Madelung's Disease Leading to Presenile Dementia in a Non-alcoholic Patient.

INTRODUCTION: Madelung's disease (MD) is a rare disorder of unknown etiology defined as the presence of multiple and symmetrical fatty accumulations most commonly involving the upper trunk, neck, and head. Excessive alcohol ingestion has been linked traditionally to the pathogenesis of the disease. The central and peripheral nervous system could both be affected. Presenile dementia, without alcohol abuse, has been rarely reported in the literature as a complication. AIM: The aim of this case report is to highlight that multiple symmetric lipomatosis can be complicated by presenile dementia even if the patient is non-alcoholic. CASE REPORT: This case report describes a middle age non-alcoholic woman who presented for increased forgetfulness. Brain CT scan showed cerebral and cerebellar atrophy inappropriate for her age. Despite being started on anticholinergic drug, her MMSE decreased 3 points in 1 year. CONCLUSION: Clinicians should consider early onset dementia as a potential complication of Madelung's disease even in patients with no preceding history of alcoholism. A brain MRI and MMSE can aid with identifying such a complication.

Cerebral aspergillosis presenting as a space occupying lesion in an immunocompetent individual.

Cerebral aspergillosis has the tendency to occur in immunocompromised patients. Less commonly, immunocompetent individuals can be affected, with neuroimaging findings being difficult to interpret. The diagnosis necessitates imaging of the brain as well as the sinuses with biopsy and pathological confirmation. A surgical excision with aggressive antifungal agents are required for a proper management. This case report describes an immunocompetent patient with cerebral aspergillosis that presented radiologically as a suspicious mass to be diagnosed pathologically and excised surgically.

Penile ossification of the entire penile shaft found incidentally on pelvic x-ray.

Penile ossification, a rare condition, has been linked traditionally to Peyronie's disease (PD) despite the presence of other less common etiologies. The ossification takes place usually in the mid-shaft of the penis with few cases reporting involvement of the entire shaft. Ultrasound has been the method of choice to demonstrate plaque calcifications. Medical and surgical treatment options exist depending on the extent of ossification and symptoms. This case report discusses the presence of ossification in the entire penile shaft which has been found incidentally on a pelvic x-ray in a patient presenting to the emergency department for a trauma of the knee.