Paratiroides/diagnóstico por imagen , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Técnica de SustracciónRESUMEN
A patient developed ossifying skeletal muscle metastases from a primary gastric mucin-producing adenocarcinoma. The unusual nature of skeletal muscle metastases and the inflammatory-like syndrome associated with heterotopic ossification is reviewed. It is suggested that this case of 'neoplasm-induced post-traumatic myositis ossificans' may be caused by the interaction of local haemorrhage and thrombosis, mucin-producing tumour implants, and the presence of large quantities of gamma-carboxyglutamic acid, an amino acid associated with the calcification of bone matrix formation.
Asunto(s)
Adenocarcinoma/secundario , Enfermedades Musculares/complicaciones , Miositis Osificante/etiología , Enfermedades Reumáticas/etiología , Neoplasias Gástricas , Ácido 1-Carboxiglutámico/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Músculos/lesiones , Miositis Osificante/metabolismoRESUMEN
Bone-forming metastases to soft tissues and muscle are a rare entity. An unusual case of heterotopic ossification occurring within metastases to muscle arising from a primary gastric adenocarcinoma is reported. No bone was found in the primary gastric malignancy. There is one prior report of ossification in muscle occurring in metastases from gastric malignancy, but no previous computed tomographic demonstration of this. The mechanism of osseous metaplasia is discussed, but its precise morphogenesis remains obscure.