[Sclerosing polycystic adenosis of the parotid gland : surgical treatment of an extensive lesion of deep tissue without superficial damage]. / Adénose sclérosante polykystique de la parotide : traitement chirurgical d'une lésion extensive du lobe profond sans atteinte superficielle.

Sclerosing polycystic adenosis (SPA) is a rare benign epithelial lesion of the salivary glands, of unknown etiology, mainly affecting the parotid gland. We report the first clinical case of SPA involving the deep parotid gland with extension in the parapharyngeal space and the masticatory region. It has been resected by an external parotidectomy approach exclusively, despite the median extension of the lesion. The objective of this article is to complete the small series of cases described in the literature, and to update the knowledge of this rare disease.

L'adénose sclérosante polykystique (SPA) est une lésion épithéliale bénigne rare des glandes salivaires, d'étiologie inconnue, atteignant principalement la glande parotide. Nous rapportons le premier cas clinique de SPA dont l'origine est le lobe profond de la parotide et qui envahit la région masticatrice et l'espace parapharyngé. Elle a été réséquée par une voie d'abord externe de parotidectomie, exclusivement, malgré l'extension médiane de la lésion. L'objectif de cet article est de compléter la petite série de cas décrits dans la littérature, et d'actualiser les connaissances de cette pathologie rare.

Bronchial lipoma : an unusual cause of pleural empyema.

We report a case of rapidly growing pleural empyema due to endobronchial lipoma. The diagnosis was established by chest computed tomography (CT). Endobronchial lipoma is a rare benign tumor of the tracheobronchial tree which can cause irreversible damage to the distal lung parenchyma if diagnosis and treatment are not carried out in time.

Appearance and vanishing of a spinal intradural arachnoid cyst after multiple epidural corticosteroid injections. A spontaneously resolving cause of symptomatic lumbar stenosis.

BACKGROUND: Spinal intradural arachnoid cyst is a rare lesion, sometimes acquired. PURPOSE: To describe the appearance and later spontaneous disappearence of a lumbar intradural arachnoid cyst, following perineural corticoid injections. METHOD: Review of the clinical data and imaging, with final spontaneous return to initial state. DISCUSSION: Atypical intradural arachnoid cysts can be related to perineural injections and can cause symptoms of spinal stenosis. Its spontaneous vanishing is a very rare event, up to now unreported.

Single left coronary artery with the right coronary artery arising from the mid-portion of the left anterior descending artery. Diagnosis with MDCT.

Single coronary artery is a very rare entity. We describe a very unusual subtype of this anomaly in which the right coronary artery arises from the mid-portion of the left anterior descending artery. MDCT allowed diagnosis of this non pathogenic variant and excluded any significant coronary stenosis.

Pylephlebitis complicating peridiverticulitis without hepatic abscess: early detection with contrast-enhanced CT of the abdomen.

Pylephlebitis is a very rare and dangerous complication of inflammatory abdominal processes, mainly appendicitis (1) and diverticulitis (2).We describe a case of peridiverticular inflammation leading to a extensive phlebitis of the adjacent sigmoid vein, extending to the inferior mesenteric vein up to the proximal portal vein, with distal embolus into the left portal vein. Contrast CT and multiplanar reconstructions allowed early diagnosis, and with antibiotic and anticoagulation therapy, no liver abscess developed.

Abnormal left single pulmonary vein: case report of an anecdotal variant.

We describe here a patient with a very rare ectopic unilateral single pulmonary vein, with normal distal drainage into the left atrium, and thus a non pathologic finding to be distinguished from clinically significant abnormalities.

Small bowel obstruction due to an internal herniation through a defect of the broad ligament.

We report on a case of internal hernia through a defect of the broad ligament of the uterus. Early diagnostic may be possible with multidetector CT and lead to early treatment. MDCT can help achieving early preoperative diagnostic and allows early laparoscopic treatment with prompt recovery.

A minimally invasive vertebral hemangioma.

We describe a very unusual vertebral hemangioma presenting with a mixture of aggressive-like pattern (epidural extension, T1 hyposignal) and quiescent, inactive lesion (fatty infiltration), in association with a spiculated calcified epidural component.This paper emphasizes that CT and/or MR findings are accurate enough to make formal assessment of vertebral hemangioma, preventing patient's anguish and moreover unnecessary treatment. Furthermore this attractive case proposes a poorly known characteristic of vertebral hemangioma which is usually encountered and described only in skull hemangiomas.

