Adult's Wilms tumor: A case report.

Nephroblastoma is the most frequent renal tumor in childhood population. Rarely, it can occur in adults. In this case, the diagnosis is frequently challenging for pathologists. No standard guidelines are available for this neoplasm in adults. It needs multidisciplinary collaboration for optimal management. Herein we report a 26-year-old man presenting with a non-metastatic right nephroblastoma. He underwent a radical nephrectomy. He is currently in complete remission after a follow-up of 18 months.

Positive urine culture prior to transrectal prostate biopsy was not associated with infectious complications development.

OBJECTIVE: Prostate cancer is one of the most common cancers worldwide. Its histological diagnosis is based on prostate biopsy. The transrectal procedure is one of the most common procedures performed by urologists. Although it is considered safe, post-biopsy infectious complications are frequently observed in practice. The aim of this study is to investigate the value of urine culture before the transrectal biopsy. Secondly, we assessed potential risk factors for infectious complications following TR-PB. METHODS: We performed a retrospective analysis of all patients who underwent urine culture tests before transrectal prostate biopsy between January 2019 and July 2020. The inclusion criteria for the study were all indications for prostate biopsy (PSA>4ng/mL or abnormal digital rectal examination). Baseline characteristics and the incidence of post-biopsy urinary tract infection were compared between patients showing positive pre-biopsy culture results and those showing negative findings. Multivariate logistic regression analyses were used to determine risk factors for infectious complications following TR-PB. RESULTS: Out of 163 patients included in our study, 19 patients (11.65%) had positive urine culture results before the biopsy. Age (P=0.068); history of hospitalization (P>0.999), history previous of quinolone use (P=0.75), history of UTI (P=0.64); median PSA level at diagnosis (P=0.267); prostate volume (P=0.78); post-void residual volume (P=0.374); percentage of patients testing positive for cancer on biopsy (P=0.81); and percentages of patients with a history of biopsy (P=0.889), diabetes mellitus (P=0.524), hypertension (P=0.714) and immunosuppressive medication use (P>0.999) were similar between the two groups. One patient in the positive urine culture group had post-biopsy prostatitis. However, 3.24% (five patients) of the negative urine culture group had the disease (P=0.789) (four patients with prostatitis and one with epididymitis). Among them, four patients were diagnosed by urine culture at the time of post-biopsy urinary tract infection. Multivariate logistic regression analysis demonstrated that history of hospitalization and history of previous quinolone use were risk factors for infection after transrectal prostate biopsy. CONCLUSION: Our study suggests that systematically performing urine cultures before transrectal prostate biopsy does not reduce the rate of infectious complications after biopsy. Positive pre-biopsy cultures were not associated with the development of post-biopsy infectious complications.

[Pneumorachis: report of three rare causes]. / Pneumorachis: illustration de trois étiologies rares.

The presence of gas in the spinal canal or pneumorachis is a rare imaging finding, typically incidental. Pneumorachis may be due to several degenerative, traumatic, infectious, tumoral or iatrogenic etiologies. We report three cases of pneumorachis in patients with lumbar back pain. A case occurred in a patient with advanced degenerative disk disease. Another was in a patient with posterior facet synovial cyst. The last was in a patient with locally advanced rectal carcinoma complicated by perforation. Pneumorachis was detected on MRI in two cases and on CT in all three cases.

Acute disseminated encephalomyelitis following herpes simplex encephalitis.

Acute disseminated encephalomyelitis is an acute immunomediated demyelinating disorder of the central nervous system, usually encountered in children or adolescents and characterized by multifocal neurologic deficits of rapid onset. It is often preceded by various infectious diseases or vaccination, but acute disseminated encephalomyelitis developing after herpes simplex encephalitis is rare. We report such a case in a 2-year-old girl which illustrates the importance of MRI features to consider acute disseminated encephalomyelitis in a patient who develops neurologic signs after the onset of HVS encephalitis.

[Exceptional digestive location of crystal deposits in primary hyperoxaluria]. / Localisation digestive exceptionnelle des dépôts cristallins dans l'hyperoxalurie primitive.

We report 3 cases of primary oxalosis with nephrocalcinosis and severe renal failure. Extrarenal involvement was noted in bones in 3 cases, the heart in 2 cases, the central nervous system in 2 cases, the skin in 1 case and the eye in 1 case. The 3 patients presented with acute digestive disorders. Ultrasonography and CT scans showed digestive wall calcifications in addition to the classic appearance of primary oxalosis such as nephrocalcinosis or bone involvement. Primary hyperoxaluria is characterized by a calcium deposit in different tissues, mainly in kidneys. Digestive wall involvement has never been reported in the literature. Primary oxaluria should be considered in the presence of such a deposit in the gut wall.

