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The Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome is a rare anomaly characterized by congenital aplasia of the uterus and vagina in women showing normal development of secondary sexual characters and normal 44 XX karyotype. We report our experience in the management of two patients with congenital absence of the vagina due to the MRKH syndrome. The first case was a 24-year-old student, who presented with primary amenorrhea, uterovaginal agenesis, right pelvi-ureteric junction obstruction, and left renal agenesis. The second patient was a 24-year-old housewife, who presented with primary amenorrhea and inability to achieve penetrative sexual intercourse. She had vaginal atresia and a grossly hypoplastic uterus. Both had successful sigmoid colovaginoplasty and are sexually active. Vaginal reconstruction using the sigmoid colon saw an immediate and satisfactory outcome in both patients

BackgroundProbably benign breast lesions in the Breast Imaging Reporting and Data Systems (BI-RADS 3) constitute a crucial category and a considerable number of all palpable breast masses. Local data concerning the outcome of such lesions in the Nigerian environment is almost non-existent.ObjectivesThe goal of this article is to report the frequency, outcome and malignancy detection rate among palpable breast masses that were categorised on ultrasound as BI-RADS category 3 (probably benign) according to the American College of Radiology (ACR).MethodsBetween January 2015 and July 2017, 603 patients had diagnostic whole-breast ultrasound scans. There were 277 women who complained of palpable breast masses, of whom 151 women were diagnosed as having BI-RADS 3 lesions. The final lesion outcome was determined by either biopsy or ultrasound follow-up examination for a total of 2 years. All data were recorded and analysed with Statistical Package for the Social Sciences (SPSS) version 20 (Chicago, USA).ResultsThe frequency of BI-RADS category 3 lesions among all the women who underwent breast ultrasound was 25% (151/603); and 54% (151/277) in patients with palpable breast masses. There were 25 patients who were excluded because of incomplete data or who were lost to follow-up. A total of 122 patients had both ultrasound examination and histopathologic diagnosis, while only 4 were followed up for 2 years on ultrasound alone. Of the 122 women biopsied, 117 (95.9%) had benign histologic outcomes, and of the remaining 5, cancer was confirmed in 2 (1.6%), while the remaining 3 patients (2.5%) had lesions considered intermediate at histology (juvenile papillomatosis, borderline phylloides and atypical ductal hyperplasia). Three out of four patients who had ultrasound follow-up alone had stable lesions after 2 years, while one patient had complete resolution.ConclusionThis study found a significantly high biopsy rate of 80% (122/151) for probably benign lesions but a low detection rate for malignancy (1.6%). Follow-up with imaging rather than biopsy for lesions sonographically described as probably benign, will reduce medical costs and unwarranted invasive procedures.

Cephalometry deals with measurement of body parts or radiological specimen. Sella turcica is an important anatomical structure located in the middle cranial fossa, housing the pituitary gland. Various shapes and sizes of the sellae turcica were reported. In this study, using computerized tomographic (CT) scans from a tertiary hospital, one hundred and seventy five (175) scans were analyzed using Radiant version 4.2 (Medixant 2017) for determination of sizes and shapes of the sella. Average dimensions from the study include: Length (12.4 mm), A-P diameter (14.1 mm), depth (9.6 mm) and transverse diameter (13.8 mm). Shapes were classified as being round (56.6%), oval (32%) and flat (11.4%). In another classification of shape variation, the findings are: Normal (68.6%), anterior oblique (9.1%), pyramidal (6.9%), double contour floor (5.7%), notching on the posterior wall (5.1%) and sella bridge (4.6%). Males tend to have higher sella sizes than females and there is statistical significant difference between them especially in respect to A-P diameter and length parameters. However, there is no sex predilection to shapes.

Cerebral infarction is the most common form of stroke in this study. CT is essential in establishing the type of stroke, which subsequently determines the type of intervention as well as follow-up evaluation the patient may require.

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Incidental papillary carcinoma of the thyroid in patients treated surgically for benign thyroid diseases including Graves' disease is a known phenomenon. However, the management of these patients remains an issue of concern and controversy for those who care for them. We report a case of metastatic papillary carcinoma of the thyroid in a patient previously treated for Graves' disease. The subject of this presentation is a 50-year-old lady who was diagnosed with Graves' disease at the age of 29, for which she had a subtotal thyroidectomy following failure of medical and radioactive iodine treatment. Three years later, the patient was referred to our nuclear medicine department with a clinical diagnosis of suspected metastatic lymph nodes presumably from a thyroid malignancy.She had an 123I diagnostic whole body scan that showed 123I avid areas in the thyroid bed as well as left cervical lymph nodes, which later turned out to be metastatic papillary carcinoma of the thyroid on histology. She was treated with therapeutic doses of 131I. Follow-up radioactive iodine scans and serum thyroglobulin assays showed no evidence of malignant thyroid tissue. The occurrence of papillary carcinoma of the thyroid after a subtotal thyroidectomy for Graves' disease is hereby reported. The need for vigilance and regular follow-up in patients who receive all forms of treatment for benign thyroid diseases is emphasized.

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