Torsion of the fallopian tube without the involvement of the ipsilateral ovary is a rare but important cause of acute abdominal pain in women as it is a surgical emergency. Although uncommon, it should be considered as one of the differential diagnosis in female children presenting with acute lower abdominal or pelvic pain. The diagnosis of isolated fallopian tube torsion is difficult pre-operatively and is often made during laparoscopic or surgical exploration because diagnostic features are usually non-specific. In this report, we present a case of isolated fallopian tube torsion with fimbrial cyst in a young female patient diagnosed pre-operatively by ultrasound.
Ectopic pregnancy in the interstitial part of the fallopian tube is a rare event, associated with a high rate of complications due to delayed diagnosis. Rupture of such pregnancy often results in catastrophic hemorrhage. Several reports highlighted the role of magnetic resonance imaging in establishing the diagnosis of interstitial pregnancy, but magnetic resonance imaging findings of a ruptured advanced interstitial ectopic pregnancy have not been published before. The authors therefore present characteristic findings on magnetic resonance imaging of a ruptured interstitial ectopic pregnancy which had reached 18 weeks, in a 25-year-old woman who presented with acute abdominal pain.
Patient: Male, 4-months
Final Diagnosis: Mesenchymal hamartoma
Symptoms: Asymptomatic chest wall mass
Medication: —
Clinical Procedure: —
Specialty: Radiology
Objective:
Rare disease
Background:
Mesenchymal hamartoma of the chest wall is a rare benign lesion that typically presents in early infancy. However, the clinical presentation can be atypical, with imaging features that mimic infection or malignancy. Imaging combined with histopathology is essential in the diagnosis. A case of mesenchymal hamartoma of the chest wall in a 4-month-old infant is presented.
Case Report:
A 4-month-old infant had an incidental finding of a large right-sided chest wall mass. Initial imaging included thoracoabdominal ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Histology of an initial open biopsy was inconclusive. The diagnosis of mesenchymal hamartoma was confirmed by histology of the resection specimen, which showed a benign, mixed, chondroid, mesenchymal, and cystic hamartoma with areas of calcification and ossification.
Conclusions:
This case showed that the diagnosis of mesenchymal hamartoma of the chest wall, which is characterized by heterogeneous components, may require a combined approach for the diagnosis that includes imaging and histology. Increased clinical awareness of mesenchymal hamartoma in infants may help to guide the approach to the correct diagnosis and prevent unnecessarily radical treatment for this benign condition.
Post-traumatic osseous cystic lesions are a rare complication in children. An aetiology of intramedullary fat seepage through the damaged bone cortex and its entrapment within the subperiosteum has been proposed. These lesions run a benign course and usually resolve spontaneously. The presence of fatty marrow gives it a distinct appearance which aids in its diagnosis and differentiation from other bone lesions. This case demonstrates a fat-fluid level within the subperiosteal cystic lesion in Magnetic Resonance Imaging (MRI) and this is a typical feature of post-traumatic cystic lesion in a child. Recognition of this imaging feature allows for a confident diagnosis, cutting down on unnecessary, potentially invasive investigations.
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