Partial facial duplication (diprosopus): a case report and review of the literature.

BACKGROUND: Diprosopus, or craniofacial duplication, is a rare entity that occurs in approximately 1 in 180,000 to 15 million live births. The degree of duplication varies from complete facial duplication to small facial structure duplication like the nose and eye. The cause of diprosopus is unknown though there are proposed factors. CASE PRESENTATION: Our African patient was a term 72 hours old female neonate who was referred to our center with impression of lower facial duplication with two oral cavity that are located side to side separated by large soft tissue, she also had flat nasal bridge with widely separated nostrils and widely spaced eyes. Besides the facial malformation she had multiple episodes of vomiting with aspiration. Her blood tests were normal. Precontract brain computed tomography (CT) scan confirmed partially duplicated mandible and maxilla, two oral cavity separated by large fatty tissue, brain tissue were well formed and the only abnormality was corpus callosum agenesis and interhemispheric lipoma. In her stay at hospital nasogastric tube (NG) tube feed was initiated and started with antibiotics for aspiration pneumonia. After 25th day the neonatal passed away with possible cause of death being respiratory failure. CONCLUSION: Craniofacial duplication is a very rare anomaly with only a few cases reported. Most of these patients are stillborn, even if they survive the prognosis is often poor. Early prenatal diagnosis is very important as termination of pregnancy can sometimes be considered an option.

Laryngeal Cancer Imaging Patterns and Agreement with Laryngoscopy Findings at Tikur Anbessa Specialized Hospital: A Retrospective Study.

Background: Head and neck cancer is the commonest cancer among male patients and the third commonest cancer in females at Tikur Anbessa Specialized Hospital from 1998 to 2010. Methods: A retrospective cross-sectional study of 90 patients with laryngeal mass who came to oncology and radiology departments at Tikur Anbessa specialized hospital from 2016 to 2019. Medical records were reviewed for clinical data, history, laryngoscope exam and computed tomography (CT) reports. The agreement between imaging and laryngoscope examination were analyzed. Results: The mean age of presentation was 51.5 years ±14 (SD). The primary patient complaint was hoarseness of voice 77(85.6%) followed by shortness of breath in 28(31.1%). Among 34 cases for which risk factors were indicated, 23 (67.6%) had cigarette smoking. Out of the 79 cases with laryngeal subsites described, 38 (48.1%) were transglottic, 27 (34.2%) were glottic and 12 (15.2%) were supraglottic. Extra-laryngeal spread was seen in 46(51.1%) patients and 42(46.7) were stage IVA. Out of 90 patients only 38(42.2%) patients had laryngoscope findings. Conclusions: Transglottic involvement with extra-laryngeal spread was common with advanced stage at presentation.

Imaging Patterns of Temporal Bone Fracture among Patients with Head Injury at Tikur Anbessa Specialized Hospital, Ethiopia.

Background: Temporal bone fracture is usually a sequel of significant blunt head injury. Fracture of the temporal bone is mainly classified according to the orientation of the fracture plane and whether there is involvement of the otic capsule. Despite its frequent occurrence, there is limited research on the frequency and pattern of temporal bone fractures in our setup. Methods: Retrospective cross-sectional hospital - based study of 60 patients who underwent computed tomography of the head for head trauma at Tikur Anbessa Specialized Hospital during the study period from October 2020 - October 2022. Results: Among the 60 patients enrolled in the study, the mean age of presentation was 31.1 years with a male-to-female ratio of 4:1. There were 69 temporal bone fractures, 9(15%) were bilateral and 51(85%) unilateral The longitudinal fracture pattern was the most common fracture pattern, occurring in 40(78.4%) of unilateral cases, 15(83.3%) of bilateral cases. Otic capsule sparing fractures accounted for 49(96.07%) of unilateral fracture cases, and all patients with bilateral involvement had an otic capsule sparing fracture. Among the 42 patients for whom data regarding post-traumatic hearing outcome was available, 4 patients had post-traumatic hearing impairment. Anatomically, the squamous portion of the temporal bone was involved in 30(43.5%) of cases. Conclusions: Fractures affecting the squamous portion of the temporal bone, longitudinal fracture patterns, and otic capsule sparing were the most frequent forms. The majority of temporal bone fractures were associated with other bone fractures and intracranial injuries.

Preliminary Review of Spine Tumor Radiologic, Intra-Operative and Histopathology Findings, Addis Ababa, Ethiopia.

Background: Spinal tumors constitute 10-32% of all primary central nervous system tumors. Accurate radiologic and histopathology diagnosis is crucial in the management and prognosis. The aim of the study was to describe the imaging patterns and to determine the agreement of imaging pattern of spinal tumors with intra-operative and histopathology findings. Methods: A retrospective cross-sectional study of 47 patients with spinal tumor done from May 2018 to October 2020. Medical records were reviewed for clinical data, history, physical examination, magnetic resonance imaging (MRI), intraoperative findings and histopathology reports. The agreement between imaging, intraoperative finding and histopathology diagnosis was analyzed. Results: Intradural extramedullary tumors constituted 37 (78%) cases followed by six (12.8 %) extradural tumors and four (9.2%) intramedullary tumors. Schwannoma accounted for 13 (27.7%) cases followed by meningioma, 12 (25.5%) cases. Twenty-seven (57.4%) cases were thoracic level and cervical level were nine (19.1%) cases. Twelve (25.5%) cases did not have a definite intraoperative diagnosis. Imaging and intraoperative diagnosis was in agreement in 21 (44.6 %) cases and disagreed in 14 (29.7%) cases. For the imaging diagnosis and histopathology, 29 (61.7%) were in agreement and 18 (38.3 %) were in disagreement. Conclusion: In conclusion, the commonest site to be involved was the thoracic spine and schwannoma was the commonest tumor. The low agreement between imaging and histopathology could have been improved by optimizing the imaging reports and techniques.

