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Bilobed testis is an extremely rare congenital malformation, and even rarer on the right side. Only 7 cases have been reported in the literature. We describe the case of a 9-year-old boy with a right bilobed testicle confirmed on ultrasound and discovered incidentally as a mass on physical examination. The aim of our work is to consider the bilobed testicle as a differential diagnosis of a testicular mass despite its rarity and to show the importance of ultrasound and MRI for its definitive diagnosis to avoid unnecessary surgery.
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We report an observation of a macro- and microcystic lymphatic malformation located in the right upper limb. This was a 5-year-old girl with no previous pathological history, followed since the age of 11 months for a congenital subcutaneous, painless and soft swelling of the right upper limb. Ultrasound of the soft tissue and magnetic resonance imaging (MRI) allowed the diagnosis of macro- and microcystic lymphatic malformation of the right upper limb. There is little epidemiological data on cystic lymphatic malformations (CLM). Superficial MLKs are more numerous than deep MLKs; of the superficial MLKs, nearly 75% are located in the head and neck, with an estimated incidence of 1.2 to 2.8 per 1000 births, and in the axillary hollows in 20% of cases. They affect equally males and females and different ethnic backgrounds. Involvement of the upper limb and particularly the arm is very rare. MRI plays an important role in the diagnosis and assessment of the tumor's boundaries. Treatment can be difficult because of the location of the tumor and its extension into the surrounding tissue.
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Septo optic dysplasia plus is a rare disease seen in children. Its diagnosis is radiological, based on brain magnetic resonance imaging (MRI). We report the case of a child aged 2 years and 4 months, with no particular pathological history; who consulted for psychomotor retardation, strabismus and low vision behavior. An endocrine biological assessment exploring the hypothalomo-pituitary function was carried out, revealing no abnormality. The diagnosis of septo-optic dysplasia plus was retained on the brain MRI data, in front of the agenesis of the septum pellucidum and of the splenium of the corpus callosum, the hypoplasia of the optic pathways and of the pituitary stalk as well as in front of the agenesis of the posterior pituitary. It was associated with a closed schizencephaly. Septo-optic dysplasia is a rare congenital malformation. Our objective is to recall its semiology in imaging and to underline the importance of MRI to establish the diagnosis. Septo-optic dysplasia is a rare clinical entity typically involving midline brain abnormalities, optic nerve hypoplasia, and pituitary insufficiency. The association with cortical malformations such as schizencephaly and polymicrogyria denotes the term septo-optic dysplasia plus. Advances in imaging currently allow early diagnosis, which is essential for adequate management. Antenatal ultrasound may suspect dysplasia, and brain MRI confirms the diagnosis.
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Hipopituitarismo , Esquizencefalia , Displasia Septo-Óptica , Criança , Feminino , Humanos , Hipopituitarismo/complicações , Imageamento por Ressonância Magnética , Gravidez , Esquizencefalia/complicações , Esquizencefalia/patologia , Displasia Septo-Óptica/complicações , Displasia Septo-Óptica/diagnóstico , Displasia Septo-Óptica/patologia , Septo Pelúcido/anormalidades , Septo Pelúcido/diagnóstico por imagem , Septo Pelúcido/patologiaRESUMO
Post-traumatic hepatic biloma is a rare complication of closed trauma of the abdomen. Generally, biloma occurs spontaneously or secondary to traumatic or iatrogenic injury to the biliary system. It can lead to significant morbidity and mortality if not diagnosed promptly and properly managed. A 4-year-old child was admitted to the emergency room with abdominal pain following a traffic accident. Clinical examinations suspected closed abdominal trauma without biological signs of icteric cholestasis. Abdominal CT scan performed within 24 hours showed a focus of hepatic laceration, and follow-up imaging at 5 days showed post-traumatic intrahepatic cystic formations. This case report aims to emphasize the importance of imaging including ultrasound, CT, MRI, MRI cholangiopancreatography (MRCP), or hepatobiliary cholescintigraphy to establish the diagnosis and guide the therapeutic gestures.
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Chiari III (CM III) is the rarest of the Chiari malformations, characterized by high cervical or occipital encephalocele and osseous defects, associated with herniation of the posterior cerebral fossa contents through the foramen magnum. We report the case of a female newborn, with a cervico-occipital mass, hypotonia and sharp osteotendinous reflexes in the lower limbs. An MRI was performed showing a low occipital encephalocele with caudal displacement of cerebellar tonsils. Because of its high contrast resolution, MRI is more useful than CT, preoperatively, to assess the content of the encephalocele. MRI can identify the position of the brain stem and spinal cord, so that they are preserved during the surgical procedure.
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Posterior Reversible Encephalopathy Syndrome (PRES) is a rare complication of Takayasu's Arteritis. We report the case of an 11-year-old girl who presented with a tonic-clonic seizure and loss of consciousness, without fever. Imaging revealed characteristic white matter edema of the occipital and parietal lobes, in keeping with PRES. Further imaging demonstrated right renal artery stenosis and wall thickening of the abdominal aorta. The combination of hypertension, the discrepancy of blood pressure recordings between upper limbs, and imaging abnormalities of the aorta and the left renal artery led to the diagnosis of PRES secondary to Takayasu's Arteritis. Treatment with oral corticosteroids, azathioprine, amlodipine, and propranolol resulted in the complete resolution of the patient's symptoms and imaging abnormalities.
