Internal drainage of extrinsic malignant ureteral obstruction with metal mesh stents provides long-term decompression of the upper urinary tract in select cases. Certain problems limit the application of metal mesh stents in the ureter. Further studies are warranted to identify independent predictors of ureteral patency after the application of metal stents for malignant obstruction.

Treatment of small but painful osteoid osteomas was traditionally based on either prolonged medication or resection. In the era of rapidly evolving minimally invasive techniques, reluctance has been posed against surgical interventions mostly due to their relatively high rates of recurrence, complications, or persistent pain. Nonetheless, incomplete pain control and intolerance to anti-inflammatory drugs unfavorably affect prognosis. The objective of this article is to explore the nature and clinical presentation of osteoid osteomas, discuss their imaging and histological features, review available data regarding surgical and percutaneous methods for addressing these lesions and comment on their feasibility, safety, and efficacy.

Splenic arteriovenous fistula (SAVF) accounts for an unusual but well-documented treatable cause of portal hypertension([1-4]). A case of a 50-year-old multiparous female who developed suddenly portal hypertension due to SAVF formation is presented. The patient suffered from repeated episodes of haematemesis and melaena during the past twelve days and thus was emergently admitted to hospital for management. Clinical and laboratory investigations established the diagnosis of portal hypertension in the absence of liver parenchymal disease. Endoscopy revealed multiple esophageal bleeding varices. Abdominal computed tomography (CT) and transfemoral celiac arteriography documented the presence of a tortuous and aneurysmatic splenic artery and premature filling of an enlarged splenic vein, findings highly suggestive of an SAVF. The aforementioned vascular abnormality was successfully treated with percutaneous transcatheter embolization. Neither recurrence nor other complications were observed.

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BackgroundTo analyze the imaging features of hibernomas on computed tomography (CT) and magnetic resonance (MRI).MethodsTwelve hibernomas were retrospectively assessed with CT and MR imaging and compared to the histology of the specimenResultsNine females and three males with a mean age of 30 years were included. Ten tumors occurred in the thigh and two affected the subcutis of the periscapular and buttock regions. On eight CT scans, seven (87,5%) lesions were homogeneous and mildly to moderately hyperdense compared to subcutaneous fat while one lesion was heterogeneous with mixed hypo and hyperattenuating areas. On six T1W images, five (83,3%) lesions appeared homogeneous and hypointense relative to subcutaneous fat and one was heterogeneous. Incomplete fat suppression was depicted in all cases. All lesions displayed marked enhancement. Large intratumoral vessels were depicted in three of the 12 (25%) cases. Septations were depicted on four of the eight unenhanced CT and on all six MRI examinations.ConclusionsHibernoma usually appears hypodense and hypointense relative to subcutaneous fat on pre-contrast CT and MR T1W with variable enhancement patterns and incomplete fat suppression on STIR or fat-saturated sequences. These characteristics relate directly to the presence of brown fat. However, atypical findings such as heterogeneous patterns of mixed fatty and non fatty components on unenhanced CT and MR T1W can be also encountered. Absence of large intratumoral vessels should not exclude hibernomas from the differential diagnosis of regional lipomatous tumors.