Bilateral renal lipomatosis: A case report

Renal replacement lipomatosis is a rare condition characterized by fatty tissue proliferation. It has been associated with aging, lithiasis disease, and renal transplantation. The clinical presentation is non-specific, and imaging is essential to confirm and make the differential diagnosis. We report a case of a patient followed for endometrial thickening or the diagnosis of renal lipomatosis that was discovered incidentally on an abdominopelvic CT scan.

Kienbock's disease: A radiological case report

Kienböck's disease is a condition characterized by avascular necrosis of the lunate. It is also known as lunatomalacia and aseptic or ischemic necrosis of the lunate.

The aim of this work is to summarize and illustrate, through a case diagnosed in our institution, the radiological aspects of this rare entity, which occupy a prominent place in the diagnosis.

A better understanding of this recently described nosological entity and a wide dissemination of its diagnostic criteria, especially by radiologists, should facilitate the diagnosis and treatment of patients.

A rare combination of complications of ruptured carotid artery aneurysm: A case report

The giant aneurysm of the subclinoid portion of the internal carotid artery is a relatively rare disease that can present serious complications. We present the case of a 40-year-old guy who was suffering from a headache and had complete ophthalmoplegia in his right eye. A brain scan shows a right temporal subdural hematoma, associated with subarachnoid hemorrhage, and total Sylvian subacute ischemic stroke. CT angiography and MRI showed a ruptured and partially thrombosed aneurysm of the subclinoid portion of the right internal carotid artery complicated by subarachnoid hemorrhage, a right subdural temporal hematoma, and total Sylvian ischemic stroke. Our purpose is to recognize the possibility of an aneurysmal rupture when evaluating an acute subdural hematoma, alone or in combination with Ischemic stroke.

Cerebral fat embolism syndrome after long bone fracture: A case report

Cerebral fat embolism is a rare and potentially fatal condition that may occur following a long bone fracture. Its characterized by respiratory, neurological, and mucocutaneous signs. Isolated severe brain syndrome remains exceptional. We report a 21-year-old male patient admitted for the cerebral manifestation of a fat embolism syndrome due to a fracture of long bone after a traffic accident injury. Neurological deterioration after a free interval was seen with generalized tonic-clonic seizures. MRI of the brain was indicated which showed numerous multifocal hyperintensities involving the deep white matter of both hemispheres producing a "starfield" appearance. This pattern of cytotoxic cerebral edema, with lesions in the white matter rather than the grey matter, is indicative of the subacute stage of fat embolism. The patient was treated with comprehensive support in the intensive care unit, he returned to normal neurological function and was discharged after 3 weeks of hospitalization.

Painful bipartite patella following injury: a case report

Bipartite patella is a normal variation in ossification development. This variation is usually asymptomatic but can cause persistent and debilitating anterior knee pain with an injury. We report the case of a 56-year-old man complaining of persistent anterior left knee pain following trauma. Standard knee radiographs show a bilateral Bipartite Patella appearance, and magnetic resonance imaging shows discrete bony edema of the cancellous bone of the accessory bone and about the synchondrosis explaining the anterior knee pain, associated with a crack in the posterior compartment of the medial meniscus. Conservative care including medical treatment with non-steroidal anti-inflammatory drugs, physical therapy was used. Magnetic resonance imaging is the most valuable diagnostic tool for evaluating detailed morphologic and pathologic changes in patients with the bipartite patella.

Facial infiltrating lipomatosis, a rare cause of facial asymmetry to be known: Case report and literature review

Facial infiltrating lipomatosis is a rare lipomatous lesion, first described by Slavin in 1983. It is a benign pseudotumor pathology. It corresponds to a non-encapsulated collection of mature adipocytes infiltrating the local tissue and hyperplasia of underlying bone leading to a craniofacial deformity. Very few cases have been reported in the literature. We report the case of a 19-year-old female patient, who was consulted for a swelling of the right hemiface progressively evolving since birth. Physical examination revealed facial asymmetry. On palpation, the mass was soft, painless, not compressible, not pulsatile, not fluctuating. In view of the asymptomatic nature and slow progression of the lesion, a lipomatous tumour, namely lipoma, was suggested. CT scan image shows a hyperplastic subcutaneous fat on the right hemiface. On the right jugal and temporal areas, there is a subcutaneous formation of fatty density, poorly limited, with no detectable peripheral capsule. It merges with the adjacent fat. In the bone window, there was a hyperplasia of underlying bone. Facial lipomatosis infiltration of the face is a benign pseudotumor pathology. As a result, it can be confused with other disorders, in particular, hemifacial hyperplasia. Combination of physical and radiological findings can establish the diagnosis. Surgical treatment is done for cosmetic purposes.

Renal angiomyolipoma with renal vein extension

Renal angiomyolipomas are uncommon benign tumors containing fatty tissue. Only a few cases of infiltrating angiomyolipomas have been reported. We aimed to describe a case of a 65-year-old woman presenting a peripheral angiomyolipoma of the left kidney with CT evidence of involvement of the renal vein. The lesion has been found incidentally during abdominal CT for an unrelated reason. The patient underwent surgical treatment considering the vascular extension of the lesion and the risk of thromboembolic complications. The pathological analysis confirmed the diagnosis of renal AML in the upper pole of the left kidney invading the renal vein without malignancy.No post-operative complications and the evolution was favorable.

