Short Stature: Think About the Pituitary Stalk Interruption Syndrome.

Pituitary stalk interruption syndrome (PSIS) is an uncommon congenital defect of the pituitary gland. It is considered one of the rare endocrinal causes of abnormally short stature. Herein, we present a case of a four-year-old girl who consulted for short stature and delayed growth. The patient's history did not include any past medical or surgical pathology. Birth history revealed a full-term delivery with a breech presentation. Clinically, the patient had a small stature, beneath the third percentile. Magnetic resonance imaging findings, through a typical triad, were consistent with PSIS. We describe through this report, what we believe is a rare typical case of PSIS. This case was discovered in a young patient with pituitary dwarfism. We hope that the concise and synthesized structure of this case report will help physicians acquire the necessary reflexes to notice and diagnose the already underdiagnosed PSIS.

Bilobed testicle diagnosed by ultrasound in a 9-year-old boy.

Bilobed testis is an extremely rare congenital malformation, and even rarer on the right side. Only 7 cases have been reported in the literature. We describe the case of a 9-year-old boy with a right bilobed testicle confirmed on ultrasound and discovered incidentally as a mass on physical examination. The aim of our work is to consider the bilobed testicle as a differential diagnosis of a testicular mass despite its rarity and to show the importance of ultrasound and MRI for its definitive diagnosis to avoid unnecessary surgery.

Lead poisoning with encephalic and neuropathic involvement in a child: case report.

Lead is a toxic substance in our environment that affects adults and children of all socioeconomic backgrounds, lead poisoning is one of the most common exposures that can cause inter alia significant neurological and functional damage in humans. Children are particularly vulnerable because of the effects of the toxicity on their developing nervous systems with potentially irreversible consequences. We report a case of severe lead poisoning encephalo-neuropathy in a 3-year-old girl, admitted for progressive paraplegia, swallowing disorders, and aphasia. A multitude of investigations undertaken could not explain her atypic symptoms, so anamnesis was redone in the sense of a toxic origin, we found a notion of pica, and a traditional herbalist father, so probably consumption of medications based on traditional medicine products. A venous blood lead level (BLL) was extremely elevated at 176.4 µg/l. The child was treated with an oral chelator succimer (SUCCICAPTAL). During the two following months in the intensive care unit, the child showed progressive respiratory distress and worsening signs of the nervous system. Despite treatment and the use of lead chelators, the patient died due to septic shock. Lead is highly toxic even at very low exposure levels, at high levels of exposure, it can damage the reproductive organs, immune system, liver and kidneys. in children, it can affect neurocognitive and behavioral development that could be irreversible. Peripheral and central nervous system damage should be considered as a possible manifestation of lead poisoning.

Cystic lymphangioma of the upper limb: Clinical case and literature review.

We report an observation of a macro- and microcystic lymphatic malformation located in the right upper limb. This was a 5-year-old girl with no previous pathological history, followed since the age of 11 months for a congenital subcutaneous, painless and soft swelling of the right upper limb. Ultrasound of the soft tissue and magnetic resonance imaging (MRI) allowed the diagnosis of macro- and microcystic lymphatic malformation of the right upper limb. There is little epidemiological data on cystic lymphatic malformations (CLM). Superficial MLKs are more numerous than deep MLKs; of the superficial MLKs, nearly 75% are located in the head and neck, with an estimated incidence of 1.2 to 2.8 per 1000 births, and in the axillary hollows in 20% of cases. They affect equally males and females and different ethnic backgrounds. Involvement of the upper limb and particularly the arm is very rare. MRI plays an important role in the diagnosis and assessment of the tumor's boundaries. Treatment can be difficult because of the location of the tumor and its extension into the surrounding tissue.

[Septo optic dysplasia plus: about a case]. / Dysplasie septo optique plus: à propos d'un cas.

Septo optic dysplasia plus is a rare disease seen in children. Its diagnosis is radiological, based on brain magnetic resonance imaging (MRI). We report the case of a child aged 2 years and 4 months, with no particular pathological history; who consulted for psychomotor retardation, strabismus and low vision behavior. An endocrine biological assessment exploring the hypothalomo-pituitary function was carried out, revealing no abnormality. The diagnosis of septo-optic dysplasia plus was retained on the brain MRI data, in front of the agenesis of the septum pellucidum and of the splenium of the corpus callosum, the hypoplasia of the optic pathways and of the pituitary stalk as well as in front of the agenesis of the posterior pituitary. It was associated with a closed schizencephaly. Septo-optic dysplasia is a rare congenital malformation. Our objective is to recall its semiology in imaging and to underline the importance of MRI to establish the diagnosis. Septo-optic dysplasia is a rare clinical entity typically involving midline brain abnormalities, optic nerve hypoplasia, and pituitary insufficiency. The association with cortical malformations such as schizencephaly and polymicrogyria denotes the term septo-optic dysplasia plus. Advances in imaging currently allow early diagnosis, which is essential for adequate management. Antenatal ultrasound may suspect dysplasia, and brain MRI confirms the diagnosis.

