Doppler ultrasonography and magnetic resonance imaging findings of testicular adrenal rest tissue in a patient with 11 ß hydroxilase deficiency. Case report.

Benign intratesticular lesions are rare; thus, radiological diagnosis is important to avoid unnecessary surgical intervention. Testicular adrenal rest tumors (TART) are the nodular testicular lesions deriving from the adrenal remnant tissue reported in patients with congenital adrenal hyperplasia. We present ultrasonographic (US) and magnetic resonance imaging (MRI) findings of intratesticular adrenal rests in a 16-year-old patient with 11 ß hydroxilase deficiency. Scrotal ultrasonography demonstrated bilateral heterogenous hypoechoic lesions located around mediastinum testis and highly vascularized on powerDoppler US. On MRI the lesions were hyperintense on T1-weighted and hypointense on T2-weighted images and enhanced brightly on post-contrast images.

Gossypiboma/textiloma mimicking as tumour recurrence.

A surgical sponge accidentally left in a surgical wound, called a textiloma or gossypiboma, is underreported in literature due to medicolegal consequences. Abdominal textiloma may be asymptomatic or present serious gastrointestinal complications such as bowel obstruction, perforation or fistula formation because of misdiagnosis. It may mimic abscess formation in early stage or soft-tissue masses in chronic stage. If there is an intraabdominal abscess resistant to catheter drainage in the postoperative period or an intraabdominal soft tissue mass with a history of previous surgery, textiloma should be included in the differential diagnosis. Whirl-like spongiform pattern especially on CT, well-defined border and fibrous capsule especially on MRI can help in the diagnosis of textiloma. We describe a case of intraabdominal textiloma mimicking abscess and soft tissue tumour on CT and MRI examination.

A rare tumor in a patient with hepatic hydatic cyst: adrenal hepatoid adenocarcinoma.

Hepatoid adenocarcinoma (HAC) is a very rare type of extrahepatic adenocarcinoma which has a clinicopathologic and morphologic similarity to hepatocellular carcinoma (HCC). Although it is not common, it can be seen in organs other than the liver. The correct diagnosis can be a challenge because of its clinically similarity to HCC and the diagnosis is usually achieved by pathological examination following the surgery. We present a 48-year-old woman who was following with the diagnosis of stage 5 hepatic hydatic cyst. In her routine blood examinations, her alpha feta protein level was found higher than normal and her abdominal computed tomography and magnetic resonance findings did not reveal any pathological findings rather than hepatic hydatic cysts. There was a high activity of FDG on PET CT in the hepatic region so we performed a right lateral hepatectomy to the patient and final pathology was adrenal hepatoid adenocarcinoma. In this paper we aimed to present a rare case of hepatoid carcinoma of the adrenal gland.

Integration of ultrasound findings with Alvarado score in children with suspected appendicitis.

BACKGROUND: The aim of this study was to investigate the integration of ultrasound (US) findings with Alvarado score in diagnosing or excluding acute appendicitis. METHODS: Data were analyzed in 122 pediatric patients with suspected appendicitis who had undergone US. The US findings were classified into four groups, and the patients were classified into three groups according to Alvarado score. US results and Alvarado score were compared. RESULTS: Alvarado score was a good predictor of appendicitis for scores ≥7. CONCLUSION: In the case of non-visualization of the appendix without a high Alvarado score, appendicitis can be safely ruled out.

Ogilvie's syndrome in an elderly patient with multi-system atrophy.

Multi-system atrophy (MSA) is characterized by symptoms of autonomic failure, such as orthostatic hypotension and constipation. When intensive bowel motility problems are seen in elderly patients with MSA, Ogilvie Syndrome is kept in mind the management, before surgery.

Retroperitoneal mature cystic teratoma arising from intra-abdominal undescended testis in an adult.

Teratomas are a type of germ-cell tumour which may contain embryological tissues from more than one germ-cell layer, usually occurring in the gonads. Primary retroperitoneal teratomas account for 1-11% of retroperitoneal neoplasms and are most commonly found in neonates and young adults. In the clinical literature, retroperitoneal mature cystic teratoma arising from an intra-abdominal undescended testis in adult males has been very rarely reported. We report a case of surgically proven retroperitoneal mature cystic teratoma arising from an intra-abdominal undescended testis in an adult male by multislice helical computed tomography and magnetic resonance imaging.

CT and MRI Findings of Hepatic Involvement in Rendu-Osler-Weber Disease.

Rendu-Osler-Weber disease is a rare autosomal dominant disorder. Hepatic involvement manifests itself as vascular, parenchymal, and biliary lesions with characteristic telangiectasias and vascular shunts. In a 37-year-old female patient, dynamic contrast-enhanced upper abdominal CT and MRI were performed. CT and MRI revealed dilated celiac trunk and hepatic artery. On early arterial phase, dilated hepatic veins showed significant enhancement. On arterial and portal venous phases, liver showed significantly heterogeneous contrast enhancement and showed homogenous enhancement in the hepatic parenchymal phase. On the magnetic resonance cholangiopancreatography, irregular biliary ducts with strictures and dilatation were seen.

Ileocecal Intussusception due to a Lipoma in an Adult.

While intestinal tumors are rare, small intestinal lipomas are even more uncommon benign neoplasms. They are usually asymptomatic, but lipomas larger than 2 cm may become symptomatic due to obstruction, bleeding, or intussusception. In this paper, US and CT findings of a lipoma located in the terminal ileum and causing ileocecal intussusception were discussed. We report a case of small bowel lipoma that became symptomatic due to intermittent obstruction episodes and ileocecal intussuception. If the diagnosis of intestinal lipoma had been made absolutely as in our case, they should be removed surgically in elective conditions.