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1

Patel, Nilay, David Cranston, and Mark Sullivan. The aetiology, epidemiology, clinical features, and investigation of kidney cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0083.

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Over 270,000 patients worldwide are diagnosed with renal cancer every year. It is the most lethal of all urological malignancies, with 33–44% of patients dying as a result of the disease. The past three decades has seen the incidence of renal cancer increasing by approximately 2% per year. This increased incidence has predominantly been within localized tumours, detected incidentally due to the increased use of cross-sectional imaging in medical practice. Despite an increase in the number of patients undergoing surgery for renal cancer, mortality rates have continued to rise. There is some evi
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2

Turner, Neil. Postural proteinuria (benign orthostatic proteinuria). Edited by Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0051.

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Postural proteinuria, synonymous with the condition known as benign orthostatic proteinuria, describes increased levels of protein excretion associated with normalization first thing in the morning. It is usually diagnosed in children, for whom it is the most common explanation for proteinuria picked up incidentally on dipstick testing. In children, it generally resolves with age and is thought to have a benign long-term prognosis, with the caveat that numbers with very long follow-up times are few. It is also seen in teenagers but becomes much less common in early adulthood. Its aetiology is
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3

Izzedine, Hassan, and Victor Gueutin. Drug-induced chronic tubulointerstitial nephritis. Edited by Adrian Covic. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0087.

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The chronic form of drug-induced tubulointerstitial nephritis (CTIN) is an insidious disease and most probably represents the common final response pattern of the kidney to a variety of agents (including analgesics, lithium, antineoplastic chemotherapeutic agents, like cisplatin and nitrosoureas, and immunosuppressive drugs, such as ciclosporin and tacrolimus). Drug-induced CTIN is usually asymptomatic, presenting with slowly progressive renal impairment. Because of its insidious nature, CTIN is often diagnosed incidentally on routine laboratory screening or evaluation of CKD. The diagnosis of
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4

Freer, Phoebe E. Skin Lesions. Edited by Christoph I. Lee, Constance D. Lehman, and Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0050.

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Skin lesions are commonly seen on breast imaging. Often, a raised skin lesion is encountered incidentally during screening mammography and can be mistaken for a mass within the breast parenchyma. In most cases, lesions confined within the dermis are benign. Occasionally, focal skin involvement may be the presenting sign of a breast cancer that is either locally extensive to the skin or has an inflammatory component. This chapter reviews the key imaging and clinical features of skin lesions that may be encountered either incidentally on breast imaging or on diagnostic imaging as an area of pati
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5

Hovinga, K. E., Y. Esquenazi, and P. H. Gutin. Meningiomas. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190696696.003.0011.

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Meningiomas are the most common primary central nervous system tumors and account for about one third of all primary brain and spinal tumors. They are classified according to the World Health Organization into 3 groups (I–III). Treatment strategies range from observation, surgery, and/or a radiation therapy. Many meningiomas are slow growing and discovered incidentally. Symptoms can vary widely, depending on the location. Patient’s specific factors and the location of the meningioma in relation to critical brain structures are all important factors in determining the optimal treatment. This ch
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6

Shaibani, Aziz. EMG Findings. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199898152.003.0028.

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While this chapter and even this book are not intended to be a textbook in electrodiagnosis, we have chosen video samples of typical abnormal discharges that neuromuscular specialists often face, such as myopathic units, myotonic discharges, myokymia, fibrillations, and neurogenic firing. Other EMG clips are embedded in other chapters. It is not unusual for referred neuromuscular patients to carry an erroneous clinical diagnosis based on incidental EMG discharges such as myotonic discharges. On the other hand, voluntary activity may be reported as abnormal discharges and a diagnosis of denerva
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7

Mathiesen, Amber, and Kali Roy. Common Perinatal Genetic Counseling Situations. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190681098.003.0009.

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This chapter highlights common situations in perinatal counseling, including challenging circumstances, complex situations, and ethical dilemmas. It discusses conflicts that may arise from pregnancy termination; the complexities surrounding the identification of incidental findings such as misattributed paternity, discovery of consanguinity, or discovery of an incidental condition; and issues surrounding privacy and confidentiality, including familial implications of genetic knowledge. Also discussed are difficult circumstances such as couples in conflict or nonparticipation of a male partner
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8

Freer, Phoebe E. Skin Calcifications. Edited by Christoph I. Lee, Constance D. Lehman, and Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0049.

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Dermal and epidermal calcifications in the breast are extremely common and are typically benign, of no clinical significance, and are unrelated to breast cancer. If the radiologist attempts to do a mammographically guided needle localization for surgical excisional biopsy of calcifications that are not recognized to be in the dermis, it is possible that the patient may proceed to surgical biopsy with no calcifications seen in the excised specimen. Therefore, it is important to recognize dermal calcifications as such at the time of screening or diagnostic imaging. This chapter reviews the key i
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9

Markus, Hugh, Anthony Pereira, and Geoffrey Cloud. Vascular anatomy and stroke syndromes. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198737889.003.0003.

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Determining the arterial territory in which a stroke occurs is important in diagnosis. It also has major implications for management; for example, treatment of a symptomatic carotid stenosis differs greatly to that of an incidental stenosis in a patient with posterior circulation stroke. This chapter describes the arterial supply of the brain and links it to stroke syndromes that present acutely to the stroke clinician. It also covers the venous supply which is important in understanding cerebral venous thrombosis.
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10

Consumptive's Guide to Health: Or, the Invalid's Five Questions, and the Doctor's Five Answers; a Comprehensive Practical Treatise on Pulmonary Consumption ... Addressed in Popular Language to Non-Medical Readers, and Incidentally to Physicians... Creative Media Partners, LLC, 2021.