Post-traumatic biloma intrahepatic a rare complication of closed abdominal trauma: A case report.

Post-traumatic hepatic biloma is a rare complication of closed trauma of the abdomen. Generally, biloma occurs spontaneously or secondary to traumatic or iatrogenic injury to the biliary system. It can lead to significant morbidity and mortality if not diagnosed promptly and properly managed. A 4-year-old child was admitted to the emergency room with abdominal pain following a traffic accident. Clinical examinations suspected closed abdominal trauma without biological signs of icteric cholestasis. Abdominal CT scan performed within 24 hours showed a focus of hepatic laceration, and follow-up imaging at 5 days showed post-traumatic intrahepatic cystic formations. This case report aims to emphasize the importance of imaging including ultrasound, CT, MRI, MRI cholangiopancreatography (MRCP), or hepatobiliary cholescintigraphy to establish the diagnosis and guide the therapeutic gestures.

Chiari type III malformation: Case report and review of literature.

Chiari III (CM III) is the rarest of the Chiari malformations, characterized by high cervical or occipital encephalocele and osseous defects, associated with herniation of the posterior cerebral fossa contents through the foramen magnum. We report the case of a female newborn, with a cervico-occipital mass, hypotonia and sharp osteotendinous reflexes in the lower limbs. An MRI was performed showing a low occipital encephalocele with caudal displacement of cerebellar tonsils. Because of its high contrast resolution, MRI is more useful than CT, preoperatively, to assess the content of the encephalocele. MRI can identify the position of the brain stem and spinal cord, so that they are preserved during the surgical procedure.

Posterior reversible encephalopathy syndrome revealing Takayasu's arteritis in a child.

Posterior Reversible Encephalopathy Syndrome (PRES) is a rare complication of Takayasu's Arteritis. We report the case of an 11-year-old girl who presented with a tonic-clonic seizure and loss of consciousness, without fever. Imaging revealed characteristic white matter edema of the occipital and parietal lobes, in keeping with PRES. Further imaging demonstrated right renal artery stenosis and wall thickening of the abdominal aorta. The combination of hypertension, the discrepancy of blood pressure recordings between upper limbs, and imaging abnormalities of the aorta and the left renal artery led to the diagnosis of PRES secondary to Takayasu's Arteritis. Treatment with oral corticosteroids, azathioprine, amlodipine, and propranolol resulted in the complete resolution of the patient's symptoms and imaging abnormalities.

[Gayet-Wernicke encephalopathy with normal thiamine level: a case report]. / Encéphalopathie de Gayet-Wernicke avec taux de thiamine normale: à propos d'un cas.

Gayet-Wernicke encephalopathy is a neuropsychiatric emergency due to thiamine deficiency (vitamin B1), secondary to several factors. We here report a case of Gayet-Wernicke encephalopathy in a 43-year-old woman who didn't consume alcoholic beverages, presenting with disorders of consciousness and diplopia with normal thiamine level. Classic triad of symptoms and Magnetic resonance imaging (MRI) played an important role, in particular, in the diagnosis of Gayet-Wernicke encephalopathy with normal thiamine levels in the absence of alcohol abuse.

[False aneurysm of the palmar arch in a child: a case report]. / Faux anévrysme de l´arcade palmaire chez un enfant: à propos d´un cas.

Superficial pseudoaneurysms of the palmar arch is a rare disorder and only a few cases have been described in the literature. In the majority of cases it develops after artery lesion following penetrating injury, previous surgery or arterial puncture. Diagnosis is based on strong clinical suspicion, especially in patients with pulsatile mass. We here report a case of false aneurysm of the superficial palmar arch following broken glass injury in a 3-year old child.

[A rare cause of mechanical occlusion in children: a case report]. / Cause rare d'occlusion mécanique chez l'enfant: à propos d'un cas.

Gastrointestinal (GI) bezoars are aggregates of undigested material found in the GI tract. Trichobezoar is the most common type of bezoars and consists of ingested hair, carpet fibers or fitted carpet fibers. They are mainly located in the gastric region, rare forms extend to the duodenum or small intestine and are described as Rapunzel syndrome. Typical CT imaging features play a diagnostic and prognostic role. We report the case of a 13-year-old girl hospitalized for occlusive syndrome due to trichobezoar.

Morel-Lavallee Syndrome: A Rare Tumefactive Lesion.

First described by the French surgeon Maurice Morel-Lavallee in 1853, Morel-Lavallee syndrome (MLS) is a serolymphatic effusion resulting from tangential injury to richly vascularized tissues. The imaging characteristics may be variable over time due to lesion progression and the eventual organization of a fibrous capsule. We report a case of extensive MLS in the lower leg of a 12-year-old child. We discuss the ultrasound and magnetic resonance imaging findings and describe the differential diagnoses. LEARNING POINTS: The diagnosis of Morel-Lavallee syndrome is based on clinical examination and imaging techniques.The post-traumatic context is important for diagnosis.Morphological aspects depend on lesion progression and the eventual organization of a fibrous capsule.

