Lipoma arborescens of the knee: A case report.

Lipoma arborescens is a rare and benign intra-articular lesion characterized by a lipomatous proliferation of the synovial membrane, usually affects the knee joint. It presents as an unusual cause of intermittent knee pain and joint effusion. We report a case of lipoma arborescens of the knee in a 23-year-old man that initially resembled inflammatory arthropathy. The diagnosis of Lipoma arborescens was made by magnetic resonance imaging of the knee and confirmed histologically by synovectomy. The purpose of our case is to show the imaging features enabling early diagnosis and appropriate treatment.

Cholecystitis-related cystic artery pseudoaneurysm: Case report.

The pseudoaneurysms of the cystic artery (CAP) are very uncommon. They usually develop as a result of an acute cholecystitis or after a cholecystectomy. Among the complications, we can find hemorrhaging, biliary blockage, and haemobilia. Limited understanding of the illness makes managing specific cases difficult. We describe a case of a cystic artery pseudoaneurysm complicating an acute cholecystitis that was successfully treated by transcatheter arterial embolization.

Bilateral thalamic infarcts: Percheron territory.

Blood supply to the human thalami is complex and multiple variants exist. The artery of Percheron is one of those variants and is characterized by a solitary arterial trunk that branches from one of the proximal segments of either posterior cerebral artery and sup- plies blood to the paramedian thalami. Its occlusion results in bilateral paramedian thalamic infarction sometimes extending to the midbrain. We report a case of bithalamic infarction secondary to occlusion of the artery of Percheron. We will illustrate the complex clinical symptomatology and underscore the role of imaging, especially MRI, for diagnosis.

Tuberculous empyema necessitans: Case report of a rare occurrence.

Empyema necessitans is a rare condition where tuberculosis is the most common cause. It can be found in both immunocompromised and immunocompetent patients, especially in endemic areas. We report a case of a 29-year-old male from North Africa, with an enlarging mass on the right thoracic wall. Imaging, particularly CT showed a cystic lesion in the right chest wall communicating with homolateral pleural effusion, compatible with empyema necessitans. It also showed patterns of pulmonary tuberculosis in the right upper lung. Treatment of empyema necessitans is a combination of medical and surgicaltreatment. Our patient underwent a surgical treatment consisting of flattening of the empyema with a Gene X-pert study of the fluid and the shell, followed by an anti-TB treatment. Anatomopathology confirmed the diagnosis of caseo-follicular tuberculosis.

Case report: The dot in circle sign: A pathognomonic MRI sign of Madura foot.

Mycetoma or Madura's foot is a rare condition in Morocco. It is a chronic infection that affects deep subcutaneous tissues and may eventually spread to deep tissues, muscles, and bones. It is caused by fungi or bacteria and most often affects the foot. Biopsy and microbiological examination help to establish a definitive diagnosis, but may delay it. Imaging plays a crucial role in early diagnosis, particularly MRI findings that show a pathognomonic sign of mycetoma which is the dot-in-the-circle sign. Computed tomography provides a better analysis of bone changes than plain radiography. Treatment is very difficult, especially if the diagnosis is delayed, and may even lead to amputation. We present here a case of mycetoma of the foot with some MRI features.

Synchronous congenital malignant rhabdoid tumor of the orbit and cerebellar atypical teratoid/rhabdoid tumor: Case report.

Malignant rhabdoid tumor is an uncommon pediatric tumor that often arises from the kidneys but can also develop in other soft tissues including the orbits, where it is known as atypical teratoid rhabdoid tumor. Orbital location is exceptional, with just a few reported cases. Imaging allows for an accurate diagnosis, but histological confirmation is required. The treatment is yet unclear but nearly often surgical, either with or without chemotherapy. In this report, we present a case of a neonate of 1-month-old with an orbital primary malignant rhabdoid tumor with synchronous cerebellar location. The patient was unable to undergo surgery, he had chemotherapy, and unfortunately died 1 week after following palliative treatment. We will illustrate this clinical experience and point out the importance of radiological imaging in the assessment of this uncommon condition.

A case of ovarian endometrial stromal sarcoma: Radiological and histopathological findings.

