Tumoral calcinosis of unusual location in a chronic hemodialysis patient.

Tumoral calcinosis is a rare cause of intratissular calcifications in hemodialysis patients with chronic renal failure. Its frequency is estimated between 0.5 and 7% of patients. We illustrate through a case of unusual localization diagnosed in Ibn Rochd University Hospital, Casablanca, Morocco, the radiographic and scannographic aspect of this little known entity. A 40-year-old man, followed for hypertensive cardiopathy, in chronic renal failure for 12 years under hemodialysis, consulted for bilateral inguinal swellings evolving in a progressive and painless way. Biological investigations revealed hyperparathyroidism with increased phosphocalcic product. He was referred to us for radiological evaluation which revealed lesions in favor of bilateral puboinguinal tumor calcinosis. Tumoral calcinosis is a rare cause of intratissular calcifications in chronic renal failure patients undergoing hemodialysis. Pubic localization with infiltration and osteolysis of the symphysis pubis is very rare. Its main risk factors are the existence of hyperparathyroidism, an increase in phosphocalcic product and probably local traumatic factors. Tumoral calcinosis has a typical appearance on radiographs: amorphous, cystic and multilobulated calcifications of periarticular distribution. The CT scan allows a better delineation of the calcified mass. Its treatment remains controversial. The knowledge of osteoarticular manifestations of chronic hemodialysis patients, especially tumoral calcinosis by radiologists, allows to easily make the diagnosis and thus avoid invasive complementary explorations for the patient and to quickly institute an effective treatment.

Transient ischemic attack due to multiple spontaneous calcified embolus of the cerebral arteries on a calcified mitral and aortic stenosis.

We report a case of calcified mitral and aortic stenosis revealed by a reversible ischemic stroke. A 59-year-old male patient, with background of hypertension, kidney failure, diabetes, and dyslipidemia, presented with neither acute onset of right-sided hemiparesis without aphasia nor any loss of consciousness. Head computed tomography (CT) revealed multiple rounded and amorph calcified high-density calcifications within the distal segments of both sylvian and posterior cerebral arteries. Angiographic CT of the carotids didn't reveal any stenosis or atherosclerotic plaques. Thoracic CT showed massive mitral and aortic valvular calcifications with a left ventricular hypertrophy.

Mirrored Appearance of Complete Common Mesentery Discovered on CT Scan for Crohn's Disease.

Incomplete 90° intestinal rotation in a clockwise direction results in complete common mesentery being placed in a mirror image to and with a similar appearance to complete common mesentery. This rotation places the colon in the right half of the abdominal cavity and the small intestine in the left half of the abdominal cavity. We report the case of a 19-year-old patient with a history of cerebral palsy secondary to meningitis who presented with melaena and inflammatory anaemia. CT enterography was performed which showed regular, non-stenosing circumferential wall thickening of the sigmoid colon and rectosigmoid junction compatible with Crohn's disease, which was confirmed by pathophysiology. It also revealed transposition of the colon to the right hemi-abdomen and the small intestine to the left hemi-abdomen, the caecum to the right iliac fossa, and the third portion of the duodenum to the left of the mesenteric vessels. LEARNING POINTS: Complete common mesentery in the mirror image is an anomaly of intestinal rotation, placing the colon in the right half of the abdomen and the small intestine in the left half of the abdomen.It can be asymptomatic and discovered incidentally during assessment for other conditions.

[Leriche syndrome in a 20-year-old young woman: a case report]. / Syndrome de Leriche chez une jeune femme de 20 ans: à propos d'un cas.

Leriche syndrome or aortoiliac occlusive disease is a particular obliterative arterial disease of the lower limbs, consisting of thrombotic occlusion of the aortoiliac junction. We here report the case of a 20-year-old female patient with no particular past medical history, presenting with acute lower limb ischemia. Lower extremity echo Doppler showed overall decrease in arterial blood flow without visualization of endoluminal material. Lower limb angioscaner showed arterial thrombosis of the abdominal aorta extended to bilateral external iliac arteries. The patient subsequently underwent aortic-bi-iliac bypass surgery with good evolution as well as assessments for possible thrombogenic mechanism.

Zinner Syndrome.

Zinner syndrome is a developmental anomaly of the urogenital tract. This condition is defined by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction. The syndrome is due to malformation of the mesonephric duct during embryogenesis. The condition used to be rare but is now frequently encountered due to the advent of MRI and CT. MRI confirms the diagnosis by revealing the seminal vesicle cyst and its contents, and the ejaculatory duct obstruction, while CT confirms renal agenesis. We report the case of a young patient with Zinner syndrome. LEARNING POINTS: Zinner syndrome consists of the triad of renal agenesis, seminal vesicle cyst and ejaculatory duct obstruction.Any insult during embryogenesis of the mesonephric duct in men can result in Zinner syndrome.Pelvic MRI is the gold standard to confirm the diagnosis of Zinner syndrome.

Spontaneous vertebral artery dissection in an elder patient: a case report.

Vertebrobasilar artery dissection (VBD) is a rare cause of posterior ischemic strokes. It is more likely to occur in young patients with a history of traumatism or hereditary connective tissue disorders. Spontaneous VBD is rare, especially in elder patients. This paper aims to report the case of an old patient that presented with a posterior ischemic stroke due to a spontaneous vertebral artery dissection (SVAD), linked to atherosclerosis. The diagnosis of SVAD was made by Magnetic resonance imaging (MRI) which is the gold standard technique to diagnose this pathology in a short time so the patient could receive adequate treatment.

[Post traumatic pseudoaneurysm of the external carotid]. / Pseudo-anévrisme post traumatique de la carotide externe.

Pseudoaneurysm is due to a disruption in the arterial wall, secondary to inflammation, trauma or iatrogenic causes such as surgery, percutaneous biopsy or drainage. We report the case of a 37-year old patient, presenting with cervical swelling that had progressively evolved after penetrating cervical trauma occurred 8 months before. Doppler ultrasound supplemented by CT angiography confirmed the diagnosis of pseudoaneurysm of the left external carotid artery. The considerable development of sectional imaging techniques and of angiography has allowed easier diagnosis.

[Osteoid osteoma: about a case]. / L'ostéome ostéoïde: à propos d'un cas.

Osteoid osteoma is a benign primary bone tumor. This tumor is relatively frequent, accounting for 12% of all benign bone tumors and about 2-3% of all bone tumors. We report a new case of osteoid osteoma confirmed histologically. A 30-year old patient was referred for evaluation of chronic ankle pain. Front and lateral radiographs of the ankle showed a heterogeneous lesion located in the neck of the talus without soft tissue abnormalities. The CT scan of the ankle showed a nodular, hypodense lesion located in the neck of the talus with a limited osteosclerotic reaction.