5-Fluorouracil-induced acute leukoencephalopathy: Case report and literature review.

Toxic leukoencephalopathy (TL) refers to damage to the brain white matter following exposure to toxic agents. Multiple agents are incriminated in this condition, including chemotherapy drugs. 5-Fluorouracil, widely used in oncology, is responsible for neurotoxicity in less than 5% of cases. We report the case of a 54-year-old male patient who presented with neurological symptoms following 5-FU-based chemotherapy for gastric adenocarcinoma, and whose MRI scan revealed signs suggestive of toxic leukoencephalopathy. We also report on the evolution of the abnormalities described on his MRI after 1 year.

An unusual case of diastatic perforation of the transverse colon: Case report and literature review.

Diastatic perforation corresponds to a bursting of the cecal wall caused by excessive distension resulting from a remote obstruction of the low large bowel. This perforation could be explained by Laplace's physical law, and by the particular vascular anatomy of the cecal wall. We report the case of a 75-year-old man admitted for peritonitis with an abdominal CT scan highly suggestive of a diastatic perforation of the cecum complicating colonic distension upstream of a stenosing tumor of the rectosigmoid junction. To our surprise, surgical exploration revealed the defect to be in the transverse colon and not in the cecum. Diastatic perforation of the transverse colon is exceptional, and would require other pathophysiological explanations than those for classical cecal perforation.

Cerebral actinomycosis following a facio-cranial trauma: A case report.

Cerebral actinomycosis is a rare, chronic, but curable bacterial brain infection. We report the case of an 18-year-old male patient with a history of facio-cranial trauma, admitted in our institution with severe headaches and behavioral disorders. Magnetic resonance imaging (MRI) was performed showing the presence of contiguous multiple small round and ovoid lesions in the right frontal lobe with "the dot in circle" appearance. The diagnosis of cerebral actinomycosis was confirmed by histological study of the biopsy sample. Despite it being a rare condition, it is important to consider this diagnosis in patients with atypical post-traumatic neurological symptoms.

Cocaine-Induced Lung Damage and Uncommon Involvement of the Basal Ganglia.

Cocaine use is responsible for multiorgan damage, including the brain and lungs. Bilateral and symmetrical involvement of the basal ganglia may be due to toxic, metabolic, vascular, inflammatory, infectious, or tumoral causes. Cocaine-related encephalopathy mainly affects the white matter, while basal ganglia involvement is an uncommon finding. Cocaine-induced lung damage varies clinically and even radiologically, with signs that lack specificity. The diagnosis of cocaine-induced lung or brain injury is based on suggestive radiological signs in the context of cocaine consumption and after the elimination of other etiologies likely to present the same patterns. The context of cocaine use is often not spontaneously declared, making diagnosis more complicated. We report the case of a 28-year-old male patient, with a history of freebase cocaine use, admitted to the emergency room in severe coma with respiratory distress. Brain MRI showed bilateral and symmetrical abnormalities of the basal ganglia. A chest CT scan revealed interstitial lung damage dominated by the ground-glass pattern. The urine toxicology test was positive for cocaine. Cocaine-related lesions can be reversible, and therapeutic management is essentially based on supportive care.

Moya-Moya Disease Revealed by a Non-lobar Intracerebral Hemorrhage in an Adult.

Moya-Moya disease (MMD) is a rare cerebral vasculopathy affecting children and adults. It is a progressive steno-occlusive arterial disease generally discovered during the etiological assessment of an ischemic or hemorrhagic stroke. Its diagnosis is based essentially on imaging. Cerebral digital subtraction angiography (DSA) remains the gold standard. We report the case of a 42-year-old male patient admitted for the loss of consciousness with a Glasgow Coma Scale (GCS) of 12/15. A brain CT scan revealed a right capsulo-lenticular hematoma with ventricular flooding and hydrocephalus. Cerebral CT angiography showed features of Moya-Moya vasculopathy, which was confirmed by a cerebral catheter angiogram.

Primary leiomyosarcoma of the sigmoid colon: Case report and review of literature.

Leiomyosarcomas of the sigmoid colon are aggressive and extremely rare tumors representing less than 0.1% of all colorectal malignancies. Few cases have been reported in the literature and their imaging features need to be more detailed. We report the case of a 70 year old male patient, smoker, with a history of arterial hypertension, admitted for abdominal pain and hypogastric mass. Computed tomography has shown a voluminous heterogeneously enhancing tumor process with a necrotic center, attached to the sigmoid wall, with multiple secondary peritoneal and hepatic masses. The anatomopathological examination of the biopsy sample with immunohistochemistry allowed the diagnosis of leiomyosarcoma of the sigmoid colon. Clinical presentation and radiological features of leiomyosarcomas are non-specific, and the definitive diagnosis is only established after an anatomopathological examination.

Choroidal Metastasis Revealing a Lung Adenocarcinoma: A Case Report.

Choroidal metastasis is the most common malignant intraocular tumor. Its diagnosis in a patient with known lung cancer is usually easy. However, without any context of already known cancer, further elements are needed to guide the diagnosis. We report the case of a 47-year-old patient with a history of smoking who presented a choroidal metastasis of left lower pulmonary lobe adenocarcinoma discovered on imaging. Imaging techniques, mainly ultrasonography, CT scan, and MRI can help guide the diagnosis of choroidal metastasis even in the absence of a known origin initially.