Gangrene of the hepatic ligaments (falciform and/or round) is an exceptional and poorly understood condition and may present a diagnostic dilemma. We report a case of necrotic falciform ligament abscess with pylephlebitis secondary to pyocholecyst. The clinical picture was impressive and noisy. The diagnosis was evoked on the CT scan, with the discovery of a circumscribed lesion of fatty density, pre-hepatic, in the fissure of the round ligament, at the junction of segments III and IV of the liver. The interest of surgical exploration is mainly diagnostic insofar as the evolution is always favourable, independently of the modalities of excision of the necrotic zones. In this article, we discuss the diagnostic and therapeutic features of this entit.
Neurofibromas are known to manifest most frequently as localized lesions, less frequently as a diffuse form, and rarely as a plexiform variety We report the clinical and imaging features of a young male patient with biopsy proven plexiform neurofibroma (PNF). A 23 years old male, followed for neurofibromatosis type 1, plexiform lesions of the left lower limb progressively increasing in volume with scrotal extension. The MRI showed thickening of the cutaneous and subcutaneous soft tissues on the medial and posterior aspect of the left thigh, extending to the perineo-scrotal region. The role of imaging is important for a variety of reasons, including delineating the extent of involvement and effect on adjacent structures, exposing associated anomalies and last but not least, for predicting possible malignant transformation. MRI is the reference standard modality for evaluating neural tissues and also for delineating the parent nerve in cases of tumors of neural origin. Therapy of plexiform neurofibromas is usually surgical, aiming at resecting deforming masses and cancerous tissue when malignant transformation occurs.
Sneddon's syndrome is a rare condition characterized by livedo and multiple ischemic strokes with no apparent cause. This report presents a case of a 34-year-old woman with a 16-year history of livedo who developed right hemibody heaviness, a decrease in visual acuity, and palpitations. The MRI showed bilateral parieto-occipital cortico-subcortical atrophy associated with abnormal signals in the deep white matter, parieto-occipital gliosis foci, and small-caliber artery vasculitis. The patient was eventually diagnosed with Sneddon's syndrome based on her clinical presentation, MRI results, and symptom evolution. The underlying mechanisms of the syndrome remain unclear, but it is thought to involve occlusion of small- and medium-sized arterioles. The neurological involvement of Sneddon's syndrome is highly diverse and dominated by cerebral ischemic events, leading over time to intellectual deterioration or even dementia. This report highlights the importance of considering Sneddon's syndrome as a differential diagnosis in cases of livedo and unexplained cerebral ischemia.
We present a case of a 25-year-old woman with isolated aplasia of the lateral semicircular canal (LSCC), a rare congenital malformation that results in the absence or underdevelopment of the LSCC. The patient had vertigo, left-sided tinnitus, and persistent chronic headaches but no hearing loss. High-resolution computed tomography (CT) and magnetic resonance imaging (MRI) were used to detect the malformation and associated vasculo-neural conflict. The aplasia of the LSCC was the only abnormality observed. The article explains the embryology of inner ear development and associated anomalies. CT and MRI were found to be effective imaging techniques for detecting ear malformations. The article also explains the importance of proper diagnosis and assessment of hearing loss for patients with this malformation.
Peliosis is a condition characterized by the appearance of multiple cystic cavities filled with blood in the parenchyma of solid organs. Although the condition most commonly affects the liver, it can also affect the spleen, lungs, bone marrow, kidneys, and lymph nodes. The case reported here concerns a 56-year-old man with recurrent left hypochondrial pain radiating to the genital organs. After examinations, a splenic lesion of liquid density was detected, leading to splenectomy and confirmation of the diagnosis of isolated and diffuse splenic peliosis. Patients with isolated splenic peliosis may be asymptomatic or describe abdominal discomfort and are often diagnosed incidentally during abdominal imaging. This condition is rare and its origin is still unknown.
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