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Spinal tuberculosis usually presents as destroyed contiguous vertebral bodies associated with intervertebral discs and paravertebral or psoas abscesses. Atypical forms are uncommonly reported. Vertebral involvement without disk destruction is a rare form that improves satisfactorily after appropriate medical management. We report the case of a 36-year-old male who had spine tuberculosis without disk involvement, associated with intercurrent active pulmonary location with good clinical improvement after treatment and follow-up imaging showing spectacular regression of bone lesions. By reporting this case, we also review the literature on this rare form of tuberculosis.
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Human echinococcosis (hydatid disease) is highly endemic in Morocco and reemerging as a significant public health problem in this country. It is a cyclozoonotic infection introduced by Echinococcus granulosus, that can invade any organ in the human body. The liver is the mostly affected organ, which is the primary site of human infestation, followed by lungs. Renal involvement by hydatid disease is commonly secondary, occurring owing to primary cyst rupture or disseminated disease. Primary renal localization, often presented as solitary cysts with no visceral involvement, is uncommon even in endemic zone. Herein, a rare cause of renal mass due to an isolated hydatid cyst in a 56-year-old woman who presented with ambiguous left flank pain for the last 10 years. Findings imaging did not reveal any other localizations of hydatid disease. For this scolicidal effect and to prevent peritoneal seeding, the patient was placed on albendazole 400 mg. Three weeks later, the surgery was performed successfully with a left total nephrectomy.
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Cannabis use is increasing rapidly among young people worldwide despite the deleterious effects of this toxic substance on health. We report a case of acute hippocampal encephalopathy in a heavy cannabis user (8-10 joints/d for 6 years) who presented with a nonfebrile status epilepticus. Brain magnetic resonance imaging revealed bilateral and symmetrical high-signal abnormalities in the hippocampal regions. The damage to these regions is often severe, long-lasting, and sometimes irreversible. Therefore, every doctor (emergency doctor, resuscitator, neurologist...) is asked to request a brain MRI in case of neurological signs in a young cannabis user.
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Urothelial cell carcinomas represent the vast majority of urinary bladder tumors. However, many inflammatory and non-neoplastic conditions can mimic a urinary bladder malignancy. In that matter, diverticulitis can progress into colovesical fistula formation with a bladder wall abscess that can mimic a pseudo mass. Nonetheless, the presence of a bladder wall mass, usually requires pathologic examination. We report the case of a 60 year old woman with recurrent urinary infections due to a focal bladder mass revealing a colovesical fistula as a complication of sigmoid diverticulitis.
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Gastric diverticula are a rare condition; they are divided into true diverticula, which are congenital, and pseudodiverticula, which are acquired. True diverticula are usually located in the posterior fundus wall, below the esophagogastric junction, and appear on abdominal computed tomography as a cystic mass that is commonly taken for an extra digestive mass, especially adrenal mass. We report the case of an asymptomatic 24-year-old female patient with gastric diverticulum who was mistakenly diagnosed in ultrasound with a renal mass.
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Considered rare, the synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is a distinct clinical entity, associating skin manifestations and osteoarticular symptoms. Anterior chest wall pain centered at sternoclavicular and sternocostal joints is an important and characteristic clinical finding that can lead to its diagnosis. Radiologists and clinicians must be aware of synovitis-acne-pustulosis-hyperostosis-osteitis syndrome as it can mimic some of the more common disease entities such as Paget's disease. We report the case of a 63-year-old male patient, with no significant medical history, who presented to the dermatology department, with severe palmar and plantar pustulosis associated with polyarthralgia. Computerized tomography scan showed sternoclavicular hyperostosis, in favor of SAPHO syndrome, with regression of clinical symptoms after non-steroidal anti-inflammatory drug treatment.
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Gastrointestinal stromal tumors (GIST) are mesenchymal neoplasms most frequently seen in the stomach and small intestine, arising in the muscularis propria of the intestinal wall. Given its nonspecific clinical presentation, it can represent a diagnostic challenge, especially in abdominopelvic locations. Lesion evaluation of abdominopelvic tumors can be difficult and lead to misinterpretation in assessing their origin. We report the case of an 84-year-old woman with a voluminous small bowel GIST mimicking a uterine neoplasm.
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MRKH syndrome, or Mayer-Rokitansky-Küster-Hauser syndrome, a rare congenital disease, manifests as a complete or partial aplasia of the uterus and the vagina's upper two-thirds with normal external genitalia and functioning ovaries. Mayer-Rokitansky-Küster-Hauser syndrome can occur in isolation (type I) or in conjunction with other congenital extragenital deformities affecting the kidneys, skeleton, heart, eyes, or auditory system (type II). The diagnosis of Mayer-Rokitansky-Küster-Hauser syndrome typically relies on imaging studies, with transabdominal ultrasonography serving as the primary modality. However, magnetic resonance imaging is considered the gold standard for detailed assessment of internal genital anatomy. We present the case of an 18-year-old woman without any notable medical history who exhibited primary amenorrhea. Mayer-Rokitansky-Küster-Hauser syndrome type II was suspected on pelvic ultrasound and subsequently confirmed via magnetic resonance imaging. The patient was provided with psychological assistance and planned for vaginoplasty.
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Adrenal gland abscesses are rare lesions usually reported to be caused by fungal pathogens and typically through hematogenous spread from other primary sources of infection. Imaging has always been known to play a major role in the characterization of focal adrenal lesions. However, given the rare occurrence of abscesses in this location, making the right diagnosis remains challenging. We report the case of a 39-year-old man with chronic renal disease on hemodialysis presenting with signs of sepsis and left upper quadrant pain revealing a left adrenal gland abscess.