RESUMEN
Inflammatory pseudotumors are reactive and rare lesions of unknown origin. They are locally aggressive, but they generally do not extend beyond the affected organ, with a favorable prognosis after radical surgical resection. Symptoms and radiologic features are often nonspecific, and pathological examination plays a pivotal role in the diagnosis of inflammatory pseudotumors along with immunohistochemical staining to rule out differential diagnosis, especially myofibroblastic inflammatory tumor. Molecular biology can play a decisive role when these latter cannot establish a definitive diagnosis. Herein, we present a case study that describes a 65-year-old woman presenting a mesocolic mass. The patient underwent a surgical excision, which included a wedge gastric resection, transverse colectomy, and colocolic side-to-side stapled anastomosis. Histopathology and immunohistochemistry confirmed an inflammatory pseudotumor. Surgery remains the main treatment and depends on the location of the tumor. No recurrences are noted; however, a standardized follow-up protocol for inflammatory pseudotumors has yet to be established.
RESUMEN
Multiple primary malignancies can occur as either synchronous or metachronous tumors, particularly in adults. Retroperitoneal liposarcoma is a rare malignancy arising from adipose tissue, while gastric adenocarcinoma is one of the most common neoplasms worldwide. The simultaneous occurrence of these 2 malignancies is extremely rare, with only 1 case reported worldwide. Here, we present the case of a 52-year-old man diagnosed with both retroperitoneal liposarcoma and gastric adenocarcinoma, marking the second reported case in the world.
RESUMEN
Inflammatory pseudotumor (IP) is a rare type of benign tumor. Although initially identified in the lung, it has now been identified in a number of somatic and visceral sites, but mesenteric presentation is uncommon and has a variable clinical presentation. As inflammatory pseudotumor mimic malignancy both clinically and radiologically, the radiologist should be familiar with this entity. The only effective treatment is complete surgical resection. We present the case of a 55-year-old woman who presented with chronic abdominal pain and was diagnosed with a mesenteric inflammatory pseudotumor, in an attempt to illustrate the different imaging aspects of this benign condition in ultrasound, computed tomography and magnetic resonance imaging, and to simplify the description of these tumors.
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Dermatophytic disease is a rare condition, primarily described in North Africa. This orphan disease owes its name to Hadida and Schousboe. Although the pathophysiology remains poorly understood, it is often associated with immune deficiency and occurs in the context of high consanguinity, as in our case. We report the case of a 24-year-old man who presented a trichophytic disease due to Trichophyton rubrum, admitted for the appearance of numerous subcutaneous nodules, prompting consultation at our institution. This dermatophytic disease typically begins with recurrent ringworm of the scalp or involvement of hairless skin. The dermatophytes involved are of anthropophilic and zoophilic origin, with T. violaceum being the most frequently isolated species in ringworm cases in the Maghreb. To date, no treatment regimen has been established. However, improving immune status and using antifungals have delayed or prevented the visceral dissemination of the disease.
RESUMEN
MRKH syndrome, or Mayer-Rokitansky-Küster-Hauser syndrome, a rare congenital disease, manifests as a complete or partial aplasia of the uterus and the vagina's upper two-thirds with normal external genitalia and functioning ovaries. Mayer-Rokitansky-Küster-Hauser syndrome can occur in isolation (type I) or in conjunction with other congenital extragenital deformities affecting the kidneys, skeleton, heart, eyes, or auditory system (type II). The diagnosis of Mayer-Rokitansky-Küster-Hauser syndrome typically relies on imaging studies, with transabdominal ultrasonography serving as the primary modality. However, magnetic resonance imaging is considered the gold standard for detailed assessment of internal genital anatomy. We present the case of an 18-year-old woman without any notable medical history who exhibited primary amenorrhea. Mayer-Rokitansky-Küster-Hauser syndrome type II was suspected on pelvic ultrasound and subsequently confirmed via magnetic resonance imaging. The patient was provided with psychological assistance and planned for vaginoplasty.
RESUMEN
Considered rare, the synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is a distinct clinical entity, associating skin manifestations and osteoarticular symptoms. Anterior chest wall pain centered at sternoclavicular and sternocostal joints is an important and characteristic clinical finding that can lead to its diagnosis. Radiologists and clinicians must be aware of synovitis-acne-pustulosis-hyperostosis-osteitis syndrome as it can mimic some of the more common disease entities such as Paget's disease. We report the case of a 63-year-old male patient, with no significant medical history, who presented to the dermatology department, with severe palmar and plantar pustulosis associated with polyarthralgia. Computerized tomography scan showed sternoclavicular hyperostosis, in favor of SAPHO syndrome, with regression of clinical symptoms after non-steroidal anti-inflammatory drug treatment.
