Splenogonadal fusion in a female: A case report of a rare congenital anomaly.

We present a case of an 18-year-old female referred for an MRI pelvis to evaluate suspected uterine anomaly by ultrasound. The MRI showed a complete septate uterus and in addition, an elongated tubular structure (isointense to the spleen) extending from the left ovary in the left retroperitoneal region/left paracolic gutter to the under-splenic surface. CT abdomen and pelvis revealed this to be a similarly enhancing structure as the spleen and appears as a tubular retroperitoneal structure connecting the left ovary to the spleen with associated vasculature joining the splenic vein cranially and the ovarian vessels caudally consistent with splenogonadal fusion.

Synchronous gnathic osteosarcoma and B-cell lymphoblastic lymphoma/leukemia: A rare case presentation.

Multiple primary malignancies are a well-recognized entity, with increased recognition and detection alongside development of hybrid imagining. We present a rare case of a 16-year-old male with gnathic osteosarcoma and incidental finding of a second silent synchronous B-cell lymphoblastic lymphoma/leukemia in the lower limb. Treated successfully by chemotherapy, radiotherapy, and surgery.

Isolated Sixth Cranial Nerve Palsy as Initial Presentation of Pituitary Apoplexy: A Case Report.

Pituitary apoplexy is a serious condition, which if left untreated, might lead to irreversible life-long complications. Hence, pituitary apoplexy should always be included in the differential diagnoses of a patient with an isolated sixth cranial nerve (CN) palsy. This report highlights the case of a patient presenting with isolated CN palsy associated with pituitary apoplexy. Although pituitary adenomas are common, they seldom present with isolated abducent nerve palsy without any other CN involvement. The 47-year-old female patient presented with acute right eye pain, diplopia, and a squint. Examination revealed an isolated unilateral sixth CN palsy. Brain MRI showed a sellar and suprasellar mass suggestive of hemorrhagic pituitary apoplexy. The patient was transferred to neurosurgery and underwent transsphenoidal resection of a pituitary macroadenoma. Postoperative follow-up showed clinical improvement. It is, thus, imperative for physicians to have the knowledge to recognize an isolated sixth cranial nerve palsy and its associated causes.

DVT as the Initial Presentation of Multiple Myeloma: A Rare Case Report and Literature Review.

Multiple myeloma patients are recognized to have a higher risk of venous thrombosis. The cause of this could be attributed to several risk factors, such as circulating prothrombotic microparticles, disease-specific variables, and alterations in coagulation and fibrinolysis factors. Recent research has revealed that these individuals also experience greater arterial thrombosis, including acute myocardial infarction and stroke. In this case report, we present the clinical profile and management of a 42-year-old patient who presented with signs and symptoms of deep venous thrombosis (DVT) and was diagnosed with multiple myeloma. The aim of this case report is to highlight a rare clinical presentation and diagnostic workup in a patient with multiple myeloma. Additionally, we discuss the possible factors provoking the development of DVT as a first presentation before treatment initiation and their possible mechanisms.

Kikuchi-Fujimoto Disease: A Rare Cause of Pyrexia of Unknown Origin and Cervical Lymphadenopathy.

Kikuchi-Fujimoto disease (KFD) is a benign disorder characterized by regional cervical lymphadenopathy with tenderness. Associated symptoms of KFD include low-grade fever, night sweats, weight loss, nausea, and sore throat. The disease is a sporadic disease known to have a worldwide distribution with a higher prevalence among Asian communities. Although the clinical and histopathological features point to a viral etiology, this hypothesis has not been proven yet. Generally, the diagnosis is made based on a lymph node excisional biopsy. Its recognition is crucial mainly because this disease can be mistaken for other disorders, including systemic lupus erythematosus or malignant lymphoma. Supportive treatment includes antipyretics, non-steroidal anti-inflammatory drugs, and corticosteroids. Spontaneous recovery occurs within a few weeks. Patients should be followed up for years to survey because there is a possibility of developing systemic lupus erythematosus. In this article, we report the case of a patient who presented with a fever of unknown origin and lymphadenopathy, treated with multiple antibiotic courses with no improvement. Workup including computed tomography of the neck with contrast and lymph node biopsy confirmed the diagnosis of KFD. His condition improved after administering analgesics and multivitamins, and he was advised to rest at home.

Post-COVID-19 Vaccine Limbic Encephalitis: A Case Report.

Limbic encephalitis (LE) diagnosis can be challenging due to its broad spectrum of clinical presentation and variety of causes. The most commonly known causes include paraneoplastic and autoimmune, but they can also occur post-vaccine. Since 2020, many people worldwide have received the coronavirus disease 2019 (COVID-19) vaccine after FDA approval. Mild self-limited neurological adverse reactions, including headache and dizziness, were reported post-vaccine. However, emerging few neurological severe events, including encephalitis, have also been reported. Herein, we present a case of a middle-aged female who presented with seizures after two days of receiving the second dose of the Moderna COVID-19 vaccine. A diagnosis of limbic encephalitis was made based on head MRI findings. It was treated with immunosuppressive agents and responded well with no additional neurological sequelae. This case is unique as it highlights a possible association between limbic encephalitis and the COVID-19 vaccine.

Isolated Great Saphenous Vein Thrombosis in a Patient With COVID-19 Infection: Case Report and Review of the Literature.

On 30 January 2020, the Director-General declared that the outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitutes a Public Health Emergency of International Concern (PHEIC), and on 11 March 2020, it was characterized as a pandemic. Since then, patients with COVID-19 infection are commonly reported to have an increased risk of thrombosis in various blood vessels due to hypercoagulability, blood stasis, and endothelial damage. In this study, we will present a case of a pregnant lady who was evaluated for right leg pain that started one week after having upper respiratory tract symptoms and COVID-19 infection confirmed by the COVID antigen (Ag) test. Further investigation with Doppler ultrasound (US) revealed complete right great saphenous vein thrombosis. This suggests that COVID-19 may lead to other adverse effects through damage to blood vessels.