Dual Ectopic Thyroid: A Case Report.

Background: Ectopic thyroid gland is an uncommon disorder in which thyroid tissue is located along the line of migration, dual ectopic thyroid is a rare entity where parts of the gland are located in two different locations. Case: A 14-year-old girl presented with dysphagia and odynophagia of six years duration with worsening of two weeks. Physical exam showed tongue base mass. Imaging revealed two enhancing masses at the tongue base and inferior to the hyoid bone. A diagnosis of dual ectopic thyroid was made. Conclusion: Dual ectopic thyroid is a rare occurrence and proper diagnosis is essential for proper management.

Dorsolumbar parasitic twin associated with lipomyelomeningocele: a case report from a tertiary teaching hospital, Ethiopia, East Africa.

A parasitic or heteropagus twin is a grossly defective fetus (or fetus part) attached externally, with or without internal connections and is dependent on the cardiovascular system of the other twin (autosite) for survival. The estimated incidence is approximately 1 per 1 million live births. To date according to the authors' knowledge; there are a few case reports published in the literature. Here we present a case of dorsolumbar parasitic twin with associated lipomyelomeningocele.

Pediatric Oculo-orbital Tumor Characteristics, Imaging and Histopathology Agreement in a Tertiary Level Teaching Hospital, Ethiopia.

Background: Oculo-orbital tumors are frequently encountered pathologies and late diagnosis results in high morbidity and mortality in developing countries. This study aims to assess the computed tomography and magnetic resonance imaging patterns of pediatric oculo-orbital tumors with particular emphasis on retinoblastoma and compare agreement between imaging and histopathology diagnosis. Methods: A retrospective analysis of 101 pediatric patients with oculo-orbital lesions from February 2017 to January 2020 at Tikur Anbessa Specialized Hospital oncology center. Medical records were reviewed for clinical data, history, physical examination, pretreatment eye exam under anesthesia (EUA), computed tomography (CT) magnetic resonance imaging (MRI) and histopathology reports. The agreement between imaging and histopathology diagnosis was analyzed. Results: Malignant oculo-orbital tumors represented 97 (96.1%) cases. Age group 2-5 years had 56 (55.4%) cases of oculo-orbital tumors. Retinoblastoma accounted for 78 (77.2%) followed by rhabdomyosarcoma in 8 (7.9%) patients. The primary patient complaint was proptosis in 78 (77.2%) followed by leukocoria in 16 (15.8%). In 88 (89.7%) cases, there was agreement between imaging and histologic findings with 72 out of the 75 histopathology confirmed cases of retinoblastoma showing an agreement. Retinoblastoma patients presented at an advanced stage with orbital and intracranial extension. Conclusions: In conclusion, patients with oculo-orbital tumors presented with advanced stage of disease. Excellent imaging and histopathology agreement was demonstrated.

Giant chronic calcified subdural empyema: a case report.

BACKGROUND: Chronic calcified subdural empyema is an exceedingly rare central nervous system infection with a handful of cases published to date. Reported cases presented with nonspecific clinical signs and symptoms. The duration between the initial onset of symptoms and diagnosis can vary drastically from a few years to up to 46 years. Although there are known predisposing causes, the initial source of infection can sometimes be difficult to identify. CASE PRESENTATION: Our patient was a 39-year-old Ethiopian man who presented with left-side body weakness of 6 years' duration with worsening of symptoms of 6 months' duration. He had no history of trauma, meningitis, or previous surgery. The results of routine laboratory tests were normal. The diagnosis was made by computed tomography and magnetic resonance imaging and was confirmed by surgery. Frontoparietal craniotomy was performed, and evacuation of non-foul-smelling collection was done. The patient was reoperated for tension pneumocephalus 48 hours after the initial surgery. He died 10 days later. CONCLUSION: This is a rare case of a giant chronic calcified subdural empyema with no known preceding history of trauma or infection.

Nasopharyngeal Carcinoma: A Retrospective Study on Imaging Patterns at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

BACKGROUND: Nasopharyngeal carcinoma is one of the rare forms of cancer globally which has a high incidence in select geographic and ethnic populations. The current study aims to assess the clinical presentation, imaging patterns and radiology-pathology correlation of nasopharyngeal carcinoma. METHODS: This is a retrospective analysis of 80 patients with newly diagnosed nasopharyngeal carcinoma who came to Tikur Anbessa Specialized Hospital from January 2016 to August 2017. The patients' history, physical examination, abdominopelvic ultrasound, chest x-ray, computed tomography scan and biopsy reports were reviewed from their medical record. Patients who had previous history of treatment for nasopharyngeal carcinoma, those who did not have biopsy and those without imaging were excluded from the study. RESULTS: This study showed that 61(81.3%) patients had neck swelling as the initial clinical symptom, and the average time of presentation of symptoms was 6(IQR 8) months. On the other hand, 56(70.0%) were diagnosed with non-keratinizing undifferentiated nasopharyngeal carcinoma while 15(3.8%) had keratinizing nasopharyngeal carcinoma. Sixty-nine (86.3%) patients had nodal metastasis; 22.5% had invasion into the paranasal sinuses; 47.5% had T4 with T1, T2 and T3 being 18.8%, 17.5% and 7.5% stage respectively at time of diagnosis. Ninety percent of the cases had a diagnosis of nasopharyngeal carcinoma on imaging, but 10% were given alternative diagnosis. CONCLUSION: Non-keratinizing undifferentiated type was the commonest histologic subtype in this study which is also recognized as the commonest one in endemic countries. A significant number did not have a specific histologic WHO type on pathology report which could in turn affect the management and assessment of risk factors.