Radiology Case Reports

Melanoma in situ of the nipple is an uncommon diagnosis, with only a few reports in the literature. Due to the variety of pathologies that can affect the nipple-areola complex, the diagnosis can be challenging. In this case report we describe a patient with cosmetic bilateral breast implants who presented with eczema of the left nipple-areola complex and suspicious microcalcifications in the lower inner quadrant of the ipsilateral breast on mammography, subsequently diagnosed with nipple melanoma and concomitant ductal carcinoma in situ...

Lemierre syndrome describes septic thrombophlebitis of the internal jugular vein (IJV) and metastatic spread of the infection following a recent oropharyngeal infection in a setting of bacteremia caused by Fusobacterium necrophorum. Lemierre-like syndrome describes similar clinical scenario with no preceding oropharyngeal infection and/or in the setting of non-Fusobacterium cause. We report a case of Lemierre-like syndrome in a setting of Enterobacter cloaca bacteremia without known preceding oropharyngeal infection...

Tuberculosis is more frequently found among high-risk populations in the United States. It has a challenging diagnosis since it can present with diverse organ involvement that may delay the diagnosis. This is especially true regarding hepatic tuberculosis, with prevalence varying in each study but highly suggestive of underdiagnosis. An 18-year-old male with high-risk exposure to multidrug-resistant tuberculosis presented with fever, night sweats, weight loss, and cough. Imaging revealed a right lung cavitary mass with bilateral pulmonary nodules, right pleural nodular thickening traversing diaphragm extending to the liver with subcapsular hepatic lobulated hypodensities...

An uncommon but potentially life-threatening complication of spinal surgery is bacterial meningitis, To the best of our knowledge, all of the documented cases have developed following open procedures, likely due to the increased potential for cerebrospinal fluid exposure and dural injury associated with these approaches, and notably, none of these documented cases were due to an endoscopic surgical approach. The low prevalence of this condition explains the reasonable but unfortunate lack of information about its natural history and associated complications in the medical literature...

Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic condition characterized by destructive granulomatous disease of the kidney with uncertain etiology. Significant risk factors for XGP are represented by the coexistence of history of nephrolithiasis, diabetes mellitus, recurrent urinary tract infections and other immunocompromised conditions. It is also associated with higher risk of malignancy, reported in up to 11% of patients. We report a case of a 76-year-old female who presented to the emergency department with an insidious onset of abdominal and right lower back pain...

Twin pregnancy is considered high-risk pregnancy because of its various effects on maternal and fetal physiology. Twin pregnancy can be dizygotic or monozygotic, the latter being less common. Depending upon the period of separation of an embryo, monozygotic twins can share amniotic cavity and placenta with the monochorionic monoamniotic form being the least common type. Diprosopus tetrophthalmus is the rarest form of monozygotic monochorionic and monoamniotic conjoint twin, where there are 2 faces on 1 head with various degrees of duplication of facial and cranial structure...

Protein S and C deficiency is a rare inherited thrombophilia that predisposes individuals to a hypercoagulable state, leading to clot formation in various locations, such as the deep veins of the legs, cerebral veins, and rarely the portal vein. We present the case of a 21-year-old male who came to the ER with hematemesis and melena secondary to chronic portal vein thrombosis (PVT) without any evidence of cirrhosis. Diagnostic investigations, including ultrasonography and computed tomography, confirmed the presence of thrombosis and cavernous transformation of the portal vein, splenic vein thrombosis, and splenomegaly...

We present the case of a young male with human immunodeficiency virus and a history of nonadherence to antiretroviral therapy who developed cryptococcal meningitis. This case highlights the diverse medical and clinical presentations of central nervous system cryptococcosis in an immunocompromised individual from a radiology perspective. CT and MR imaging demonstrated basal ganglia enhancement and leptomeningeal involvement, characteristic of this pathogen. This report underscores the significance of advanced imaging modalities, in particular MRI, in diagnosing cryptococcal meningitis...

Injuries to blood vessels occur in 0.8% of the cases following laparoscopic cholecystectomy. They may result from direct penetration while insertion of trocar or by thermal injury (electrocautery). Pseudoaneurysm of hepatic artery is a rare occurrence. It is a serious complication following acute or chronic injuries to hepatic artery, with only 0.06% to 0.6% of the cases being reported. Endovascular embolization is usually the first line treatment in the management of pseudoaneurysm of hepatic artery with high success rate...

The pancreas is a more common metastatic site for renal carcinoma; however, metastatic spread of ovarian carcinoma to the pancreas is very rare, with only a few sporadic cases published in the literature. The clinical presentation is usually dominated by epigastric pain. We report a rare case of pancreatic metastases occurring approximately 13 years after a bilateral hysterectomy with salpingo-oophorectomy for bilateral serous ovarian carcinoma.