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11

Chakera, Aron, William G. Herrington, and Christopher A. O’Callaghan. Haematuria. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0055.

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Haematuria is the presence of blood in the urine. Haematuria may be either macroscopic (frank haematuria) or detectable only on urine dipstick (microscopic haematuria). Frank haematuria can appear quite dramatic and usually leads patients in the community to seek medical attention. The high incidence of urinary tract infections as an underlying cause means that patients often have associated dysuria and frequency. Significant haematuria can lead to clot formation in the urinary tract and obstruction. The resulting symptoms are equivalent to those from obstruction due to stones. Microscopic hae
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12

Argote-Romero, Graciela. Wilms Tumor. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0041.

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Wilms tumor, known as well as nephroblastoma, is the most common primary malignant renal tumor in children. Over 95% of all renal tumors in patients under the age of 15 are Wilms tumors. The mean age at the time of diagnosis is 3.5 years. Wilms tumors are usually an incidental finding, a large abdominal mass discovered by a family member or pediatrician. Hematuria and hypertension can be present at the time of initial diagnosis. Up to 8% of the patients will have von Willebrand disease; therefore, all patients should have baseline coagulation studies. All patients should have either computed t
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13

Brown, Jim, and Neal Navani. Non-surgical management of early-stage lung cancer. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0004.

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As low-dose computed tomography screening of ‘high-risk’ smokers is occurring with increasing frequency, the incidental discovery of solitary pulmonary nodules is becoming more frequent, and lung cancer multidisciplinary teams are now often faced with balancing risk and benefit when making decisions regarding the radical treatment of patients with a clinical diagnosis of early lung cancer but borderline fitness. Surgery offers the best prospect of cure but is associated with significant mortality and morbidity; the elderly and frail experience more toxicity and a greater impact on the quality
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14

Andrade, M. J. Tumours and masses. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0022.

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Transthoracic and transoesophageal echocardiography is the first-line diagnostic tool for imaging space-occupying lesions of the heart. Cardiac masses can be classified as tumours, thrombi, vegetations, iatrogenic material, or normal variants. Occasionally, extracardiac masses may compress the heart and create a mass effect. Cardiac masses may be suspected from the clinical presentation. This is the case in patients with an embolic event presumed of cardiac origin or in patients with infective endocarditis. Otherwise, a cardiac mass can be identified during the routine investigation of common,
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15

Sullivan, Mark, John Henderson, Inderbir Gill, and Nilay Patel. Upper urinary tract obstruction. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0031.

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Obstructive uropathy refers to the clinical sequelae of impairment of free urinary flow in the urological tract. The clinical manifestation of obstructive uropathy depends on the level and duration of obstruction, whether it is partial or complete, and whether infection has supervened. Obstruction may be clinically silent—and incidental radiological, biochemical, or examination findings may suggest the diagnosis. The radiological techniques used to demonstrate obstruction can be divided into anatomical and functional studies. These include ultrasound, urography, cross-sectional imaging, mictur
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16

Lachmann, Helen J., and Giampaolo Merlini. The patient with amyloidosis. Edited by Giuseppe Remuzzi. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0152.

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Amyloidosis is a disorder of protein folding in which normally soluble plasma proteins are deposited in the extracellular space in an abnormal insoluble fibrillar form. The process of amyloid formation and deposition causes cytotoxicity and progressive organ dysfunction. Amyloid is remarkably diverse and can be hereditary or acquired, localized or systemic, and lethal or merely an incidental finding. The most important numerically are AL amyloidosis, in which the fibrils are composed of monoclonal immunoglobulin light chains, and AA amyloidosis, in which the acute phase reactant Serum Amyloid
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17

Ball, Steve, and Sajid Kalathil. Adrenocortical cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0094.

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Adrenocortical cancer (ACC) is rare and associated with poor prognosis. The incidence is estimated at 0.7–2 cases per one million. Overall survival rate at five years for ACC is 37–47%. While the pathogenesis of ACC is incompletely understood, inherited predisposition syndromes are common in childhood ACC. Clinical presentation can be with symptoms and signs of hormone excess (functional tumours), mass effects, or as an incidental radiological finding. A multidisciplinary approach combining radiology, biochemistry, and tissue-based pathology is needed to establish a diagnosis to guide a surgic
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18

Andrade, Maria João, Jadranka Separovic Hanzevacki, and Ricardo Ronderos. Cardiac tumours. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0052.

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Transthoracic and transoesophageal echocardiography represent the first-line diagnostic tools for imaging space-occupying lesions of the heart. Cardiac masses can be classified as tumours, thrombi, vegetations, iatrogenic material, or normal variants. Occasionally, extracardiac masses may compress the heart and create a mass effect. Cardiac masses may be suspected from the clinical presentation. This is the case in patients with an embolic event presumed to be of cardiac origin or in patients with infective endocarditis. Otherwise, a cardiac mass can be identified during the routine investigat
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19

Neligan, Patrick J., and John G. Laffey. Obstetric physiology and special considerations in ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0365.

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Pregnant patients constitute less than 1% of intensive care unit admissions, and fewer than 1% of obstetric patients become critically ill. Critical illness may result from pregnancy-specific diseases, diseases that pregnancy predisposes to, or are co-incidental to pregnancy. The presence of a second patient—the foetus—may necessitate adjustments to therapeutic and supportive strategies. However, the foetus is generally robust despite maternal illness. The physiological changes of pregnancy are significant, but may delay the diagnosis of critical illness, requiring modifications to standard ma
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