A rare case of Erdheim Chester disease.

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis. There are few documented cases in the medical literature. Here, we present an infrequent case of a 53-year-old patient who presented with cutaneous xanthelasma and a gradual decline in general health characterized by asthenia, anorexia, and chronic dyspnea over the last 5 years. Chest, abdominal, and pelvic CT scans revealed distinct findings suggestive of ECD, including peri-renal fat infiltration resulting in the "hairy kidney" sign, hepatosplenomegaly, renal artery ostial stenosis, pneumopericardium thickening, interstitial lung parenchymal involvement, metaphyseal-diaphyseal osteosclerosis affecting long bones, and sinus osteosclerosis. A biopsy confirmed the diagnosis. This case highlights the importance of radiologists being familiar with the characteristic radiologic signs of ECD to avoid unnecessary repeat examinations, delays in diagnosis, or misdiagnosis.

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.

Diagnostic imaging of foot mycetomas: A report on two cases.

Mycetomas caused by aerobic actinomycetes are called actinomycetomas. It is primarily localized in subcutaneous tissue but it can spread to different tissue planes including the skin, deep tissues and structures and eventually the bones. We report the cases of 2 patients referred for evaluation of soft tissue masses involving the foot. A 40-year-old male and a 25-year-old male, in both cases MRI was performed to assess the extension, which was later completed by a CT scan. MRI revealed a low intensity matrix that represents fibrosis containing multiple high intensity lesions corresponding to the mycetoma grains. Within some of the lesions a low-intensity focus was identified. This "dot-in-circle sign" on an MRI is a pathognomonic feature of mycetoma. The purpose of this work is to describe the characteristic MRI appearance of foot mycetoma.

Giant fibrous polyp issuing from the uterine cervix: A case report.

Fibrous uterine polyps are very common in women during or after menopause, and less often seen in women of child-bearing age, with a maximum of frequency between 40, and 49 years. They can have various locations in the uterus depending on the patient's age, mostly the body, and fundus. We report a rare case of cervical localization of a pedicled fibrous polyp issuing from the cervix, in a 44-year-old female patient with 3 living children and a history of miscarriage, who had been presenting breakthrough bleeding, and pelvic pain for 3 months. It is essential to remind young radiologists of the different presentations of fibrous polyps, how to explore them better and when to fear malignancy and thus insist in a histologic study, in order to help clinicians to choose the most adequate treatment option.

Eccrine porocarcinoma: an extremely rare cutaneous tumor from a radiological point of view - case report and review of the literature.

Eccrine porocarcinoma is a rare type of skin neoplasm. It represents less than 0.01% of all epithelial cutaneous tumors. Early diagnosis is the only way to minimize the mortality rate, given its aggressive nature and the high rate of local recurrence and metastasis. Clinical diagnosis is challenging and the confirmation is histological. Few studies have been published about the radiological features of eccrine porocarcinoma. We report a case of a localized eccrine porocarcinoma along with ultrasound, MRI features, and a review of the literature to highlight the role of imaging in the diagnosis and treatment plan.

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.

Bilateral patellar tendon rupture on lupus undergoing corticosteroids: a case report.

BACKGROUND: Patellar tendon rupture is a rare condition, especially when it is bilateral. The most frequent associated pathologies are systemic lupus erythematosus, chronic renal failure, or treatments like corticosteroids. The aim of this case report is to draw attention to the non-specific clinical aspect of this condition, to recall its radiological signs, and highlight the diagnostic contribution of musculoskeletal ultrasound. CASE PRESENTATION: A 39-year-old man was diagnosed with a systemic lupus erythematosus with cutaneous, pulmonary, cardiac, hematological, renal, and immunological manifestations. He was treated with high-dose corticosteroids. Within 3 months he presented with a total functional impotence of the knees. On physical examination, there was a gap in the right infrapatellar region, his patellae were abnormally ascended, and his left knee was swollen. Insall-Salvati ratio on knees conventional radiographies was 2.5 in the right and 2.25 in the left knee, assessing bilateral patella alta. Ultrasound revealed a complete and bilateral patellar tendon rupture. The treatment consisted in a surgical repair and physiotherapy. The patient was able to mobilize independently after 6 months. CONCLUSIONS: Bilateral patellar tendon rupture is exceptional. Systemic lupus erythematosus and corticosteroids are among trigger factors. Careful examination of the patellae should be done in front of knee extension deficit. Ultrasound plays a determining role in the diagnosis.