Angiomyolipomas are benign mesenchymal lesions often diagnosed incidentally, composed of adipose tissue, dysmorphic blood vessels, and smooth muscle. They are usually unilateral and symptomatic only when larger than 4 centimeters, posing a risk of spontaneous rupture and severe retroperitoneal hemorrhage. Treatment varies from conservative management to selective embolization or nephrectomy, depending on tumor size and patient condition. This case report describes a 26-year-old female with a giant renal angiomyolipoma treated with angioembolization, who subsequently developed postembolization syndrome...

Varicella pneumonia represents a relatively uncommon yet severe complication arising from initial varicella infection. Between 5% and 15% of instances of adult varicella infection may result in various pulmonary conditions. Predominantly afflicting adults, its severity is compounded by factors like smoking, compromised immune systems, pregnancy, age, chronic obstructive pulmonary disease, and male gender. We represent the case of an adult female lacking prior immunity to varicella, who experienced heightened oxygen needs with severe hemoptysis without skin symptoms...

Mitochondrial myopathy with lactic acidosis and stroke-like episodes is a rare mitochondrial disorder, most often revealed by symptoms and signs that typically include mitochondrial myopathy, encephalopathy with stroke-like episodes, seizures and/or dementia, and lactic acidosis. Imaging findings, although diverse, usually present characteristic features that help differentiate these disorders from vascular syndromes. We present a case of a 2-year and 4-month-old girl with recurrent ischemic strokes associated with nonterritorial cortico-subcortical foci on brain imaging, along with stenosis of the terminal portion of the internal carotid arteries associated with a neovascular network...

Wandering spleen is a rare clinical entity characterized by the laxity, absence, or abnormal attachment of splenic supporting ligaments leading to hypermobility and abnormal positioning of the spleen in the abdominal cavity. The abnormally increased mobility of the spleen predisposes it to torsion and infarction. Authors present a case of wandering spleen complicated to torsion and infarct in a middle aged lady. The patient presented with acute abdominal pain, diagnosed by abdominal computed tomography and underwent surgery and splenectomy...

Hemosuccus pancreaticus, also known as pancreatic pseudoaneurysm, is a rare type of upper gastrointestinal bleeding that originates from the major duodenal papilla or ampulla of Vater and extends into the duodenum via the pancreatic duct. By 2021, only 150 cases had been reported worldwide. Without treatment, the mortality rate can be as high as 90%, but it drops to 25%-37% with intervention. We report a case of a 64-year-old woman who experienced intermittent upper gastrointestinal bleeding over a year. Imaging revealed a hematoma and pseudoaneurysm in the pancreas, which was successfully treated with angiographic embolization...

Chronic kidney disease (CKD) is a complex medical condition that extends beyond the progressive decline in renal function. It is associated with mineral and bone disorders, notably secondary hyperparathyroidism due to dysregulated calcium and phosphate metabolism. However, distinguishing between secondary and primary hyperparathyroidism can be challenging. We report the case of a 74-year-old male with CKD, who presented with elevated serum levels of parathyroid hormone (PTH), CKD, and unexplained hypercalcemia, despite management for secondary hyperparathyroidism...

Parry Romberg syndrome (PRS) is a rare self-limiting disease, typically occurring in children and young adults, that causes slow progressive atrophy of one-half of the face. It primarily affects the subcutaneous tissue and skin with some cases exhibiting deeper extension to glandular, osseous and muscular structures. Neurologic and ocular involvement is variable. Neuroimaging with computed tomography (CT) scan aids in demonstrating radiological features, assessing disease severity, and detecting neurological and ocular complications...

Hydatid cyst is the condition caused by larvae of the parasite Echinococcus granulosus, usually involving the liver, lung, and spleen. Involvement of the cerebrum with a hydatid cyst is a rare entity, comprising 2%-3% of all cases of hydatidosis. Intraventricular extension of cerebral hydatid cysts occurs in only a limited percentage of cases. Cerebral hydatid cysts can present with nonspecific symptoms, usually with features of raised intracranial pressure. Therefore, it is crucial to consider cerebral hydatid cysts as a potential diagnosis, especially in pediatric patients with nonspecific neurological symptoms, particularly those from areas endemic to the parasite...

The girl neonate with 1500 g, was transferred to the neonatal intensive care unit due to tachypnea and prematurity. She received supportive and therapeutic care in the course of hospitalization. Due to the high level of alkaline phosphatase in the examinations and x-rays of the wrist, premature osteopenia was diagnosed and she was treated with high doses of calcium and phosphorus. Alkaline phosphatase was measured weekly in the course of treatment, with its downward trend indicating an appropriate response to treatment...

Pancreatic duct adenocarcinoma (PDAC) accounts for about 85-90% of all solid pancreatic tumors, which is well-known for poor prognosis and high morbidity. Despite the massive advent of chemotherapy and radiotherapy in recent years, surgical removal is still considered the cornerstone management option in this situation. Pancreaticoduodenectomy or Whipple procedure is generally contraindicated in metastasis or tumors that encase more than 50% of vessels. Vascular reconstruction is a state-of-the-art technique which requires the remarkable involvement of vascular experts in the setting of PDAC-invading vessels...