Person: Schiappacasse, Giancarlo
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Schiappacasse
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Giancarlo
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Publication Secondary rectal linitis plastica caused by prostatic adenocarcinoma - magnetic resonance imaging findings and dissemination pathways: A case report(2024) Labra, Andrés; Schiappacasse, Giancarlo; Cocio, Rolando; Torres, Jorge; González, Fernando; Cristi, Joaquin; Schultz, MarcelaBackground: Secondary rectal linitis plastica (RLP) from prostatic adenocarcinoma is a rare and poorly understood form of metastatic spread, characterized by a desmoplastic response and concentric rectal wall infiltration with mucosal preservation. This complicates endoscopic diagnosis and can mimic gastrointestinal malignancies. This case series underscores the critical role of magnetic resonance imaging (MRI) in identifying the distinct imaging features of RLP and highlights the importance of considering this condition in the differential diagnosis of patients with a history of prostate cancer. Case summary: Three patients with secondary RLP due to prostatic adenocarcinoma presented with varied clinical features. The first patient, a 76-year-old man with advanced prostate cancer, had rectal pain and incontinence. MRI showed diffuse prostatic invasion and significant rectal wall thickening with a characteristic "target sign" pattern. The second, a 57-year-old asymptomatic man with elevated prostate-specific antigen levels and a history of prostate cancer exhibited rectoprostatic angle involvement and rectal wall thickening on MRI, with positron emission tomography/computed tomography PSMA confirming the prostatic origin of the metastatic spread. The third patient, an 80-year-old post-radical prostatectomy, presented with refractory constipation. MRI revealed a neoplastic mass infiltrating the rectal wall. In all cases, MRI consistently showed stratified thickening, concentric signal changes, restricted diffusion, and contrast enhancement, which were essential for diagnosing secondary RLP. Biopsies confirmed the prostatic origin of the neoplastic involvement in the rectum. Conclusion: Recognizing MRI findings of secondary RLP is essential for accurate diagnosis and management in prostate cancer patients.Publication Caracterización imagenológica de los tumores de intestino delgado resecados en nuestra institución entre los años 2017 y 2020(2022) Schiappacasse, Giancarlo; Labra, Andrés; Laguna, Juan P.; Mercado, Fernando; Lara, BastiánLos tumores de intestino delgado son infrecuentes, sus manifestaciones clínicas son inespecíficas y plantean un diagnósti co diferencial amplio; sin embargo, algunos presentan características que pueden orientar el diagnóstico. El objetivo de este artículo es caracterizar las neoplasias de intestino delgado resecadas en nuestra institución y realizar una revisión de la literatura que permita aportar en el diagnóstico y el manejo de estos pacientes. En la población estudiada, el tumor neu roendocrino fue el de mayor incidencia, superando al adenocarcinoma que durante años estuvo en el primer lugar. El estu dio por imágenes radiológicas cumple un papel fundamental en la detección y la caracterización de estas lesiones. Además, la creciente demanda de estudios de imágenes por síntomas inespecíficos permite obtener hallazgos incidentales de en fermedad neoplásica en estadios más precoces.Publication Magnetic resonance imaging of paraurethral and paravaginal lesion: relevant diagnoses, key findings and surgical correlation(https://doi.org/10.21037/tau-2024-726, 2025) Labra, Andrés; Cocio, Rolando; Saavedra, Álvaro; Schiappacasse, Giancarlo; Blaskovic, FernandaParaurethral and paravaginal lesions are uncommon entities that often present diagnostic challenges due to their anatomical complexity, varied etiologies, and overlapping clinical presentations. Accurate identification and characterization of these lesions are essential for appropriate management and surgical planning. A structured diagnostic approach, based on clinical history, lesion location, and imaging features, is critical to avoid misdiagnosis and unnecessary interventions. Magnetic resonance imaging (MRI) has emerged as the modality of choice due to its excellent soft-tissue contrast, multiplanar capabilities, and non-invasive nature, offering superior delineation of lesion extent and relationship with adjacent pelvic structures. This pictorial review seeks to support radiologists and clinicians by offering a comprehensive yet practical guide to the imaging evaluation of paraurethral and paravaginal lesions. Through high-resolution MRI images and original anatomical illustrations, we aim to reduce the gap between imaging interpretation and clinical decision-making. We summarize the primary MRI indications for evaluating female urethral pathology, provide an overview of common and rare differential diagnoses, and highlight relevant MRI protocol considerations. Additionally, we include correlations with surgical findings when available, to enhance clinical applicability. Rather than providing an exhaustive catalog of entities, our focus is to promote standardized imaging assessment and highlight key anatomical and diagnostic considerations that may facilitate a more confident and informed multidisciplinary approach to these often-overlooked pelvic pathologies.Publication Renal angiomyolipomas: Typical and atypical features on computed tomography and magnetic resonance imaging(2025) Labra, Andrés; Schiappacasse, Giancarlo; Constenla, Diego; Cristi, JoaquinAngiomyolipomas (AMLs) represent the most common benign solid renal tumors. The frequency of their detection in the general population is increasing owing to advances in imaging technology. The objective of this review is to discuss computed tomography (CT) and magnetic resonance imaging findings for both typical and atypical renal AMLs, along with their associated complications. AMLs are typically defined as solid triphasic tumors composed of varying amounts of dysmorphic and tortuous blood vessels, smooth muscle components and adipose tissue. In an adult, a classical renal AML appears as a solid, heterogeneous renal cortical mass with macroscopic fat. However, up to 5% of AMLs contain minimal fat and cannot be reliably diagnosed by imaging. Fat-poor AMLs can appear as hyperattenuating masses on unenhanced CT and as hypointense masses on T2WI; other AMLs may be isodense or exhibit cystic components. Hemorrhage is the most common complication, and AMLs with hemorrhage can mimic other tumors, making their diagnosis challenging. Understanding the variable and heterogeneous nature of this neoplasm to correctly classify renal AMLs and to avoid misdiagnosis of other renal lesions is crucial.