Endometrial stromal sarcoma (ESS) is an uncommon uterine mesenchymal neoplasm. The primary extra-uterine location of ESS is a very rare occurrence. We present a case of a 39-year-old woman presented with severe abdominal pain, MRI showed bilateral ovarian tumors with heterogeneous intensity on T2-weighted imaging (T2WI) and T1-weighted imaging (T1WI), with restricted diffusion, including hyperintense areas on T1WI, not erased on T1-weighted fat-suppressed imaging, hypointense on T2WI, and not enhanced after contrast. This mass extended to the Douglas and invaded the uterine and the rectum serosa suggesting an underlying endometriosis. No abnormalities were suspected in the endometrium. The exploration revealed a friable mass arising from ovaries associated with nodules in the small intestine and sigmoid. The patient underwent bilateral adnexectomy and the anatomopathological study revealed a low-grade endometrial stromal sarcoma. This is one of the few reports covering the radiological features of low-grade extra-uterine ESS in the ovary which is probably secondary to degeneration of endometriosis with no evidence of primary uterine ESS.

Unusual intracystic papilloma arising from ectopic axillary breast tissue: Case report.

Accessory breast tissue (supernumerary breast tissue) is due to the absence of regression of the primitive milk lines during embryonic life which extends from the axilla to the groin. It is mostly located in the axilla where it is often confused with the axillary extension of the breast, or any pathological process occurring in armpits. Ectopic mammary glands should not be misdiagnosed as it can potentially undergo the same pathological processes that occur in a normally located breast including benign or malignant breast tumors. We report the case of an intracystic papilloma arising from left axillary accessory breast tissue in a 63-year-old woman. The principal symptom was pain in a palpable left axillary mass without inflammatory signs. Subsequent imaging and histopathologic examination proved it to be a papillary tumor in ectopic breast tissue.

Incidental finding of undiagnosed aortic coarctation in an elderly patient with a rare association with thymic carcinoma: a case report with review of the literature.

Aortic coarctation is a congenital malformation that is relatively prevalent, occurring in approximately 5 out of every 1000 births. The narrowing typically happens at the aortic isthmus between the left subclavian artery and the arterial ligament. It is frequently associated with a bicuspid aortic valve. Generally, coarctation of the aorta is identified and treated during childhood or early adulthood. If left untreated, this condition can lead to a reduced life expectancy in individuals who have not received treatment. We present a case of a 52-year-old man who complained of chest pain, sputum, and hemoptysis persisting for approximately 2 years. Contrast-enhanced computed tomography (CT) scans revealed the presence of an anterior mediastinal mass, which was later confirmed to be a thymic carcinoma (on histological study). Additionally, an incidental finding of a thoracic aortic coarctation with a well-developed collateral circulation was observed. The discovery of aortic coarctation in adult patients as an incidental finding is rare and particularly uncommon in association with mediastinal or thoracic tumor pathology. Adult and elderly patients with uncorrected coarctation generally have a low survival rate, and the management strategies for such cases are controversial, especially when it is associated to other pathologies. Due to the complexity of therapeutic management and the limited literature available on postsurgical outcomes in these cases, making therapeutic decisions requires a multidisciplinary approach and personalized consideration for each individual case. This approach is necessary to evaluate the risk-benefit ratio and determine the most suitable therapeutic solution.

Hydatid pulmonary embolism underlying cardiac hydatid cysts - A case report.

Cystic hydatidosis is an endemic parasitic disease with usual localization in liver and lungs. Rarely it localizes in uncommon sites, the right ventricle being an exceptional localization. We present an extremely rare case of a young man with hydatid pulmonary embolism complicating right-ventricle hydatid cysts. Echocardiography, CT pulmonary angiogram and MR-angiography were performed for the diagnostic evaluation. Our patient did not undergo surgery. He was discharged on a regimen of albendazole, and is still being followed-up. Hydatid disease rarely presents with pulmonary embolism. It has uncharacteristic clinical features, requiring particular diagnosis and therapy.

Hydrosalpinx with adnexal torsion in an adult patient-A case report.