Pancreatic Lipoma: A Pancreatic Incidentaloma Diagnosis with Computed Tomography

Lipoma of the pancreas is a rare benign tumour which is usually discovered incidentally on imaging. We present a case of an incidentally discovered pancreatic lipoma in a 79-year-old man with non-metastatic prostate adenocarcinoma who was referred to radiology for follow-up imaging. Fat-containing tumours originating from the pancreas are very rare. Most lipomas show characteristic features on imaging that allow their differentiation. We present the imaging features of a pancreatic lipoma on ultrasound, CT and MRI, discuss the differential diagnosis, and provide a brief review of the literature.

LEARNING POINTS

Pancreatic lipoma is a rare mesenchymal tumour that is being increasingly recognized.Pancreatic lipoma is commonly asymptomatic and incidentally detected.CT and MRI allow confirmation of the diagnosis and elimination of other differential diagnoses.

Amyotrophic Monoplegia Secondary to Posttraumatic Rupture of the Brachial Plexus's Roots: A Case Report and Review of the Literature

Brachial plexus lesions most often occur in multiple trauma. We report a case of a 37-year-old patient who presented an upper left limb total sensitivomotor deficit and amyotrophy after a cervical and upper limb trauma. Cervical magnetic resonance imaging (MRI) was performed. It noted pseudomeningoceles at the levels of C6-C7, C7-D1, and D1-D2 in T1 hyposignal , T2 and STIR hypersignal , not enhanced by the injection of Gadolinium extending in foraminal and extraforaminal spaces without visualization of the corresponding rootlets. Traumatic brachial plexus injury is a potentially serious debilitating injury which can be well explored on MRI.

Unusual Location of a Giant Cell Tumour

Giant cell tumours (GCT) are rare aggressive non-cancerous tumours which usually affect the long bones. We describe a case of GCT of the first rib in a young woman without a relevant history. The patient presented a left cervico-thoracic mass which was biopsied in our department (CT-guided biopsy). She was referred to the thoracic surgery department after histological results.

LEARNING POINTS

Giant cell tumours (CGT) are benign tumours that usually occur on long bones with costal localization being a rare entity.Ultrasound can be a useful tool to assess the nature of the lesion.Diagnosis is based on lesion biopsy, but aggressive surgical resection can be performed.CGT should be considered in the differential diagnosis of costal tumours.

[Imaging features of multiple maxillomandibular brown tumors: a case report]

Les tumeurs brunes sont des lésions ostéolytiques rares, survenant chez 1,5 à 1,7% des patients en insuffisance rénale chronique terminale. Elles sont le produit d´un remodelage osseux sous l´effet de la parathormone. Nous rapportons l´observation d´une jeune femme suivie pour insuffisance rénale chronique terminale sous hémodialyse et qui présentait des tuméfactions maxillo-mandibulaires indolore apparues 7 mois avant sa consultation. L´examen clinique a retrouvé une déformation faciale avec à la palpation deux masses maxillaires et mandibulaires. Le bilan biologique a révélé une hypocalcémie, une hyperphosphatémie avec une hyperparathyroïdie. Le scanner de la face a révélé de multiples masses ostéolytiques au niveau de l´os maxillaire et de la mandibule avec importante raréfaction de la trame osseuse et des signes de résorption osseuse diffuse. Le diagnostic de tumeurs brunes multiples de la face a été retenu sur un faisceau d´arguments cliniques, biologiques et radiologiques. Les tumeurs brunes sont une entité rare dont l´atteinte maxillo-mandibulaire est fréquente chez l´insuffisant rénale chronique. Elle doit être connue du praticien d´où l´intérêt de cette observation.

Curvilinear pericallosal lipomas diagnosed incidentally during evaluation following trauma with corpus callosum abnormalities in two patients

Pericallosal lipomas are the most habitual location for an intracranial lipoma. They are fat-containing lesions arising from the interhemispheric fissure intimately related to the corpus callosum, which is often abnormal. They originate from aberrant differentiation of the persistent primitive meninx. Most Pericallosal lipomas are asymptomatic and come into clinical attention during neuroradiological investigations for other conditions. MRI is the modality of choice to characterize not only the extent of the lipoma but also the frequently associated agenesis/dysgenesis of the corpus callosum. Pericallosal lipomas can be divided into two groups: The Tubulonodular type and The curvilinear type. Curvilinear lipomas are less common than Tubulonodular. We report the clinical and radiological findings of curvilinear Pericallosal lipoma in two patients with corpus callosum abnormalities revealed incidentally during evaluation following trauma.

Cerebral cryptococcosis with pseudo-meningiomatous revelation?

We report the case of a 28-year-old woman with history of lupus treated by Mycophenolate Mofetil and admitted for febrile meningeal syndrome associated with diplopia. Both initial and control brain MRI showed pseudo-meningiomatous lesion while second CSF microscopy revealed characterizing images of Cryptococcus neoformans.

[Bilateral adrenal tuberculosis: about a case]

La localisation surrénalienne isolée de la tuberculose représente moins de 2% des incidentalomes surrénaliens. C'est la cause infectieuse la plus fréquente des insuffisances surrénaliennes. Nous rapportons le cas d'un patient âgé de 53 ans, sans antécédents particuliers, qui présente un tableau d'insuffisance surrénalienne lente évoluant depuis six mois. L'examen physique n'a pas retrouvé de masse ni d'hépato-splénomégalie. La tension artérielle était à 120/60 mmHg. L'examen biologique n'a pas objectivé de syndrome inflammatoire et un taux de LDH normal. La TDM a objectivé une hypertrophie bilatérale des glandes surrénales siège de calcifications. L'intradermo réaction à la tuberculine était positive à 25mm. La recherche de BK dans les expectorations et dans les urines était négative. Le test au Quantiferon^® était positif. Un traitement antibacillaire d'épreuve a été démarré avec une amélioration clinique avec prise de poids de 5kg en 12 mois. Les dosages hormonaux restent bas.