New case in ORADLIST image forum
ewnlam at BLUE.WEEG.UIOWA.EDU
Thu Dec 11 10:43:12 PST 1997
Unfortunately, CT in this instance, will only tell you if there is a mass
there or not. And we already know there is one there from the
pantomograph. One way of distinguishing between neuromas/neurofibromas
and schwannomas is to use contrast-enhanced MR. If the lesion is a
schwannoma, then the enhancement should form a ring around the lower
intensity nerve (in a plane perpendicular to the length of the nerve),
thus giving the appearance of a doughnut heavily powdered with
confectioner's sugar. If the lesion is a neuroma/neurofibroma, then you
will see enhancement of the doughnut hole, itself.
...who says the pathologists have cornered the market on food descriptions
On Thu, 11 Dec 1997, G.V. Packota wrote:
> I cannot say whether or not the bilateral expanded portions of the
> mandibular canals are Schwannomas or not, but I think most of us would
> agree that benign neurogenic tumors should be considered in the
> differential diagnosis.
> We are following a woman in her early 30's who had virtually the same
> radiographic appearances on her panoramic radiograph several years ago.
> She is also asymptomatic, with no clinical manifestations of
> neurofibromatosis. The size and appearance of the canals have not changed
> in three years. Occlusal radiographs show the buccal and lingual cortices
> are thinned adjacent to the lesions. The lesions did not enhance on CT
> scans with contrast. The CT study confirmed that the lesions were
> continuous with the rest of the canal. The patient and her surgeon have
> opted to follow the lesions radiographically rather than risk paresthesia
> from an incisional biopsy. Another followup is due this spring.
> I don't know if the above comments have been of any help. I sure found the
> new case interesting. I look forward to further comments from others.
> Garnet Packota
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