Adnexal torsion is a common gynecological emergency and a significant cause of acute pelvic pain in women. Hydrosalpinx-induced torsion of the adnexa is a rare situation and requires prompt and accurate management. Twenty-three years old nulliparous woman admitted in our structure for acute pelvic pain. The ultrasound revealed an enlarged right ovary with an adnexal cystic mass. We suspected the diagnosis of a right adnexal torsion due to cystic ovarian mass. Laparotomy revealed torsion of the right adnexa and a second large mass appearing to be a hydrosalpinx. Diagnosis of adnexal torsion is difficult and is based on a range of arguments obtained by anamnesis, clinical examination, ultrasonography and other investigations. Early diagnosis is important for preserving tubal and ovarian function, given the risk of ovarian necrosis in young women. Laparoscopy is the gold standard for diagnosing and treating adnexal torsion. The treatment can be conservative or radical, consisting of detorsion of the twisted adnexa, with or without adnexectomy.

Pelvic cellulitis, a rare complication of bartholinitis: report of two cases.

Pelvic or pelviperineal cellulitis is a rare but serious complication of bartholinitis and can be life-threatening. It is described of polymicrobial nature. The diagnosis of pelvic cellulitis remains essentially clinical with signs of local inflammation. The interest of imaging, CT in particular, is to assess the extent of the infection and abcess. In this report, we describe 2 cases of pelvic cellulitis complicating a bartholin's abscess caused by negative gram bacilli in 2 diabetic women in their sixties.

Mediastinal and pericardial hydatidosis: A case report with review of the literature.

Hydatidosis is an echinococcosis caused by the development of Echinococcus granulosus larvae in humans. The lung is the second most frequent site after the liver. The primary mediastinal and pericardial localisations are extremely rare. Ultrasound and CT scans play an important role in the diagnosis of this disease.We report the case of an 11-year-old female patient from a rural environment with a history of dogs contact, whose symptomatology consisted of chest pain, dyspnoea, all evolving in a febrile context. The imagery showed the existence of multiple mediastinal and pericardial collections. This patient was rapidly managed with albendazole (ABZ) and scanography revealed an excellent therapeutic response. Primary mediastinal and pericardial hydatidosis is a very uncommon disease. It can be unfortunately revealed at the stage of vital prognosis complications. Ultrasound and computerized tomography (CT) are helpful for localizing and defining the morphologic features of hydatid cysts. It should be kept in mind, especially in patients from endemic areas.

A Case Report of Spinal Dural Arteriovenous Fistula: A Threatening Cause of Paraplegia.

Spinal dural arteriovenous fistulas (SDAVFs) are rare entities and are often misdiagnosed. They usually occur in adults above the age of 50 and 60 years. While they most commonly involve the thoracolumbar region, they can occur anywhere along the spinal cord. Clinical symptoms are insidious and not specific and may progress slowly, over several years, to severe myelopathy with paraplegia. Early diagnosis is critical because the deficits are potentially reversible if carefully treated. Delayed treatment may result in severe and irreversible neurological disability. Imaging diagnosis relies on MRI and conventional spinal angiography. Once identified, the dural arteriovenous fistula should be immediately treated by either endovascular embolization or surgical ligation. In this report, we present a case of SDAVF in a 65-year-old male that was managed by open surgery.

Lumbar puncture as a cause of tension pneumocephalus, pneumorrachis, and sacral meningocele infection leading to death: An extremely rare case report.

Although it was first described over 100 years ago, lumbar puncture is still an important diagnostic tool for a variety of infectious and noninfectious neurologic conditions. With the widespread use of this common and relatively safe performed medical procedure, minor and major complications can occur even when standard infection control measures and good techniques are used, including post lumbar puncture headaches, infection, bleeding, cerebral herniation, radicular pain, and even pneumocephalus in extremely rare cases. We describe a previously unreported complication of lumbar puncture performed for the diagnosis of meningitis in a 33-year-old woman with no medical history causing pneumorrachis, tension pneumocephalus, and sacral meningocele infection leading to death. Lumbar puncture is a simple diagnostic procedure with few complications, but if the technique is incorrectly performed, or if it is accompanied by occult congenital malformations such as sacral anterior meningocele in our case, the consequences can be fatal.

Early hepatocellular carcinoma developed within dysplastic nodule as nodule-within-nodule appearance: Case report with literature review.

