Chiari zero malformation with syringobulbia.

Chiari zero malformation is a relatively new and rare subtype of Chiari malformations. Most of the patients present with signs and symptoms of Chiari malformation without actual cerebellar tissue herniation, with or without syringomyelia. Furthermore, Chiari zero cases can be associated with syringobulbia in rare instances. We present a case of a 39-year-old patient diagnosed with Chiari zero associated with syringomyelia and syringobulbia.

Absent Meckel's cave as a possible cause of trigeminal neuralgia: A case report.

Trigeminal neuralgia (TN) is a debilitating yet potentially treatable facial pain disorder.TN is difficult to miss clinically, as patients' clinical presentation is often strikingly stereotypical: unilateral, paroxysmal, stimulus-dependent pain involving the trigeminal territory. Magnetic resonance imaging (MRI), which is used for further evaluation of an underlying etiology of TN, most commonly shows neurovascular compression of the trigeminal nerve to be the culprit. Secondary etiologies, though less common, do exist. An absent Meckel's cave with ipsilateral TN was reported in a few case reports and series, and whether an etiological relationship exists is yet to be established. We herein present a case of a 22-year-old female patient who presented with typical TN clinical manifestations. MRI was ordered to assess for the underlying cause and an ipsilateral absent Meckel's cave was the only significant finding. This case report adds to the scarcity of literature highlighting this entity, further larger clinical studies are needed to establish a causal relationship.

Epidermal inclusion cyst of the axilla with calcifications.

Epidermal inclusion cyst (EIC) is a benign mass that may occur in any area of abundant hair. It presents as a slowly growing firm nodule that is mostly asymptomatic. It may be confused with malignancy, making a definitive preoperative diagnosis difficult. Herein, we present a case of a 41-year-old patient with an EIC of the axilla containing calcifications on the mammogram.

Antopol Goldman lesion: A case report.

Antopol Goldman lesion is a renal pelvis subepithelial hematoma or hemorrhage, a sporadic disease. Although the causes are not well established yet, multiple factors were linked. Radiology is the cornerstone for the diagnosis. However, it may be mistaken for renal tumors. Herein we present a case of a 17-year-old male who presented with recurrent flank pain and gross hematuria and was diagnosed with an Antopol Goldman lesion.

A case of acheiria.

Congenital limb anomalies are rare. Acheiria is a congenital limb abnormality that presents as an absence of the hand and it is often diagnosed by prenatal ultrasonography. Herein we present a case of an 11-year-old female patient with acheiria. This case stresses on further studying the relationship between advanced pregnancy age, drugs or herb use during pregnancy and acheiria.

Functional cystic parathyroid adenoma with bilateral mandibular brown tumor: a case report.

Primary hyperparathyroidism is a disorder of increased parathyroid hormone secretion. Among various causes, parathyroid adenoma is one of the common causes. However, Cystic parathyroid adenoma is a very rare entity. Patients may present with various signs and symptoms related to hypercalcemia, with brown tumors being the end-stage presentation. Although radiological modalities play a central role in diagnosing parathyroid adenomas, histopathology is important to attain a diagnosis. Herein, we present a case of a 53-year-old patient who presented with functional cystic parathyroid adenoma with bilateral mandibular brown tumor.

Unilateral renal agenesis, blind-ended ureter and ectopic ureterocele: An incidental finding on abdominal CT scan.

Congenital renal anomalies are among the most common birth defects. They are often detected antenatally. If not, they can manifest in adulthood with variable clinical presentations. Herein, we present a case of a 72-year-old male patient who was incidentally found to have an extremely rare combination of urinary tract defects comprising: right-sided unilateral renal agenesis, blind ureter, and ectopic ureterocele.

Supradiaphragmatic origin of the right renal artery: a case report.

Renal arteries are the main blood supply to the kidneys. They originate from the abdominal aorta at the level of the first and second lumbar vertebrae. However, variations in their origin are common. Therefore, studying renal arteries before any surgical intervention such as renal transplant surgery, conservative or radical renal surgeries, renal trauma, and others, is crucial to avoid undesirable avoidable complications or morbidities. Herein, we report a case of an isolated right supradiaphragmatic renal artery that was discovered incidentally in a 66-year-old female patient with normal blood pressure.

Joubert-Plus syndrome with an atretic cephalocele: a case report.

Joubert syndrome is a rare heterogeneous disease affecting the cerebellum. It usually presents with hypotonia, abnormal breathing pattern, with distinctive cerebellar and brain stem malformation called the molar tooth sign. It may present with different organ involvement or with other neurological alterations such as Dandy-Walker syndrome. Joubert syndrome with dandy walker syndrome is called Joubert-Plus syndrome, an exceedingly rare entity. Dandy-Walker syndrome is defined by hypoplasia and upward rotation of the cerebellar vermis and cystic dilation of the fourth ventricle. Atretic cephalocele is another rare diagnosis which is characterized by a herniation of intracranial contents through a skull defect. Herein, we present a case of a 6-month-old patient who presented with floppiness and a scalp nodule. After further evaluation, he was diagnosed with Joubert-Plus syndrome with an atretic cephalocele.

Adult Presentation of Joubert Syndrome Presenting With Dysphagia: A Case Report.