Ectopic infraorbital nerve in a maxillary sinus septum: another potentially dangerous variant for sinus surgery.

We report on two patients with ectopic infraorbital nerve and canal located in a maxillary sinus septum. This very rare anatomic variation may possibly generate complications during sinus surgery if it passes unnoticed during the preoperative CT work-up.

Metastases of clinically occult testicular seminoma mimicking primary extragonadal retroperitoneal germ cell tumors.

BACKGROUND: Whether extragonadal germ cell tumors develop primarily in the retroperitoneum or whether they are essentially metastases of a primary testicular tumor has long been debated and remains controversial. PATIENTS AND METHODS: Three patients presenting with apparent primary extragonadal retroperitoneal germ cell tumors are reported. Ipsilateral testicular evaluation was extended with palpation, ultrasonography and finally histological examination. RESULTS: The retroperitoneal extragonadal tumors were found during abdominal MSCT. It was a fortuitous finding in the two first patients.The third patient presented with abdominal pain attributed to necrosis of the large mass which was subsequently firstly drained through endoscopic ultrasound-guided transduodenal puncture. The seminomatous nature of the retroperitoneal tumors was obtained through transduodenal echoendoscopic-guided cytopuncture in the first case, celioscopic resection in the second case and delayed percutaneous CT guided biopsy in the third symptomatic case. The first two patients had a history of cryptorchidism with substantial clinical testicular atrophy; ultrasonography showed microlithiasis and a small intratesticular tumor in the first patient and an hypoechoic but rather homogeneous atrophic testis in the other; orchiectomy confirmed small seminomatous intratesticular tumors in the two cases. The third patient had an atypical hypoechoic area on testicular ultrasound and histopatholgy revealed a burn-out primary tumor. CONCLUSIONS: So-called primary extragonadal retroperitoneal germ cell tumors are extremely rare and should first be considered as metastases of a viable or burned-out testicular cancer until proven otherwise. All ipsilateral testicular abnormalities revealed by the patient's history, clinical examination and mostly by testicular ultrasound must be treated adequately with orchiectomy because they may act as a sanctuary for later tumor growth.

A specific database for providing local and national level of integration of clinical data in cystic fibrosis.

It has recently been stated that a database is an essential tool in the management of CF. The purpose of this work is to create a specific database allowing optimal performance of storage, search and retrieval functions on patients with CF. A specific database was developed using a Windev licence, for application via Microsoft supported platforms or Intranet system. The database allows real-time point of care data management of medical, investigational and administrative data. It is currently being used in the 6 Belgian reference centres. It represents a useful tool for gathering information on routine clinical and lab data, bacteriology, treatments, complications and specific outcomes for clinical and research purposes. The ongoing evolution of the database includes enhancements toward research data orientation including comparison of patient data between different centres and completeness of the National CF registry questionnaire. A complimentary copy of the software can be provided to multidisciplinary accredited CF centres worldwide upon request.

Synovial haemangioma diagnosed during knee arthro-CT.

Synovial haemangiomas are uncommon lesions most frequently found in the knee. We report a case in the popliteal area fortuitously demonstrated during knee msCT arthrography in a young female. The diagnosis was made possible by the sharp enhancement of the tumor caused by the venous drainage of the contrast medium injected into the synovial cavity. The diagnosis was confirmed by msCT angiography and MRI.

Hypoplasia of the internal carotid artery: a noninvasive diagnosis.

We present the characteristic imaging findings of hypoplasia of the internal carotid artery (ICA) in two cases, one accompanied by an intracranial aneurysm. Finding of a diffuse luminal narrowing of the ICA on MR angiography or digital subtraction angiography (DSA) could wrongly evoke severe acquired diseases such as dissection or atherosclerosis. Absence of associated wall thickening and flow disturbances on color Doppler sonography (CDS) should suggest carotid hypoplasia. Confirmation of the diagnosis is obtained by CT of the skull showing a small carotid canal. Non-invasive procedures are sufficient to differentiate this rare congenital anomaly from acquired string signs.