Close follow-up of patients with liver cirrhosis has led to increased detection of hepatocellular carcinoma (HCC) at an early stage, especially with magnetic resonance imaging (MRI) innovations. We report the case of a 70-year-old man, with a recent history of liver cirrhosis due to chronic hepatitis C virus (HCV) complicated by hepatocellular carcinoma (HCC), and for whom trans-arterial chemoembolization (TACE) was planned, as the patient was assigned Child B7 at admission. Angiography performed during the first TACE cycle shows not only the "tumor blush" corresponding to previously detected HCC but also an additional small foci of HCC uptake seen within a large dysplastic nodule giving the appearance of "nodule-within-nodule." Early detection of hepatocellular carcinoma improves prognosis. Hence, it is essential to be aware of all early aspects of HCC, including the nodule-within-nodule appearance on cross-sectional imaging, and also in angiography, as in this case.

Sigmoid lipoma as an exceptional cause of intussusception and bowel obstruction in adults: A case report and review of literature.

Acute intestinal intussusception in adults is a rare condition, most often secondary to an organic lesion (tumor or inflammation), representing 1%-5% of intestinal obstructions. Pure colic intussusception on lipoma rectal causing bowel obstruction is an exceptional situation. A 60-year-old man presented to the emergency department for acute abdominal pain with marked abdominal distention and red rectal bleeding. A contrast-enhanced abdominal CT scan was performed, which revealed a recto-sigmoid intussusception on lipoma, causing mechanical intestinal obstruction. The patient underwent a partial reduction of the intussusception with partial sigmoid resection and end colostomy. Colonic lipomas of the recto-sigmoid region represent a very rare condition and a subsequent etiology for intussusception and bowel obstruction in adults. However, it should be considered in the differential diagnosis of such situations.

A rare case of sphenoid giant cell tumor: Case report & review of imaging features post short-term denosumab treatment.

Background: Giant cell tumors (GCTs) are locally aggressive but rarely malignant bone neoplasms that uncommonly involve the skull. In this report, we describe a tumor of the sphenoid sinus. Case presentation: A 51-year-old female was presented with headache, and bilateral decreased visual acuity, CT scan, and brain MRI revealed an infra-sellar enhancing tumor expanding to the sellar and supra-sellar region which proved to be a GCT. the patient had received 03 months of preoperative denosumab-based treatment and imaging follow-up showed regression in size and morphology modifications of tumor tissue. Conclusion: This is one of few reports to describe the appearance of sphenoid bone GCT, and the first report to highlight the effects of short-term denosumab treatment in GCTb in such a location.

Recurrent stroke in young adults caused by atypical fibromuscular carotid dysplasia.

Background: Carotid Web and focal carotid diaphragm are atypical fibromuscular dysplasia. The bilateral stroke due to this dysplasia is extremely rare. We will report a series of three young patients, admitted for a bilateral ischemic stroke caused by carotid bulb web and internal carotid diaphragm. Also, we will discuss their manifestations and treatment modalities. Case presentations: In our study, we will report a series of three North African patients, two females an one male, at the mean age of 37, admitted for an ischemic stroke caused by bilateral carotid bulb web and bilateral internal carotid diaphragm.All of our patients were young and didn't have a history of drug use. Conclusions: In our series, only end-vascular treatment was performed which was necessary to prevent any recurrence. Antiplatelet therapy was used in all cases to prevent any stroke during the follow-up.

A case of a giant left ventricular pseudoaneurysm.

A Left ventricular pseudoaneurysm is an outpouching resulting from myocardial free wall rupture which is contained by an adherent pericardium or scar tissue. It most often occurs after transmural myocardial infarction, but may also follow cardiac operations, trauma, inflammation, or infection. In contrast to patients with true ventricular aneurysms, those with false aneurysms most commonly die of hemorrhage. Transthoracic echocardiogram, computed tomography scan and cardiac MRI are currently the noninvasive modalities, whereas coronary arteriography and left ventriculography are invasive modalities used for diagnosis. As this condition is lethal, prompt diagnosis and timely management are vital. We present a case report of a patient with no prior risk factors who presented for 1 year with palpitations during exercise and rest, as well as intermittent chest pain. A transthoracic echocardiogram was performed. Echocardiogram revealed an unexpected outpouching of the left ventricle. A computed tomography scan confirmed the diagnosis by revealing a massive left ventricule pseudomanoeuvre. The patient was offered surgery, but he refused the procedure due to the surgical risk.