Bilateral pneumothorax unveiling cystic pulmonary metastases from facial angiosarcoma: A case report.

Cutaneous angiosarcoma is a rare malignant vascular tumor that most often affects the scalp and face of elderly males. It is most frequently associated with lung metastases, with the appearance of thin-walled cyst. We report the case of a 78-year-old male who presented with acute chest pain and dyspnea, subsequently revealing bilateral pneumothorax caused by cystic pulmonary metastases from a neglected facial angiosarcoma. The diagnosis was confirmed through comprehensive radiological evaluations, emphasizing the critical role of CT imaging. This case underscores the critical need to not underestimate pneumothorax complicating cystic lung lesions and to consider angiosarcoma metastases, particularly in elderly men, as a potential diagnosis.

Bilateral renal lipomatosis: A case report.

Renal replacement lipomatosis is a rare condition characterized by fatty tissue proliferation. It has been associated with aging, lithiasis disease, and renal transplantation. The clinical presentation is non-specific, and imaging is essential to confirm and make the differential diagnosis. We report a case of a patient followed for endometrial thickening or the diagnosis of renal lipomatosis that was discovered incidentally on an abdominopelvic CT scan.

A rare presentation of multiple sclerosis: Schilder's disease.

Schilder's disease is a rare form of multiple sclerosis. It concerns mostly teenagers and young adults. The Clinical signs and symptoms might be atypical for early multiple sclerosis which often mimics intracranial neoplasm or abscess. Their coursemay be either progressive or relapsing and remitting, with a high sensitivity to steroids. The knowledge of this rare form ofmultiple sclerosis may help radiologists in assessing a precise diagnosis. We report the case of a young 22-year-old patientadmitted to the emergency room with an array of headache, vomiting and frontal syndrome. Magnetic resonance imaging shows2 bilateral demyelinating frontal areas. The patient was put under corticosteroids bolus with discreet improvement in her clinicalcondition. After 6 months of follow-up, we did not notice any real clinical improvement. Although Schilder's disease isconsidered to be a variant of Multiple Sclerosis, its clinical and imaging features behaves more like a demyelinating conditionwith its monophasic course with, however, serious clinical consequences if the treatment is delayed.

Kienbock's disease: A radiological case report.

Kienböck's disease is a condition characterized by avascular necrosis of the lunate. It is also known as lunatomalacia and aseptic or ischemic necrosis of the lunate. The aim of this work is to summarize and illustrate, through a case diagnosed in our institution, the radiological aspects of this rare entity, which occupy a prominent place in the diagnosis. A better understanding of this recently described nosological entity and a wide dissemination of its diagnostic criteria, especially by radiologists, should facilitate the diagnosis and treatment of patients.

Facial infiltrating lipomatosis, a rare cause of facial asymmetry to be known: Case report and literature review.

Facial infiltrating lipomatosis is a rare lipomatous lesion, first described by Slavin in 1983. It is a benign pseudotumor pathology. It corresponds to a non-encapsulated collection of mature adipocytes infiltrating the local tissue and hyperplasia of underlying bone leading to a craniofacial deformity. Very few cases have been reported in the literature. We report the case of a 19-year-old female patient, who was consulted for a swelling of the right hemiface progressively evolving since birth. Physical examination revealed facial asymmetry. On palpation, the mass was soft, painless, not compressible, not pulsatile, not fluctuating. In view of the asymptomatic nature and slow progression of the lesion, a lipomatous tumour, namely lipoma, was suggested. CT scan image shows a hyperplastic subcutaneous fat on the right hemiface. On the right jugal and temporal areas, there is a subcutaneous formation of fatty density, poorly limited, with no detectable peripheral capsule. It merges with the adjacent fat. In the bone window, there was a hyperplasia of underlying bone. Facial lipomatosis infiltration of the face is a benign pseudotumor pathology. As a result, it can be confused with other disorders, in particular, hemifacial hyperplasia. Combination of physical and radiological findings can establish the diagnosis. Surgical treatment is done for cosmetic purposes.

Painful bipartite patella following injury: a case report.