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Gayet-Wernicke encephalopathy is a neuropsychiatric emergency due to thiamine deficiency (vitamin B1), secondary to several factors. We here report a case of Gayet-Wernicke encephalopathy in a 43-year-old woman who didn't consume alcoholic beverages, presenting with disorders of consciousness and diplopia with normal thiamine level. Classic triad of symptoms and Magnetic resonance imaging (MRI) played an important role, in particular, in the diagnosis of Gayet-Wernicke encephalopathy with normal thiamine levels in the absence of alcohol abuse.
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Diplopia/etiologia , Tiamina/sangue , Encefalopatia de Wernicke/diagnóstico , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Encefalopatia de Wernicke/fisiopatologiaRESUMO
Superficial pseudoaneurysms of the palmar arch is a rare disorder and only a few cases have been described in the literature. In the majority of cases it develops after artery lesion following penetrating injury, previous surgery or arterial puncture. Diagnosis is based on strong clinical suspicion, especially in patients with pulsatile mass. We here report a case of false aneurysm of the superficial palmar arch following broken glass injury in a 3-year old child.
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Falso Aneurisma/diagnóstico , Traumatismos da Mão/complicações , Ferimentos Penetrantes/complicações , Falso Aneurisma/etiologia , Pré-Escolar , Humanos , Masculino , Artéria UlnarRESUMO
Gastrointestinal (GI) bezoars are aggregates of undigested material found in the GI tract. Trichobezoar is the most common type of bezoars and consists of ingested hair, carpet fibers or fitted carpet fibers. They are mainly located in the gastric region, rare forms extend to the duodenum or small intestine and are described as Rapunzel syndrome. Typical CT imaging features play a diagnostic and prognostic role. We report the case of a 13-year-old girl hospitalized for occlusive syndrome due to trichobezoar.
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Bezoares/diagnóstico por imagem , Estômago/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Bezoares/patologia , Feminino , Hospitalização , Humanos , Estômago/patologiaRESUMO
First described by the French surgeon Maurice Morel-Lavallee in 1853, Morel-Lavallee syndrome (MLS) is a serolymphatic effusion resulting from tangential injury to richly vascularized tissues. The imaging characteristics may be variable over time due to lesion progression and the eventual organization of a fibrous capsule. We report a case of extensive MLS in the lower leg of a 12-year-old child. We discuss the ultrasound and magnetic resonance imaging findings and describe the differential diagnoses. LEARNING POINTS: The diagnosis of Morel-Lavallee syndrome is based on clinical examination and imaging techniques.The post-traumatic context is important for diagnosis.Morphological aspects depend on lesion progression and the eventual organization of a fibrous capsule.
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Sturge-Weber syndrome (SWS) or encephalofacial angiomatosis is a rare neurocutaneous and congenital ocular syndrome. It can cause two malformations: congenital facial capillary planar angioma and leptomeningal venous-capillary angioma (most often parieto-occipital homolateral angioma). Neuroimaging, in particular magnetic resonance imaging (MRI), plays an important role in the diagnosis, ideally before the occurrence of neuro-ocular complications. We report the case of a child in whom SWS was suspected based on facial angioma and pharmaco-resistant epilepsy.
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Epilepsia Resistente a Medicamentos/etiologia , Hemangioma/etiologia , Síndrome de Sturge-Weber/diagnóstico por imagem , Criança , Hemangioma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Síndrome de Sturge-Weber/fisiopatologiaRESUMO
Solid pseudopapillary tumors (SPTs) constitute 0.2 to 2.7% of non-endocrine primary tumors of the pancreas and comprise the majority (70%) of pediatric pancreatic neoplasms. These tumors are of unclear pathogenesis, low malignancy and favorable prognosis. Surgical resection offers an excellent chance for longterm survival, even in the presence of distant metastasis. The objective of this study is to review our experience in the management of SPT in a 12 years old girl at the pediatric hospital of the University hospital of Casablanca, in Morocco and provide an update on current management in pediatric population.
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Neoplasias Pancreáticas/diagnóstico , Criança , Feminino , Humanos , Marrocos , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/terapia , PrognósticoRESUMO
Diastematomyelia is a rare spinal dysraphism in which the spinal cord and its content are split. Two types of diastematomyelia have been described. We report the case of a 12 year old male patient presenting with reduced lower limb muscle strength without associated sphincteric disorders. The patient underwent axial, sagittal and coronal T1 and T2-weighted MRI sequence of the spine. MRI showed a bifid appearance of the bone marrow of thoracolumbar vertebrae in two hemi-cords without bone spur separating the two hemi-marrows, compatible with type 1 diastematomyelia. It was associated with low tethered spinal cord with syringomyelic cavity involving the left hemi-marrow and with biloculated fibrotic lesion at the level of the right hemi-marrow compatible with a neuroenteric cyst. MRI also showed incomplete closure of the posterior arch of D12 vertebra which communicated with a subcutaneous pocket in relation to a dermal sinus. Diastematomyelia is a rare abnormality of the spine which can be associated with other malformations. Therapeutic strategy essentially depends on the progression of the clinical signs (neurological) and of associated malformations.