Isolated bilateral pyramidal tract lesions? An unusual case of demyelination following trauma. A case report.

This paper describes the case of a young woman who developed quadriparesis due to isolated bilateral pyramidal tract lesions suggestive of demyelination following trauma.

Bilateral subdural hemorrhage following lumbar puncture in a case of suspected meningitis. A case report.

Intracranial subdural hemorrhage is a rare complication of lumbar puncture. Caudal traction and tear of the subdural veins due to negative pressure caused by leakage of cerebrospinal fluid (CSF) following lumbar puncture (LP) is the mechanism. Prolonged headache or neurological symptoms following LP should warrant cross-sectional imaging to rule out subdural hemorrhage as it can be fatal. We report a case of subdural hemorrhage following LP in a patient with suspected meningitis and communicating hydrocephalus.

A case report of primary osteosarcoma of the ovary.

Primary osteosarcoma is one of the rare tumors affecting ovaries. This case is being reported for its rarity, along with a review of the literature. In this study, the patient, a 43-year-old woman, presented with an abdominopelvic mass. Exploratory laparotomy was performed, which revealed an extensive left ovarian mass infiltrating the uterus, small bowel, and urinary bladder. Subtotal hysterectomy and small bowel resection followed by end-to-end anastomosis and bilateral salpingo-ophorectomy were performed. Histopathology showed primary osteosarcoma of the ovary. Eighteen days after surgery, she started presenting with progressive abdominal distention and ultimately developed subacute intestinal obstruction. She was started on carboplatin and epirubicin combination but failed to respond and died of fast progressive disease. It is concluded that primary osteosarcoma of the ovary is a rare disease with poor prognosis.

Methanol poisoning: diagnosis and management. A case report.

Methanol poisoning is an uncommon but potent central nervous system toxin. The diagnosis and the management of its sequelae remain a challenge to clinicians. A case is hereby presented in which computed tomography of the brain played an important role in making the diagnosis due to poor patient's history and unavailability of methanol assay. Parkinsonism and visual sequelae are well-recognised complications in the survivors. This patient developed parkinsonism in the form of mainly severe tremors and mild rigidity. He benefited from treatment on amantadine.

Cystosarcoma phyllodes: report of two cases.

Cystosarcoma phyllodes is a rare predominantly benign tumour usually affecting the female breast. In a retrospective review of giant breast masses seen over a period of 20 years, we encountered two cases of this tumour, one benign and the other malignant, the latter exhibiting the very unusual feature of axially lymph node metastases. We present these two cases and briefly review the literature.

Giant fat containing breast masses: report of six cases.

Six patients with giant fat containing breast masses encountered over a 20 year period are presented including a brief review of the literature. These benign tumours especially the giant varieties are rare but are likely to be increasingly diagnosed because of the widespread use of mammography.

Giant fibroadenoma of the breast in an Arab population.

In a retrospective study of giant breast masses over a period of 20 years (1980-2000), we encountered 18 patients with fibroadenomas. Most of them were adolescents and young adults. The bimodal age incidence seen in Caucasians was not observed. The masses ranged from 6 to 15 cm in size and in the youngest patient, they were bilateral. All 18 patients were examined by mammography and 10 of them by ultrasonography (US) as well. The right breast was involved in 12 patients and the left in six. The diagnosis was confirmed pathologically in all patients, by excision biopsy in 17 patients and by fine needle aspiration cytology and excision biopsy in one patient. The radiological findings were the same as those previously described. All patients were treated by simple enuculation. There was only one recurrence over a follow-up period from 2 months to 3 years.

Leiomyoma of the urinary bladder: case report.

A case of leiomyoma of urinary bladder, a rare benign tumour, is presented. The patient was a 42 year old female who presented with dysuria and frequency of micturition. The radiological features, diagnosis and management are discussed and the literature on this subject is briefly reviewed.

The prevalence and pattern of congenital anomalies of the urinary tract detected by intravenous urography in Kuwait.

We conducted a prospective population-based study in Kuwait to determine the prevalence and pattern of previously undiagnosed congenital anomalies of urinary tract in patients undergoing intravenous urography (IVU) and to examine the demographic factors associated with these anomalies. The study included 2398 consecutive patients undergoing IVU, for various indications, in all the six public hospitals in Kuwait, during the period 1 June 1999-30 September 2000. Patients were also interviewed to obtain selected demographic information. Multiple logistic regression was used to identify factors associated with the anomalies. The average age (+/- SD) of the patients (1623 males, 775 females) was 39.2 +/- 15.1 years. A total of 335 anomalies (12.1% in males, 17.9% in females; p < 0.001) were detected in 300 (12.5%) patients (10.9% males, 15.9% females; p < 0.01). About half (47.2%) of the anomalies involved the kidney, 28.4% renal pelvis, 22.4% ureters, and 2.1% bladder. Multiple regression analysis showed that age < 20 years (odds ratio (OR) = 12.5; 95% confidence interval (95% CI): 7.0-22.3) female gender (OR = 1.5; 95% CI: 1.2-2.0) Kuwaiti nationality (OR = 1.7; 95% CI: 1.2-2.3) and family history of congenital malformation (OR = 3.8; 95% CI: 2.2-6.6) were independently associated with the anomalies of the urinary tract. Overall, 42% of the patients reported a consanguineous marriage between their parents. The frequency of anomalies was higher in individuals who had consanguineous parents (13.8 vs. 11.6%; OR = 1.2) but this positive association did not reach statistical significance. Considering the relatively high prevalence of previously undiagnosed congenital anomalies of the urinary tract, it is important to establish clinical guidelines for early detection and management of these conditions to decrease the associated morbidity and mortality.

Spontaneous rupture of the renal pelvis.

The object of the case report is to present a case of spontaneous rupture of the renal pelvis with no underlying pathological condition to account for the rupture, a very rare and unusual occurrence. The patient was a 46-year-old Korean who presented with severe left loin pain and vomiting. The diagnosis was suspected on intravenous urography and confirmed by CT. Treatment was by ureteral stenting. The patient made a complete recovery. The differential diagnosis of this condition is discussed and the literature is reviewed.