[Spontaneous spinal epidural hematoma: a report of 3 cases]. / L'hématome spontané épidural rachidien: à propos de 3 cas.

We report MR imaging features in 3 cases of spontaneous spinal epidural hematoma, a potential neurosurgical emergency.

[Magnetic resonance imaging features of desmoplastic cerebral ganglioglioma of infancy: report of 1 case]. / Imagerie par résonance magnétique du gangliogliome desmoplastique infantile cérébral: à propos d'un cas.

Desmoplastic infantile ganglioglioma is a rare intracranial tumor of infancy, characterized by solid and cystic component, voluminous size and supratentorial location. These tumors are diagnosed usually below the age of 2 years. We report 1 case of desmoplastic ganglioglioma in 13-year-old male. Computed tomography and magnetic resonance imaging diagnosed supratentorial mixed cystic and solid tumor, which presented as a large cystic component with intense contrast enhancement of a mural nodule. The tumor was surgically removed, and histology revealed desmoplastic ganglioglioma. The patient had a good follow up. This observation emphasizes the possibility of desmoplastic ganglioglioma in older infants. It mustn't be considered as a specific entity of very young age infant and must be recognized in older infant because it may be misdiagnosed as malignant glioma. Despite the pseudo malignant appearance, these tumors have a good prognosis after surgery and when excision is complete they don't led to recurrences.

[Atypic radiologic aspect of a renal cell carcinoma in children]. / Présentation radiologique atypique d'un carcinome à cellules claires du rein chez l'enfant.

Renal cell carcinoma is rare in children and is usually found in late childhood. The authors report on an exceptional case of renal cell carcinoma in a 10-year-old girl. The radiological aspect is misleading and has not been previously reported in the literature. Renal cortex was thin because of congenital megalo-ureter, so the tumor developed entirely into excretory cavities (to the proximal ureter), while a primitive urothelial disease (tumoral or inflammatory) was first evoked. The atrophied cortex was the tumoral starting point which prolapsed into excretory cavities, upraising the urothelial epithelium.

[Cerebral hydatid disease: imaging features]. / Hydatidose cérébrale: aspects en imagerie.

Cerebral hytatid cysts (HC) are extremely rare, forming 2% of all intra cranial space occupying lesions even in counties where the disease is endemic. HC diagnosis is usually based on a pathognomonic computed tomography (CT) pattern. In order to assess the value of MR we reviewed the CT (n=25) and magnetic resonance (MR, n=4 including diffusion and proton magnetic resonance spectroscopy in 1) imaging of 25 patients with pathologically confirmed cerebral hydatid disease. 19 HC were seen in children under 16 years. All were supra tentorial with 22 in the middle cerebral artery territory. HC was solitary in 18 cases, unilocular in 23 and multi-vesicular in 2 with heavily calcified pericyst in 1. 2 cysts were intra ventricular and 1 intra aqueducal. The most typical features were well defined, smooth thin walled spherical or oval cystic lesions of CSF density and/or signal with considerable mass effect (20/25). Surrounding oedema with complete or incomplete rim enhancement was seen in 3 cases which were labelled as complicated and/or infected cysts. Although CT is diagnostic of hydatid disease in almost all cases (22/25), MRI including diffusion and spectroscopy precisely demonstrate location, number, cyst capsule, type of signal and enhancement and allows diagnosis of atypical or complicated HC and appears more helpful in surgical planning.

[MRI findings in the diagnosis of pseudotumoral humeral hydatid]. / Apport de l'IRM dans le diagnostic d'une hydatidose humérale pseudo-tumorale.

Hydatidosis of bone is rare. Vertebral localizations predominate. Standard imaging may be misleading, suggestive of a malignant tumor or infection. We present the case of a patient with a humeral hydatid. This localization is very rare and presents an unusual radiographic aspect. Computed tomography produces an image suggestive of a tumor. The correct diagnosis can be established with MRI, particularly with the STIR sequence. In our patient, MRI enabled us to establish the diagnosis preoperatively and evaluate extension. MRI has been found to be highly contributive to the diagnosis of hydatidosis of bone and for assessment of intra- and peri-osseous extension.

[Primary lymphoma of bone: imaging features]. / Lymphomes osseux primitifs: apport de l'imagerie médicale.