Joubert syndrome (JS) is a rare autosomal recessive disease affecting the cilium, an intracellular organelle. It has a wide spectrum of presentations with the involvement of multiple genes. JS has multiple subtypes that are either pure JS or JS with other organ involvement such as the kidneys, liver, and others. However, all subtypes share the involvement of the cerebellar peduncles and the brainstem, which presents as "a molar tooth sign" on magnetic resonance imaging, hypotonia, and intellectual disability. It has a higher prevalence among children with few able to survive to adulthood. Unfortunately, survivors live with debilitating comorbidities. Here, we present the case of a 20-year-old patient who presented with a new onset of dysphagia that led to a diagnosis of JS.

Management of Glaucoma in an Adult Presentation of Sturge-Weber Syndrome.

Sturge-Weber syndrome (SWS) is a rare neurocutaneous syndrome. It is described by the presence of leptomeningeal angiomas, ocular involvement such as choroidal hemangioma and glaucoma, and port-wine stain over the face. Management of SWS-associated ocular complications is challenging and needs regular follow-ups. Herein, we present a case of a 28-year-old male patient who underwent glaucoma surgery but did not adhere to regular follow-ups and later presented with left-sided exophthalmos and eye pain. Management with medical treatment (latanoprost) was effective in the short term, but regular follow-ups are crucial to prevent further progression due to high failure rates.

Renovascular Compression by the Diaphragmatic Crus: A Case Report.

Renovascular hypertension (RVHT) is among the most prevalent causes of treatment-resistant hypertension. Mostly it is caused by renal artery stenosis (RAS). With atherosclerosis being the most common cause of RAS, RAS due to external compression by the diaphragmatic crus is rare. The treatment of rare causes requires individualization due to the differences between their etiologies. Herein, we present a case of an 18-year-old patient presenting with high blood pressure readings. On follow-up, he was diagnosed with hypertension. On further evaluation, the right diaphragmatic crus compressed the right renal artery. This case emphasizes medical management in patients with hypertension secondary to diaphragmatic crus compression, and radiological findings in such cases.

Duplex Collecting System With Ectopic Ureter Into the Posterior Urethra: A Case Report.

The ureters are muscular tubes that carry urine from the kidneys to the urinary bladder and are typically implanted in the superolateral angle of the trigone of the urinary bladder. Although renal anomalies are common, especially in the kidneys, ectopia of the ureter is rare. Clinical presentation depends on the insertion of the ectopic ureter, varying from asymptomatic (mostly in males) to recurrent urinary tract infections (UTIs) and incontinence (mostly in females). Radiology is the best diagnostic tool to achieve a diagnosis. Ultrasound (US), intravenous renogram (IVR), micturition cystourethrogram (MCUG), and others are used to diagnose ectopic ureters, with US and MCUG being the gold standard modalities. Treatment depends on the functionality of the part drained by the ectopic ureter. Heminephroureterectomy and ureteroureterostomy are among surgical treatments for ectopic ureter, and it is either open or laparoscopic surgery. Herein, we present a case of a four-year-old female patient who presented with recurrent UTIs and incontinence.

An Adult With Dyke-Davidoff-Masson Syndrome: A Case Report.

Dyke-Davidoff-Masson syndrome (DDMS) is a rare disease affecting the brain with almost 100 cases previously reported, with only 21 cases among adults. Due to the intricacy of clinical manifestations and radiological findings, it is difficult to reach the diagnosis. It usually includes atrophy of the cerebral hemisphere, dilation of the lateral ventricle, hypertrophy of skull bones, and hyperpneumatization of air sinuses. Herein, we present a case of a 55-year-old female patient who presented with a new-onset seizure. This case emphasizes the importance of considering DDMS in the differential diagnosis of adult-onset seizures, especially in patients with a previous history of brain insult, and demonstrates the possibility of developing this condition despite the lack of childhood symptoms. To our knowledge, this is the first case reported in Jordan.

Primary Hepatic Neuroendocrine Tumor: A Case Report and Literature Review.

Primary hepatic neuroendocrine tumors (PHNETs) are an utterly rare subtype of neuroendocrine tumors (NETs) that arise from cells of the neuroendocrine system. Due to the rarity and lack of distinctive radiological features, diagnosis and management of this tumor are challenging. Herein, we report a case of PHNET in a 19-year-old previously healthy female patient whose diagnosis was confirmed by histopathology and immunohistochemistry. This case emphasizes the importance of considering PHNETs in the differential diagnosis of a hepatic mass, management of patients with this disease, and post-operative follow-up.

Mucormycosis with extensive cranial nerve involvement as the first presentation of diabetes mellitus: A case report.

Mucormycosis, a rare fungal infection, mainly affects individuals with diabetes mellitus and those who were immunocompromised and has a high mortality rate. Its most common presentation is similar to that of acute bacterial sinusitis with symptoms of nasal congestion, headache, and fever. The involvement of multiple cranial nerves in mucormycosis was rarely reported in the literature and indicates severe disease. Herein, we report the case of a 56-year-old man who was referred to the ophthalmology outpatient clinic for facial nerve palsy. He was treated with systemic steroids for 10 days with no improvement. On examination, he had a loss of vision and a frozen orbit due to involvement of cranial nerves II, III, IV, V, VI, and VII. An extensive workup revealed a hemoglobin A1C of 10%. However, he was never diagnosed with diabetes mellitus previously and denied any of the classical symptoms of diabetes mellitus. He underwent ethmoidectomy, maxillectomy, and drainage of an intraorbital abscess after appropriate imaging studies. Histopathology confirmed the diagnosis of mucormycosis, and the patient was started on systemic amphotericin B. This case emphasizes the importance of screening for diabetes mellitus. Early recognition of underlying diabetes mellitus in this patient may have prevented the development of mucormycosis along with its devastating complications.