Radiological Diagnosis of a Rare Prepontine Lesion: Ecchordosis Physaliphora.

Ecchordosis physaliphora (EP) is a notochordal remnant tissue rarely encountered during routine clinical practice. These lesions usually do not produce any significant symptoms as they are slow-growing and mostly small in size. Symptoms are due to mass effects on adjacent structures when they are large or extra-tumoral hemorrhage. Because of histological similarity with chordoma, diagnosis is challenging, and this differentiation is essential as the disease course and treatment differ significantly. Imaging plays a crucial role in identifying and distinguishing these lesions. We report the case of a 16-year-old male who presented with intermittent headache and neck pain for six months. His routine clinical examinations were within normal limits. On neurological assessment, there was no focal neurodeficit. Evaluation of cranial nerves did not reveal any evidence of palsy. Routine hematological tests were also normal. A computed tomography (CT) scan of the brain revealed a mass in front of the pons. Magnetic resonance imaging (MRI) for further evaluation revealed a T1 hypointense and T2/fluid-attenuated inversion recovery hyperintense lesion in the pre-pontine cistern. There was no enhancement in the mass either in the post-contrast CT or MRI scans. There was no bony erosion and clivus was normal. Based on the location and characteristic imaging features, a diagnosis of EP was made. There may be several other lesions that may present as a mass in the pre-pontine region. Histopathological tests may find it difficult to distinguish between lesions that originate from notochord remnants. Imaging studies play a vital role in confirming the diagnosis and help in planning treatment and follow-up.

Testicular Torsion: Successful Management of a Late-Diagnosed Case.

Testicular torsion is an emergency. It usually occurs spontaneously, without an apparent cause but has been associated with anatomical, traumatic, and environmental factors. In the case of the acute scrotum, a high degree of clinical suspicion is the most important factor in early diagnosis. Scrotal Doppler helps to confirm the diagnosis of testicular torsion. Prompt recognition and treatment are critical for testicular viability. Surgical intervention, even in late-diagnosed selected cases may yield desirable results. We report a case of a 16-year-old boy who came to the urology outpatient department (OPD) with a history of scrotal pain for approximately 12 hours.

Radiological diagnosis of rare pancreatic serous cystadenoma.

Serous cystadenoma of the pancreas, also known as microcystic adenoma, is a very rare type of pancreatic neoplasm. It is a benign cystic lesion. It is composed of many small cysts lined by cuboidal or flattened cells containing glycogen. Herein, we report a rare case of serous cystadenoma of the pancreas in an 82-year-old male. The tumor was located in the body and tail of the pancreas and postoperative sample revealed a sponge-like appearance due to multiple tiny cysts containing clear serous fluid. Microscopic analysis showed cystic spaces lined by cuboidal cells with intracytoplasmic glycogen.

Diagnosis of tubo-ovarian filariasis with retroperitoneal extension: A radiological challenge.

The purpose of this report is to describe a very rare case of bilateral tubo-ovarian filariasis with retroperitoneal extension in a 20-year-old female patient. The patient complained of low-grade fever with whitish cloudy urine. Computerized tomography imaging revealed hypodense cystic abdominopelvic masses with nonenhancing septations involving the retroperitoneum and ultrasound showing the characteristic "dancing larvae sign" suggesting filariasis.