Angiofibroma

Angiofibromas are benign tumors of the fibrous connective tissue within the nasopharynx. They are invasive and aggressive. Angiofibromas are genetic and primary affect adolescent males. Angiofibromas are known to cause tubercous sclerosis, which is caused by an abundance of endothelium in the lined vascular spaces. Angiofibromas can cause nasal obstruction, abnormal speech, and difficulty swallowing.If left untreated, it can develop into ear canal obstruction. Angiofibormas are visualized with either CT or MRI. There are used to determine the size of the tumor and if there is any encroachment into other structures.
Angiofibroma - Angiofibromas are treated with surgery. Embolization of the tumor is preformed before the tumor is excised. If the tumor is not able to be removed, radiation may be utilized in an attempt to shrink the tumor’s size.

Orbital Cellulitis

Orbital Cellulitis

Orbital cellulitis is an acute infection of the eye caused by a bacteria or fungus. It is sometimes a byproduct of injury, a sty, ethmoid sinusitis, or an insect bite. Orbital cellulitis usually affects only one eye. It can affect the globe of the eye, the upper cheek, the eyebrow, or even the eyelid. Most patients present with swelling or redness around the eye, high fever, and/or painful eye movement.

Time is very critical in the treatment of orbital cellulitis. If left untreated, it can lead to blindness, brain abscesses, or meningitis. When a patient presents with eye swelling, and fever, usually a CBC and blood cultures are drawn. A sinus x-ray and a contrasted CT are preformed in order to assist in the diagnosis.

Axial contrast-enhanced CT image of the orbit shows soft tissue thickening of the right preseptal region (between arrows). The retroorbital fat is normal (arrowheads).

The severity of the infection determines the treatment course. Generally, the patient is admitted to the hospital to receive IV antibiotics. If the IV antibiotics prove to be ineffective, sometimes it is necessary to go in and surgically decompress the infection.

Prolactioma

Prolactinomas are benign tumors of the pituitary gland. They are the most common type of pituitary gland tumors. Prolactinomas can cause an increase or decrease the amount of the hormone prolactin. Changes in prolactin levels affect women and men differently. Prolactinomas are more common in women than in men and rarely affect children. Women may experience milk production (galacotorrhea), missed menses (amenorrhea) or irregular menses, and reduced sex drive (libido). Men may develop enlarged breasts (gynecomastia), low libido, vision loss, and headaches.

Blood tests are preformed to check for high levels of prolactin. MRI is the best imaging modality to determine if a tumor is a prolactinoma. Prolactinomas are usually too small to be visualized on CT.

Prolactinoma.		Prolactinomas

Prolactinomas are usually treated with medications that mimic Dopamine. Dostinex is on drug that is used in treatment of prolactinomas because of its dopamine like effect on the pituitary. Dopamine controls the amount of prolactin the pituitary gland produces. Medications usually control symptoms and patients are able to live a normal life. If the tumor has not shrunk or symptoms are not controlled by medication within six months of starting them, surgery or stereostatic radiation is recommended.

Glomus Tympanicum Tumors

Glomus tympanicum tumors are benign neoplasms that involve the tympanic membrane. The glomus tumors affect the glomobody of the middle ear. The glomobodies are tiny structures that regulate oxygen pressure in the ear and the mastoids.

Glomus tympanicum tumors usually affect one ear. They present with hearing loss and tinnitus. They can also cause headaches, bloody ear discharge, and palpations. Glomus tumors cause severe pain on the affected ear when they come in contact with cold air or water. The tumors have either a reddish or bluish discoloration behind the tympanic membrane when the ear canal is visualized.

Normal Ear Drum	Glomus Tympanicum

Females are almost three times more likely to have glomus tympanicum tumors than males. Adults between the ages of 40-60 are most likely to develop glomus tympanicum tumors.

Visualization of the tympanic membrane is performed using an otoscope. Hearing tests are also utilized to determine the amount of hearing loss. CT scans are done to determine the size of the tumor. Glomus tympanicum tumors appear as thickness on CT images.

Glomus jugulare tumor.
CT scan demonstrates a permeative destructive skull-base mass with involvement of the mastoid air cells

The best treatment is surgery. If the tumor is small, it is removed via a small incision in the ear canal. If the tumor is large, it is removed via an incision behind the ear. If the tumor is excessively large, the tumor may be subjected to radiation.

Glioblastomas Multiforme

Glioblastomas are the most common and aggressive forms of brain tumors. Nearly 23% of all brain tumors are glioblastomas. They affect the glial cells which surround and support the main component of the brain: nerve cells. There are two categories of glioblastomas: giant cell and gliosacroma. Glioblastomas spread easily to other surrounding brain tissues.

Glioblastomas often present with seizures, nausea, vomiting, headaches, and hemi paresis. With progression of the size of the brain tumor, it can cause memory loss, personality deficits, and neurological deficits. Glioblastomas can be detected with either CT or MRI. A sterotatic biopsy is the preferred procedure to confirm the tumor type.

Axial CT head

T-2 weighted MRI Sagittal

Glioblastomas are treated with anticonvulsants to prevent or reduce seizures. Corticosteroids may be administered to help with brain edema and inflammation. Chemotherapy and radiation can be used to shrink the tumor. Surgery is the best treatment to remove the tumors. Recurrence of glioblastomas is very high even when the entire tumor is removed. Mortality is very common, especially when the entire tumor can not be removed.

Glioblastoma is the type of brain tumor that killed Senator Ted Kennedy.

Let me Introduce Myself

Hello! My name is Joanna Howard. I have been an X-ray tech for 13 years and a CT tech for 12 years. I have wanted to get my Bachelors degree for almost 10 years. I am a mother of two girls; 8 and 2.