Wandering Spleen: An Overview.

An ectopic (or "wandering") spleen results from abnormal ligamentous laxity failing to fixate the spleen in its normal location in the left upper quadrant. Ligamentous laxity can be acquired due to conditions, such as splenomegaly or pregnancy, but is often congenital. Because of this laxity, there is an elongated vascular pedicle, which is prone to torsion and resultant splenic infarction. These patients generally present with abdominal pain and other nonspecific symptoms making the diagnosis very difficult to make clinically. As such, the radiologist plays a crucial role in the diagnosis and care of these patients, as often the diagnosis is only considered after imaging.

Congenital and Acquired Disorders of Ureteral Course.

A wide variety of entities can alter the course of the ureter in the abdomen and pelvis. These include conditions both intrinsic and extrinsic to the ureter leading to a number of different ureteral abnormalities including thickening, displacement, dilatation, etc. An understanding of ureteral pathology, as with any organ, first requires understanding of the normal anatomic appearance. The ureter can be evaluated in a number of ways, including radiographs, such as intravenous pyelogram and retrograde pyelogram, as well as computed tomography or magnetic resonance urography. The unopacified ureter can also be evaluated on examinations tailored for evaluation of other pathologic entities. Although the full spectrum of ureteral pathology is rather broad, this article serves as a review of the normal embryology and anatomy of the ureter, methods of evaluating the ureter at imaging, and entities that can alter the course of the ureter. These potential disorders of ureteral course include embryologic causes; surgical procedures; and displacement by inflammatory, neoplastic, and anatomic abnormalities.

A Case of Desmoplastic Small Round Cell Tumor.

Desmoplastic small round cell tumor is a rare, aggressive tumor primarily affecting young males. It is considered a childhood cancer, and is characterized by a unique chromosomal translocation which leads to failure to suppress tumor growth. It is classified as a soft tissue sarcoma, sharing some features with other small round cell tumors such as Ewing's Sarcoma and primitive neuroectodermal tumor. Typical imaging findings include multiple heterogeneous, lobular abdominal masses, which can grow very large. Often there is a dominant mass with additional peritoneal, omental, retroperitoneal and retrovesical masses. Prognosis is relatively poor with a 3 year survival rate of 50% in those treated aggressively with surgical resection, chemotherapy, and radiation therapy. The clinical presentation, imaging characteristics and pathology are discussed in regards to a recent case.

Pelvic alveolar rhabdomyosarcoma in a young adult.

Rhabdomyosarcomas are soft-tissue tumors, rare in adults. Accounting for nearly 5% of childhood cancers, they represent less than 0.03% of adult malignancies (1, 2). Three different subtypes of rhabdomyosarcoma have been described (embryonal, alveolar and pleomorphic), making up approximately 50%, 30%, and 20% of the cases, respectively (3). Although the definitive diagnosis is made pathologically, some distinguishing features among these subtypes, and between rhabdomyosarcomas and other soft-tissue tumors, can be suggested on MRI and CT. We present an interesting case of a 20-year-old female with a locally aggressive pelvic alveolar rhabdomyosarcoma. While the prognosis has improved with newer treatment techniques, overall survival rates remain poor. Our case study presents typical features of a rare disease, which can often present a diagnostic dilemma for clinicians.