RESUMEN
Pheochromocytoma, a neuroendocrine tumor, represents a rare medical condition characterized by the excessive secretion of catecholamines. These tumors often exhibit distinctive features on imaging studies, notably appearing hypervascular. Furthermore, they may present as cystic masses with thin walls, a characteristic that becomes more evident following the administration of contrast medium. The cystic form of adrenal pheochromocytoma, as exemplified in our case, is particularly uncommon, thus underscoring the importance of recognizing its atypical presentation. Accurate diagnosis hinges on a thorough understanding of both the clinical manifestations and radiological findings suggestive of pheochromocytoma. However, definitive confirmation typically necessitates histological examination of the surgical specimen post-adrenalectomy. By shedding light on this rare variant, our case emphasizes the critical role of comprehensive diagnostic approaches in managing such complex medical conditions. Additionally, it underscores the significance of multidisciplinary collaboration among clinicians, radiologists, and pathologists to ensure timely and accurate diagnosis, ultimately guiding appropriate treatment strategies and optimizing patient outcomes.
RESUMEN
Cystitis glandularis is a rare benign condition, occurring in only 1% of the general population, and it tends to affect males more frequently. This pathology is characterized by reactive metaplasia of the bladder's urothelium, which results from chronic and recurrent irritation of the bladder wall. Symptoms are nonspecific and primarily marked by an irritative urinary syndrome accompanied by hematuria. We present a case of a young male patient with cystitis glandularis, discovered as a result of bilateral uretero-hydronephrosis detected during an ultrasound examination subsequent to an irritative urinary syndrome. The diagnosis was initially suggested by a CT scan; it was ultimately histologically confirmed following the endoscopic resection of the tumor.
RESUMEN
Gastric diverticula are a rare condition; they are divided into true diverticula, which are congenital, and pseudodiverticula, which are acquired. True diverticula are usually located in the posterior fundus wall, below the esophagogastric junction, and appear on abdominal computed tomography as a cystic mass that is commonly taken for an extra digestive mass, especially adrenal mass. We report the case of an asymptomatic 24-year-old female patient with gastric diverticulum who was mistakenly diagnosed in ultrasound with a renal mass.
RESUMEN
Spinal tuberculosis usually presents as destroyed contiguous vertebral bodies associated with intervertebral discs and paravertebral or psoas abscesses. Atypical forms are uncommonly reported. Vertebral involvement without disk destruction is a rare form that improves satisfactorily after appropriate medical management. We report the case of a 36-year-old male who had spine tuberculosis without disk involvement, associated with intercurrent active pulmonary location with good clinical improvement after treatment and follow-up imaging showing spectacular regression of bone lesions. By reporting this case, we also review the literature on this rare form of tuberculosis.
RESUMEN
The Buschke-Lowenstein Tumor is a giant condyloma acuminatum caused by human papillomavirus, most commonly types 6 or 11. It is a rare condition with an estimated frequency of 0.1% in the general population. Transmission primarily occurs through sexual contact. It particularly affects men, predominantly appearing on the penis, characterized by its deep-seated growth, potential for degeneration, and tendency to recur after treatment. Surgery is the preferred treatment. We present the case of a50-year-old patient with a history of recurrent urethritis and multiple sexual partners. The patient sought medical attention for a swelling on the penis that had been progressively developing over the past 10 years. An MRI was performed for a locoregional study, revealing a perineal and penile mass with polylobed contours resembling a cauliflower, along with a sizable perineal mass Histological examination of a biopsy sample from the penis confirmed the diagnosis. Unfortunately, due to the tumor's characteristics and the patient's condition, surgery was contraindicated.
RESUMEN
A pheochromocytoma is a tumor that typically originates within the chromaffin cells of the adrenal glands, resulting in excessive production of catecholamines. Cystic forms are exceptional and pose a diagnostic challenge, especially those that are non-secreting. The most prevalent symptom associated with this condition is arterial hypertension, which can be either persistent or, more commonly, intermittent. The Ménard triad, comprising headaches, excessive sweating, and palpitations, may accompany episodes of hypertension. The presence of elevated levels of methoxylated derivatives serves to confirm the diagnosis of an adrenal pheochromocytoma. We report the case of a woman who presented with arterial hypertension associated with the Ménard triad, along with elevated methoxylated derivative levels. Imaging modalities revealed a predominantly cystic left retroperitoneal mass. The diagnosis of a cystic pheochromocytoma was established and confirmed through histological examination of the surgical specimen after adrenalectomy.
