A ganglioglioma versus a schwannoma: Which is in the sacral spine?

INTRODUCTION AND IMPORTANCE: Sacral spinal gangliogliomas, rare WHO grade I tumors, present a surgical challenge due to their proximity to critical nerve roots. Symptoms often include lower back pain, sciatica, and bladder dysfunction. Diagnosis is confirmed through MRI and biopsy, with surgical resection being the primary treatment. CASE PRESENTATION: A 66-year-old woman presented with left lower limb pain and weakness. MRI showed an intradural lesion at the left S1 root. She underwent surgery, resulting in near-total tumor resection. Postoperatively, she was pain-free and ambulatory. Pathology confirmed a ganglioglioma. CLINICAL DISCUSSION: Initially suspected as a disc herniation, MRI indicated a schwannoma-like lesion, but surgery and pathology revealed a ganglioglioma. Total resection was challenging due to the tumor's neural adherence. Radiotherapy and chemotherapy are generally not used for low-grade gangliogliomas. CONCLUSION: Treating sacral spinal gangliogliomas requires precise surgery and a multidisciplinary approach. Accurate diagnosis and careful planning are essential for minimizing neurological risks and improving patient outcomes. Continued research is crucial for advancing treatment strategies.

Brucellosis Presenting as Isolated Abdominal Lymphadenopathy Masquerading as Lymphoma: A Case Report.

Mesenteric lymphadenopathy associated with high-grade fever can be frequently associated with hematologic malignancies, especially if accompanied by joint pain, weight loss, and anorexia. However, this constellation of symptoms, also known as "B Symptoms," can be the uncommon presenting manifestation of brucellosis, still a common zoonotic disease in the Middle Eastern basin. In this article, we report the case of a Lebanese man who presented with "B symptoms" of three weeks duration, who was thought to have lymphoma but was later found to have systemic brucellosis.

Kikuchi-Fujimoto disease associated with a flare-up of a leukocytoclastic vasculitis: A rare case report and review of literature.

RATIONALE: Kikuchi-Fujimoto disease (KFD) also known as histiocytic necrotizing lymphadenopathy is an exceedingly rare cause of cervical lymphadenopathy, commonly accompanied by systemic symptoms such as fever, fatigue, night sweats, myalgia, skin rash. PATIENT CONCERNS: In this paper, we report the case of a 22-year-old female patient who experienced a flare-up of leukocytoclastic vasculitis that was complicated by the appearance of a cervical lymph node with dysphagia, fever and nausea. DIAGNOSIS: Infectious and autoimmune workup came back negative. INTERVENTIONS: Excisional lymph node biopsy was done and the pathology results were consistent with histiocytic necrotizing lymphadenitis in keeping with Kikuchi-Fujimoto disease. OUTCOMES: Patient improved on intravenous corticosteroids and was discharged on per os prednisone. Six month follow-up shows complete resolution of her symptoms. LESSONS: KFD should be ruled out in patients with autoimmune or inflammatory diseases who develop lymphadenopathies.

Extra-Gastrointestinal Stromal Tumor (EGIST) in the Pelvis Mimicking Retroperitoneal Sarcoma.

Extra-gastrointestinal stromal tumors (EGISTs) are rare mesenchymal tumors accounting for less than 1% of total gastrointestinal tumors. They tend to be aggressive and have a poor prognosis. Unfortunately, there is a lack of data or controversial data due to its scarcity. Therefore, we report a case of pelvic EGIST misdiagnosed as retroperitoneal sarcoma. We opted for surgical management followed by adjuvant oral chemotherapy with imatinib.