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November 2015
What's New...?

ServoCAT Accessories

ServoCAT Release 7.0A
Software (Jan 2015)

Long Exposure Imaging
with a DOB? YES!

Need a vacation...?
try a 30" in 7+mag skies!

New Install and Usage Video on DVD!

  home about us site features legal contact search permissions lectures med students all cardiac chest gi bone gu ddxs neuro peds faculty lectures notes bone cardiac chest gi gu neuro images bone cardiac chest gi cases of the week pictorial ddxs case of the week archives all cases 2002 2003 2004 2005 2006 2007 2008 medical students index recognizing series 22 must see's quizzes quick quizzes test yourself 1 question quiz miscellaneous cardiac imagecards flashcards most commons pictorial ddxs   sacrococcygeal chordoma general considerations   rare primary malignancy of bone originates from embryonic remnants of the notochord location 50% occur in sacrum 40% of all sacral tumors most common in 4th or 5th sacral segment 35% at skull base around clivus benign tumors but may locally invade and compress 15% in remainder of spine cervical spine most common occurs between the ages of 30-70 with a 2:1 male:female ratio clinical findings low back pain is most frequent symptom (70%) constipation or fecal incontinence rectal bleeding sciatica from nerve root compression frequency, urgency, straining on micturition   imaging findings large presacral mass (>10cm) with displacement of the rectum and/or bladder solid tumor with cystic areas in 50% destroys multiple sacral and coccygeal segments sequestered bone fragments are common sclerotic rim in 50% may have amorphous calcifications, especially peripherally may cross the sacroiliac joint ct findings ct is helpful in defining bone destruction and calcification within lesion with contrast, the pseudocapsule may enhance usually low attenuation soft tissue mass with destruction of the sacrum and/or coccyx may show sequestered bone fragments or calcifications within tumor mri findings modality of choice, especially for clival lesions low to intermediate intensity on t1 those lesions that show high signal intensity on t1 have a larger mucinous component very high signal intensity on t2 high water content following gadolinium injection, chordomas may show a honeycomb appearance heterogeneous on t1 and t2 lesions may rim enhance differential diagnosis plasmacytoma giant cell tumor chondrosarcoma differentiation from chordomas difficult both radiologically and pathologically may require immunohistochemical studies metastatic carcinoma lymphoma treatment all chordomas are relatively radioresistant gamma knife is helpful in sparing adjacent tissues sacral chordomas are usually treated with an en bloc resection of the tumor the surgical management of clival tumors is more difficult because of the surrounding structures complications metastases in 7-14% of all chordomas; rare with sacral chordomas lymph node lung liver infection is a frequent complication prognosis 8-10 years average survival very high (nearly 100%) recurrence rate following surgical removal sacrococcygeal chordoma. cheap viagra online buy viagra jelly uk cheap viagra online cheap viagra pills online viagra doesnt work anymore review generic viagra viagra free sample coupon (left) axial ct scan demonstrates a large soft. What is brand viagra - buy viagra online cheap viagra side effects howtosmudge.com/pjn-generic-viagra-canadian-online-ke/ viagra without a doctor prescription viagra online viagra doesnt work anymore viagra for sale Discount viagra or viagra sell viagra online legal viagra doesnt work anymore how long it take viagra to take effect cheap viagra online canadian pharmacy viagra cheapest online
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