RESUMEN
Cannabis use is increasing rapidly among young people worldwide despite the deleterious effects of this toxic substance on health. We report a case of acute hippocampal encephalopathy in a heavy cannabis user (8-10 joints/d for 6 years) who presented with a nonfebrile status epilepticus. Brain magnetic resonance imaging revealed bilateral and symmetrical high-signal abnormalities in the hippocampal regions. The damage to these regions is often severe, long-lasting, and sometimes irreversible. Therefore, every doctor (emergency doctor, resuscitator, neurologist...) is asked to request a brain MRI in case of neurological signs in a young cannabis user.
RESUMEN
Urothelial cell carcinomas represent the vast majority of urinary bladder tumors. However, many inflammatory and non-neoplastic conditions can mimic a urinary bladder malignancy. In that matter, diverticulitis can progress into colovesical fistula formation with a bladder wall abscess that can mimic a pseudo mass. Nonetheless, the presence of a bladder wall mass, usually requires pathologic examination. We report the case of a 60 year old woman with recurrent urinary infections due to a focal bladder mass revealing a colovesical fistula as a complication of sigmoid diverticulitis.
RESUMEN
Human echinococcosis (hydatid disease) is highly endemic in Morocco and reemerging as a significant public health problem in this country. It is a cyclozoonotic infection introduced by Echinococcus granulosus, that can invade any organ in the human body. The liver is the mostly affected organ, which is the primary site of human infestation, followed by lungs. Renal involvement by hydatid disease is commonly secondary, occurring owing to primary cyst rupture or disseminated disease. Primary renal localization, often presented as solitary cysts with no visceral involvement, is uncommon even in endemic zone. Herein, a rare cause of renal mass due to an isolated hydatid cyst in a 56-year-old woman who presented with ambiguous left flank pain for the last 10 years. Findings imaging did not reveal any other localizations of hydatid disease. For this scolicidal effect and to prevent peritoneal seeding, the patient was placed on albendazole 400 mg. Three weeks later, the surgery was performed successfully with a left total nephrectomy.
RESUMEN
Gastrointestinal stromal tumors (GIST) are mesenchymal neoplasms most frequently seen in the stomach and small intestine, arising in the muscularis propria of the intestinal wall. Given its nonspecific clinical presentation, it can represent a diagnostic challenge, especially in abdominopelvic locations. Lesion evaluation of abdominopelvic tumors can be difficult and lead to misinterpretation in assessing their origin. We report the case of an 84-year-old woman with a voluminous small bowel GIST mimicking a uterine neoplasm.
RESUMEN
Adrenal gland abscesses are rare lesions usually reported to be caused by fungal pathogens and typically through hematogenous spread from other primary sources of infection. Imaging has always been known to play a major role in the characterization of focal adrenal lesions. However, given the rare occurrence of abscesses in this location, making the right diagnosis remains challenging. We report the case of a 39-year-old man with chronic renal disease on hemodialysis presenting with signs of sepsis and left upper quadrant pain revealing a left adrenal gland abscess.
RESUMEN
Retroperitoneal lymphatic malformation is a rare benign vascular malformation, of various locations, which can reveal itself at any age in its abdominal localizations. The retroperitoneal localization of this malformation is extremely rare. The clinical symptomatology is polymorphic depending on the lesion volume and the presence or absence of complications. The diagnosis is evoked by the liquid character of the retroperitoneal mass on ultrasound, CT scan and abdomino-pelvic MRI, brought during surgery and confirmed by the histological study of the surgical specimen. The treatment of choice is complete surgical removal of the mass.
RESUMEN
Neurofibromatosis type 2 (phacomatosis) is a rare inherited autosomal dominant condition defined by the development of numerous central neuronal tumors. In addition to classic intracranial schwannomas, intracranial and spinal meningiomas, and intramedullary ependymomas, it can be associated with a few cutaneous abnormalities. In this report, we discuss the case of a 21-year-old female who was examined for persistent headache with cutaneous masses and bilateral hearing loss. Magnetic resonance imaging of the cranium and the whole spine detected multiple meningiomas, intracranial, and intramedullary tumors.