[Sturge-Weber syndrome: about a case]. / Le syndrome Sturge-Weber: à propos d'un cas.

Sturge-Weber syndrome (SWS) or encephalofacial angiomatosis is a rare neurocutaneous and congenital ocular syndrome. It can cause two malformations: congenital facial capillary planar angioma and leptomeningal venous-capillary angioma (most often parieto-occipital homolateral angioma). Neuroimaging, in particular magnetic resonance imaging (MRI), plays an important role in the diagnosis, ideally before the occurrence of neuro-ocular complications. We report the case of a child in whom SWS was suspected based on facial angioma and pharmaco-resistant epilepsy.

Solid pseudopapillary tumor of the pancreas: a rare entity in children.

Solid pseudopapillary tumors (SPTs) constitute 0.2 to 2.7% of non-endocrine primary tumors of the pancreas and comprise the majority (70%) of pediatric pancreatic neoplasms. These tumors are of unclear pathogenesis, low malignancy and favorable prognosis. Surgical resection offers an excellent chance for longterm survival, even in the presence of distant metastasis. The objective of this study is to review our experience in the management of SPT in a 12 years old girl at the pediatric hospital of the University hospital of Casablanca, in Morocco and provide an update on current management in pediatric population.

Forme rare du dysraphisme spinal fermé: la diastématomyélie: A rare form of closed spinal dysraphism: diastematomyelia.

Diastematomyelia is a rare spinal dysraphism in which the spinal cord and its content are split. Two types of diastematomyelia have been described. We report the case of a 12 year old male patient presenting with reduced lower limb muscle strength without associated sphincteric disorders. The patient underwent axial, sagittal and coronal T1 and T2-weighted MRI sequence of the spine. MRI showed a bifid appearance of the bone marrow of thoracolumbar vertebrae in two hemi-cords without bone spur separating the two hemi-marrows, compatible with type 1 diastematomyelia. It was associated with low tethered spinal cord with syringomyelic cavity involving the left hemi-marrow and with biloculated fibrotic lesion at the level of the right hemi-marrow compatible with a neuroenteric cyst. MRI also showed incomplete closure of the posterior arch of D12 vertebra which communicated with a subcutaneous pocket in relation to a dermal sinus. Diastematomyelia is a rare abnormality of the spine which can be associated with other malformations. Therapeutic strategy essentially depends on the progression of the clinical signs (neurological) and of associated malformations.

[Interest of imaging in tumors benign bone in children]. / Intérêt de l'imagerie dans les tumeurs osseuses bénignes chez l'enfant.

Benign bone tumors are more common than malignant tumors in pediatrics. The exostosis (ostéchondrome) is the most common. The different imaging techniques are pivotal in the study of tumors including its standard radiography. The aim of this work is to highlight the interest in imaging the diagnostic management of bone benign tumors in children through a retrospective study of 169 patients. All patients were investigated by plain radiography, scanner supplement with multiplanar reconstruction before and after injection of PDC and / or MRI 1. 5 Tesla was performed according to the indication. The average age is 6 years with a slight male predominance. Clinically, the swelling is present in 35% of cases. The pain in 29% of cases. The most common location is the metaphyseal long bone on: Femur: 25% of cases, humerus: 17% of cases, Tibia: 21% of cases. Main Benign tumors are found exostosis (20. 12%), bone cyst (31. 95%) and osteoblastoma (16, 57%). The imagery is used to specify the topography and extension of the lesion in the bone provide arguments in favor of benign and sometimes in favor of the cause of the injury. The only standard radiograph often provides a diagnosis of certainty in some cases.

Acute paraplegia and pulmonary edema after benzathine penicillin injection.

Accidental intra-arterial injection is a potentially devastating complication of the intragluteal injection of benzathine penicillin. A 35-year-old woman developed after intramuscular injection of benzathine penicillin G acute paraplegia and noncardiogenic pulmonary edema. Noninvasive positive pressure ventilation was initiated with furosemide and corticosteroids. A magnetic resonance imaging scan showed findings consistent with syringomyelia and spinal cord ischemia at T9 through T10. Vascular injury may be the result of microemboli of the injected crystals of the penicillin salts. The mechanism of noncardiogenic pulmonary edema is perhaps an immunogically mediated one. At 2-year follow-up, she had no improvement in neurologic status. The deficit is considered permanent.

[Giant retroperitoneal liposarcoma]. / Le liposarcome rétropéritonéal géant.

The authors report a case of giant retroperitoneal liposarcoma. The diagnosis was suspected after scanography and magnetic resonance imaging and confirmed by the histological analysis of the extracted piece after surgical treatment. Postoperative evolution was favourable after one year without recurrence or distant metastasis. The authors discuss the pathologic and therapeutic aspects and the prognosis of retroperitoneal liposarcoma.