Navigating the complexity of skull base osteomyelitis: a case study and comprehensive review.

Skull base osteomyelitis is a rare and life-threatening infection of the skull base, commonly seen in elderly diabetic patients as a result of otogenic or paranasal infection. The diagnosis is based on a series of arguments, including a high clinical suspicion, imaging findings, negative biopsies for malignancy, and microbiological isolation. Complications, including abscess formation and vascular involvement, mandate a multidisciplinary treatment approach, primarily involving broad-spectrum antibiotics and surgical debridement, but the prognosis is usually poor. Herein, we describe the case of a 55-year-old male, who 15 years prior, underwent radiation therapy for nasopharyngeal carcinoma. He presented with an infection of the skull base with extensive bone erosion accompanied by an uncommon complication; an intra clival abscess. Despite aggressive antibiotic therapy, the patient ultimately succumbed to septic shock.

Bilateral swelling of the lacrimal glands as first manifestation of systemic sarcoidosis in a patient with breast cancer.

Sarcoidosis, a multifaceted granulomatous disease primarily affecting the lungs, occasionally presents in atypical locations. Lacrimal gland involvement, though rare, poses distinct diagnostic challenges. This case report details a 52-year-old female with bilateral lacrimal gland swelling initially suggestive of metastatic tumor due to a history of breast cancer. Subsequent investigations, including CT and MRI, unveiled pulmonary sarcoidosis. Discussion emphasizes the diverse ocular manifestations of sarcoidosis, with lacrimal gland participation potentially indicating early stages. Diagnostic complexities involve differentiation from other lacrimal pathologies, including neoplasms, lymphoproliferative disorders, Sjögren's syndrome, Wegener's granulomatosis, tuberculosis, and IgG4-related disease. In summary, while lacrimal gland involvement in sarcoidosis is infrequent, it should be considered in orbital masses, necessitating a comprehensive approach for accurate diagnostic orientation in such cases.

Endoscopic management of a transgastric migrated gossypiboma: A case report.

Textiloma, also known as gossypiboma, is a rare but well-documented entity. It involves the omission of surgical material during surgery. Gossypiboma remains a diagnostic dilemma to this day, due to its wide spectrum of clinical symptoms and numerous radiological pitfalls. The recommended treatment for gossypiboma is surgical removal. Endoscopic removal has been performed by some teams and has shown satisfying results. We report the case of a 33-year-old woman with a transgastric migrating gossypiboma, managed by an endoscopic extraction.

Transgastric migration of retained intraabdominal surgical sponge: Gossypiboma in the fundus.

The retention of a surgical sponge is a rare complication that presents diagnostic challenges and carries the risk of potential complications. Two distinct foreign body reactions, fibrinous, and exudative, can result in the formation of a granuloma (known as gossypiboma) or lead to complications such as abscess formation and migration into the gastrointestinal tract. In this report, we present the case of a 33-year-old woman with a history of splenectomy who presented with symptoms including epigastric pain, vomiting, and episodes of hematemesis. Imaging studies, including computed tomography and magnetic resonance imaging, revealed a mass consistent with a gossypiboma that had migrated transmurally into the stomach. The diagnosis was subsequently confirmed through gastroscopy, and successful endoscopic removal of the retained surgical sponge was performed.

A rare presentation of a spinal diffuse midline glioma in a child: a case report.

Our patient had an extremely rare type of pediatric Diffuse Midline Glioma (DMG) with modified H3 K27 that occurred in the cervical spinal cord. Due to its location in the spinal cord, slow clinical presentation with torticollis for 7 months, and the non-specific radiological appearance of this tumour, it was initially considered to be a low-grade glioma. Based on imaging findings, the neurosurgery team performed a complete surgical resection, but the pathological features were consistent with a high-grade, diffuse midline glioma. Therefore, we are reporting a case of an altered high-grade DMG H3K27 glioma, which is difficult to diagnose due to its slow clinical symptoms which caused a delay in diagnosis, non-specific imaging, and with difficulty in accessing histopathological markers in low and middle income countries (LMIC).

Acquired cystic lymphangioma imitating breast cancer recurrence.

Cystic lymphangioma is a benign, congenital lymphatic malformation mainly encountered in infants during the first 2 years of life. It is rarely found in adults. Cystic lymphangioma of the breast is an extremely uncommon entity, and only a few cases have been described in the literature. We present the case of a 52-year-old female who had a mastectomy and chemoradiotherapy for breast cancer 8 years ago and in whom we discovered a suspicious mass of the treated breast through an annual imaging check-up. A cancer recurrence was suspected, and the patient underwent surgical resection. Pathology results were consistent with a cystic lymphangioma.

Primary amenorrhea secondary to imperforate hymen.

Hymen imperforation is uncommon. Symptoms include primary amenorrhea, cyclical lower abdominal pain, and rarely a pelvic mass syndrome. Delayed discovery may lead to endometriosis and infertility. Pelvic ultrasound and nuclear magnetic resonance detect associated genito-urinary malformations. Hymenectomy is the standard surgical treatment.

Spinal epidural lipomatosis.

Spinal epidural lipomatosis (SEL) is a rare pathologic growth of histologically normal nonencapsulated adipose tissue in the epidural space. It can cause myelopathy or radiculopathy. Etiologies include chronic exposure to endogenous or exogenous steroids and obesity. Idiopathic forms are much infrequent. We present a case of lumbar SEL compressing the thecal sac in a 50-year-old female patient.