Introduction:
The management of proptosis, particularly when accompanied by vision loss and ocular palsy, presents a diagnostic challenge for clinicians. This case study highlights the intricate journey towards diagnosing a rare case of myxoid liposarcoma, aided by collaborative efforts and innovative interventions.
Patient Presentation:
A patient presented with painful proptosis, vision loss, ocular palsy, and autoimmune hemolytic anemia, signaling a complex underlying pathology.
Diagnostic Dilemma:
Despite exhaustive diagnostic efforts, including multiple endonasal biopsies for chronic mucosal thickening in paranasal sinuses, a definitive diagnosis remained elusive. Imaging studies revealed a bulky left lateral rectus intra-orbital mass with retro-orbital fat stranding, suggestive of a pseudotumor or as definitive mass.
Innovative Intervention:
An accurate diagnosis was achieved by performing CT-guided lateral rectus intramuscular muscle biopsy via local anesthesia, bypassing invasive surgical procedures.
Diagnostic Breakthrough:
Histopathological examination and immunohistochemistry confirmed the unexpected diagnosis of myxoid liposarcoma involving the orbit and paraorbital fat with retro-orbital muscle involvement and mucosal thickening.
We extend our sincere gratitude to Dr. Govind Eriat for his exemplary leadership and expertise in this complex case.
Special thanks to the dedicated team of pathologists and the Anesthesiology team for their invaluable contributions and unwavering commitment to patient care.
Conclusion:
This case exemplifies the collaborative spirit and innovative approach required to navigate complex diagnostic dilemmas. By leveraging advanced imaging modalities and embracing interdisciplinary collaboration, intervention radiologists as clinicians can uncover rare pathologies and pave the way for tailored treatment strategies, ultimately improving patient outcomes.
Key Takeaways:
Proptosis with ambiguous etiology demands a comprehensive diagnostic approach, often involving advanced imaging techniques and innovative biopsy procedures. Collaborative efforts by clinicians, pathologists, and intervention radiologists are integral to achieving accurate diagnoses in rare or elusive pathologies. Innovative strategies, such as CT-guided biopsies, offer valuable insights and guide tailored treatment strategies in challenging diagnostic scenarios.
Introduction:
The management of benign thyroid nodules poses a significant challenge in clinical practice, often necessitating surgical intervention with its associated risks and drawbacks. However, recent advancements in Interventional Radiology have paved the way for a revolutionary approach known as Thyroid Nodule Ablation, offering a minimally invasive alternative to conventional surgery. This case study highlights the remarkable outcomes achieved through this innovative technique, underscoring its potential to redefine the standard of care for benign thyroid nodules.
Patient Presentation:
A 40-year-old woman presented with a 4-year history of progressive neck swelling attributed to a thyroid nodule. After initial diagnostic confirmation of a benign adenoma via Fine-Needle Aspiration Cytology (FNAC) and normal thyroid function tests, her symptoms persisted, prompting further evaluation.
Diagnostic Workup:
Ultrasound investigations revealed a well-defined hypoechoic lesion in the left lobe of the thyroid, with subsequent FNAC confirming the benign nature of the nodule. Being euthyroid status, the patient experienced ongoing neck swelling, necessitating reevaluation.
Treatment Decision:
Given the patient’s desire to avoid surgery and the promising benefits of Thyroid Nodule Ablation, she opted for this minimally invasive intervention after thorough counseling. The procedure offered several advantages, including outpatient-based treatment, nil scarring, and rapid recovery.
Procedure Details:
Under precise ultrasound guidance, the procedure commenced with a small pinhole-sized incision in the neck, ensuring the preservation of vital anatomical structures. A needle was then inserted into the left thyroid nodule, delivering targeted heat to achieve complete ablation while safeguarding nearby nerves and vessels.
Outcome:
Following the procedure, the patient experienced a significant reduction in nodule size, alleviating her cosmetic concerns. Importantly, there were no signs of nerve injury or adverse effects on thyroid function, reaffirming the safety and efficacy of Thyroid Nodule Ablation.
Conclusion:
This case exemplifies the transformative potential of Thyroid Nodule Ablation in the management of benign thyroid nodules. By offering a safe, effective, and minimally invasive alternative to surgery, this innovative technique heralds a new era in thyroid nodule management, prioritizing patient comfort and clinical outcomes.
Key Takeaways:
Thyroid Nodule Ablation represents a paradigm shift in the management of benign thyroid nodules, offering a minimally invasive alternative to surgery. The procedure is associated with no scarring, rapid recovery, and preservation of thyroid function, making it an attractive option for patients. The success of this innovative and advanced non-surgical minimally invasive Interventional Radiology treatment in thyroid nodule management is backed by several research and data across the globe.
83-year-old male with Urosepsis
Treated with percutaneous aspiration of perinephric phlegmon. 15ml of purulent pus was aspirated using a 5F aspiration catheter and ultrasound guidance. The patient is doing well with IV antibiotics.
With this simple, yet advanced, pinhole, minimally invasive procedure, infected fluid was aspirated and helped in patient improvement.
Far far away, behind the word mountains, far from the countries Vokalia and Consonantia, there live the blind texts. Separated they live in Bookmarksgrove right at the coast
Dr. Naveen Chandrashekhar offers expert, minimally invasive interventional radiology services, focusing on precise, image-guided treatments for vascular issues, oncology, and more, ensuring faster recovery and improved patient outcomes.
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