Bipartite patella is a normal variation in ossification development. This variation is usually asymptomatic but can cause persistent and debilitating anterior knee pain with an injury. We report the case of a 56-year-old man complaining of persistent anterior left knee pain following trauma. Standard knee radiographs show a bilateral Bipartite Patella appearance, and magnetic resonance imaging shows discrete bony edema of the cancellous bone of the accessory bone and about the synchondrosis explaining the anterior knee pain, associated with a crack in the posterior compartment of the medial meniscus. Conservative care including medical treatment with non-steroidal anti-inflammatory drugs, physical therapy was used. Magnetic resonance imaging is the most valuable diagnostic tool for evaluating detailed morphologic and pathologic changes in patients with the bipartite patella.

A rare combination of complications of ruptured carotid artery aneurysm: A case report.

The giant aneurysm of the subclinoid portion of the internal carotid artery is a relatively rare disease that can present serious complications. We present the case of a 40-year-old guy who was suffering from a headache and had complete ophthalmoplegia in his right eye. A brain scan shows a right temporal subdural hematoma, associated with subarachnoid hemorrhage, and total Sylvian subacute ischemic stroke. CT angiography and MRI showed a ruptured and partially thrombosed aneurysm of the subclinoid portion of the right internal carotid artery complicated by subarachnoid hemorrhage, a right subdural temporal hematoma, and total Sylvian ischemic stroke. Our purpose is to recognize the possibility of an aneurysmal rupture when evaluating an acute subdural hematoma, alone or in combination with Ischemic stroke.

Arrested pneumatization of sinus sphenoid, revealed by hypo-acusis: A case report.

The sphenoid bone is a complex structure in terms of its embryological origin. At birth, the sphenoid sinus is not pneumatised. Pneumatisation begins at around 4 months of age until the age of 12-14 years. If this process is absent or interrupted for reasons that are often unknown, it is called arrested pneumatisation. This report describes the case of a 15 year old patient, who consulted an ENT specialist for chronic headaches and hearing loss on the left side. Clinical ENT examination (including otoscopy) is normal. Tonal audiometry revealed a sensorineural hearing loss in the left ear. A CT scan of the petrous bone was normal but revealed a hypodense lesion in the left sphenoid bone. Lipoma was suggested. A brain MRI was performed in a clinic to better characterize the lesion. MR images showed a well-defined lesion with fatty content. The diagnosis was nasosinus fibrous dysplasia. In view of the diagnostic discrepancy, the patient was referred to our department for a specialist opinion. An additional brain scan revealed a non-eroded, non-expansive fatty density lesion with well-defined internal curvilinear calcification in the left sphenoid sinus location. Our final diagnosis was arrested pneumatisation. Most patients with arrested pneumatization of the skull base are asymptomatic. Sometimes it may be revealed by nonspecific signs and be confused with severe skull base disease, especially if the radiologist is not familiar with its existence or its typical features.

Pancreatic Lipoma: A Pancreatic Incidentaloma Diagnosis with Computed Tomography.

Lipoma of the pancreas is a rare benign tumour which is usually discovered incidentally on imaging. We present a case of an incidentally discovered pancreatic lipoma in a 79-year-old man with non-metastatic prostate adenocarcinoma who was referred to radiology for follow-up imaging. Fat-containing tumours originating from the pancreas are very rare. Most lipomas show characteristic features on imaging that allow their differentiation. We present the imaging features of a pancreatic lipoma on ultrasound, CT and MRI, discuss the differential diagnosis, and provide a brief review of the literature. LEARNING POINTS: Pancreatic lipoma is a rare mesenchymal tumour that is being increasingly recognized.Pancreatic lipoma is commonly asymptomatic and incidentally detected.CT and MRI allow confirmation of the diagnosis and elimination of other differential diagnoses.

[Bilateral adrenal tuberculosis: about a case]. / Tuberculose surrénalienne bilatérale: à propos d'un cas.

Isolated adrenal tuberculosis accounts for less than 2% of adrenal incidentalomas. This is the most frequent infectious cause of adrenal insufficiencies. We report the case of a 53-year old patient with no previous medical history presenting with adrenal insufficiency with slow progression over six months. Physical examination didn't show any mass or hepatosplenomegaly. Blood pressure was 120/60 mmHg. Laboratory tests didn't show inflammatory syndrome. LDH level was normal. CT scan showed bilateral hypertrophy of the adrenal glands characterized by calcifications. Intradermo tuberculin reaction was positive at 25mm. The analyses to detect Koch's bacillus in the sputum and in the urine were negative. Quantiferon® test was positive. Trial antibacillar treatment was started with clinical improvement and 5kg weight gain in 12 months. Hormonal assays were low.