Primary lymphoma of bone (PLB) has benefited from recent advances in medical imaging and immunohistochemical study that are of prognostic and therapeutic value. From 3 case reports of PLB involving the iliac bone and the skull base, we review the definition of PLB and their main features. The importance of complete initial workup for staging in order to exclude secondary bone lymphomas, more frequent and of worse prognosis, is emphasized. Diagnosis of PLB involving the skull base is more difficult to obtain and nearly always requires neurosurgical biopsy unlike PLB of peripheral bones that are more readily amenable to percutaneous biopsy.

[Esophageal mucocele: report of 2 pediatric cases]. / Mucocèle oesophagienne à propos de deux observations pédiatriques.

Two cases of esophageal mucocele in pediatric patients are reported: two children of 5 and 9 years respectively underwent surgical isolation of the esophagus and esophagocoloplasty for caustic stenosis related to accidental ingestion of caustic soda. Clinical pattern of mediastinal compression was proved with cervical fistulous tract in one case. In both cases, thoracic computed tomography was a sensitive imaging method to demonstrate the mucocele and its extension. Esophageal mucocele is rarely described in children, especially following esophageal corrosive stricture.

[Abdominal actinomycosis. Report of 4 clinical cases studied with radiography]. / Actinomycose abdominale. A propos de 4 observations radiocliniques.

We report 4 cases of pathologically proven abdominal actinomycosis. US and CT demonstrated an infiltrative abdominal mass with ill-defined margins and heterogeneous enhancement after IV contrast. The ileo-cecal region was involved in one case; the mass appeared following cholecystectomy and recurred 3 years after surgical resection in one case; and no predisposing factor was identified in the 2 other cases. In one of these, recurrence was observed 12 years after the first episode. Actinomycosis must be included in the differential diagnosis of invasive abdominal lesions with "malignant" appearance.

[Radioclinical profile of cardiopericardial hydatid: report of 17 cases]. / Profil radioclinique du kyste hydatique cardiopéricardique: à propos de 17 cas.

Hydatid cysts concerning the heart are rare, accounting for 0.5 to 2% of all hydatic sites. The risk of serious complications in this location makes rapid diagnosis and surgical treatment essential. The aim of our study is to clarify the role of imaging in the diagnosis of the disease and to propose an adequate strategy. We report on 17 patients who underwent surgery for cardiopericardial hydatid cyst in the cardiovascular and thoracic unit of Sahloul hospital in Sousse from January 1988 to December 1998. Clinical investigation included in all cases chest X ray, ECG and ultrasonography (US). A computed tomography (CT) scan was performed in 14 cases, magnetic resonance imaging in three cases, transesophageal US in five cases, and coronary angiography in fsix cases. Examination for other hydatic sites was realized in all cases, and brain CT was performed in four cases. The hydatid cyst was variably localized in the left ventricle wall (five cases), the right ventricle (five cases), the pericardium (five cases), the interventricular septum (four cases), the right auricle (one case) and the left auricle (one case). The existence of other cardiac hydatid sites was found in 12 cases. All patients underwent surgery. Outcome was favorable in 14 cases, with a mean of 3 years and 5 months survey. Three patients died. The combination US-CT scan allowed a precise topographical inventory, reducing the need for MRI to the complicated cases and to the rare cases of inconclusive results by US-CT scan.

[Tuberculous mesenteric lymphadenitis: a case report]. / La lymphadénite mésentérique d'origine tuberculeuse: à propos d'un cas.

The authors report a case of mesenteric tuberculous lymphadenitis which mimic a pancreatic cystadenoma. They emphasize ultrasound and CT scan features which lead to the recognition of tuberculosis and permit a percutaneous fine needle biopsy. Laparotomy seems the most reliable method for a positive diagnosis. The place of different imaging methods is discussed.

[Value of imaging in the assessment of malignant fibrous histiocytoma of the soft tissues]. / Place de l'imagerie dans le bilan des histiocytomes fibreux malins des parties molles.

Malignant fibrous histiocytoma (MFH) is a rare and potentially highly malignant sarcoma. The authors report 6 cases of MFH in various sites: two in the chest wall, one in the pelvis, two in the gluteal zones and one on the scalp. Ultrasonography and computed tomography were the main imaging methods used in the assessment of the structure and extension of the tumor. A poor prognosis was noted in four cases: death within a few months in the two thoracic sites, recurrence in the pelvic and scalp lesions, radical surgery allowed recovery in two cases. A review of the literature showed that MRI and CT are complementary in the initial staging and follow-up of these patients.