Pulmonary artery penetration due to fish bone ingestion: A rare case report.

Accidental fish bone ingestion is a common manifestation at emergency departments. In most cases, ingested foreign bodies usually pass uneventfully through the gastrointestinal tract and complications only present in less than 5% of all patients. In this report, we present the first documented case of pulmonary artery injury due to a fish bone in a 63-year-old male patient hospitalized with hemoptysis after accidentally swallowing a fish bone 30 days ago. This patient subsequently had surgery and endoscopy to safely remove the foreign body and then recovered well on a follow-up examination. For cases of fish bone ingestion, contrast-enhanced chest computed tomography is one of the most essential tools to assess vascular problems and associated mediastinal infections-risk factors for life-threatening and long-term recurrent inflammation. Reconstructing planes along the foreign body axis and changing windows when analyzing CT scans is necessary to avoid missing lesions and dilemmas.

Endovascular intervention with high-flow priapism: A case report.

High-flow priapism is a rare condition in the form of priapism unrelated to sexual stimulation. The disease causes a decline in quality of life and has the risk of causing long-term erectile dysfunction if not treated promptly. We report a case of a 48-year-old male patient with prolonged high-flow erection after trauma who received endovascular intervention with n-butyl-2 cyanoacrylate biological glue. Results after 40 days of intervention and use of sildenafil 25 mg/day, the patient has an erection and has normal sexual activity. Cavernous arteriovenous fistula causing priapism with high flow is a rare condition. Computed tomography helps supplement information about feeding vessels as well as accompanying injuries for comprehensive assessment before treatment. Currently, there are many treatment methods, but transcatheter arterial embolization is modality of choice for achieve clinical efficacy and can safely and flexibly reduce the risk of secondary erectile dysfunction.

Laparoscopic treatment for median arcuate ligament syndrome in children: A case report.

In median arcuate ligament syndrome (MALS), the median arcuate ligament compresses the celiac trunk and surrounding nerves leading to chronic functional abdominal pain and vague gastrointestinal symptoms. MALS can be effectively treated by dividing the arcuate ligament through open surgery or laparoscopy. This is a rare vascular condition and mostly encountered in adult patients. We hereby report a case of a pediatric patient diagnosed with MALS and treated successfully by laparoscopic approach. An 11-year-old girl presented with severe abdominal cramps for 3 months, accompanied by nonbilious vomiting. Computed tomography (CT) angiography demonstrated clear images of celiac trunk compression suggesting MALS. Laparoscopic surgery to cut the ligament and decompress the celiac artery was performed. The patient was discharged on day 7 postoperative with no recurrence of symptoms after 12 months of follow-up. This report suggested the diagnostic value of CT scan, and the safety and the feasibility of laparoscopic surgical techniques to treat MALS in children.

Imaging characteristics of posterior interosseous nerve syndrome.

Posterior interosseous nerve syndrome (PINs) is a rare nerve compression syndrome that affects the deep branch of the radial nerve in the supinator muscle region. In this article, we aimed to report a case of a 58-year-old male who had clinical symptoms, electromyographic, ultrasound, and MRI features suggestive of PINs due to compressing the arcade of Frohse. He subsequently underwent surgical correlation at our hospital, and the clinical symptoms were improved significantly.

Germinoma of basal ganglia.

Basal ganglia germinomas (BGGs) are rare lesions. Because of the atypical features of early-stage clinical symptoms and imaging characteristics, BGGs are easily misdiagnosed with non-tumorous conditions. This article presented cases of 2 young male patients who came to the hospital due to right arm weakness. Brain Magnetic Resonance Imaging (MRI) images in the first case revealed a lobulated mixed component mass on the left basal ganglia. The solid part showed restricted diffusion on diffusion-weighted imaging, heterogeneous strong enhancement, and no signal of calcification or bleeding. The second case in the left putamen showed hypointensity on T2*, mild enhancement, and atrophy of the ipsilateral cerebral peduncle, increased choline, and decreased n-acetyl-aspartate (NAA) on spectroscopy. Follow-up MRI after 6 months showed a mass increase in size and hypointensity part on T2*. BGGs have been confirmed on biopsy in both cases. With isolated chemotherapy application, there is no sign of remission in the first patient. The second patient was treated with chemotherapy and radiotherapy, and MRI images after treatment showed a complete response.

Imaging features of shoulder tuberculosis with rice bodies formation: A case report.

Osteoarticular tuberculosis is less common than pulmonary tuberculosis and is often overlooked in the differential diagnosis of people with joint disease. In this article, we present a case of a 71-year-old female patient admitted to the hospital because of pain and limited movement of her right shoulder for a year. The patient had diabetes for 10 years, and no history of tuberculosis or previous history of tuberculosis exposure. Blood test results showed inflammatory condition and positive IGRA test. X-ray, ultrasound and magnetic resonance imaging images revealed osteolytic and sclerotic lesions of the humeral head, diffuse thickening of the synovial membrane, and loose bodies in the joint and bursa. The clinical diagnosis was tuberculous inflammatory osteoarthritis of the right shoulder. The patient underwent arthroscopy surgery to remove loose bodies and the inflamed portion of the synovium and send them to the pathology department. Histopathological examination of the loose bodies and synovial membrane revealed features suggestive of tuberculosis of the shoulder joint. Afterward, the patient was treated with antituberculosis drugs according to the guideline and rehabilitation exercises. After 3 months of treatment, the clinical symptoms were reduced, the pain rating was decreased and the range of motion was increased.

Apparent diffusion coefficient histogram in the differentiation of benign and malignant testicular tumors.

Purpose: This retrospective study assessed the value of histogram parameters of the apparent diffusion coefficient (ADC) map (HA) in differentiating between benign and malignant testicular tumors. We compared the diagnostic performance of two different volume-of-interest (VOI) placement methods: VOI 1, the entire tumor; VOI 2, the tumor excluding its cystic, calcified, hemorrhagic, and necrotic portions. Materials and methods: We retrospectively evaluated 45 patients with testicular tumors examined with scrotal contrast-enhanced magnetic resonance imaging. These patients underwent surgery with the pathological result of seven benign and 39 malignant tumors. We calculated the HA parameters, including mean, median, maximum, minimum, kurtosis, skewness, entropy, standard deviation (SD), mean of positive pixels, and uniformity of positive pixels by the two different VOI segmentation methods. We compared these parameters using the chi-square test, Mann-Whitney U test, and area under the receiver operating characteristic curve (AUC) to determine their optimal cut-off, sensitivity (Se), and specificity (Sp). Result: This study included 45 patients with 46 testicular lesions (seven benign and 39 malignant tumors), one of which had bilateral testicular seminoma. With the VOI 1 method, benign lesions had significantly lower maximum ADC (p = 0.002), ADC skewness (p = 0.017), and ADC variance (p = 0.000) than malignant lesions. In contrast, their minimum ADC was significantly higher ADC (p = 0.000). With the VOI 2 method, the benign lesions had significantly higher ADC SD (p = 0.048) and maximum ADC (p = 0.015) than malignant lesions. In contrast, their minimum ADC was significantly lower (p = 0.000). With the VOI 1 method, maximum ADC, ADC variance, and ADC skewness performed well in differentiating benign and malignant testicular lesions with cut-offs (Se, Sp, AUC) of 1846.000 (74.4%, 100%, 0.883), 39198.387 (79.5%, 85.7%, 0.868), and 0.893 (48.7%, 100%, 0.758). Conclusion: The HA parameters showed value in differentiating benign and malignant testicular neoplasms. The entire tumor VOI placement method was preferable to the VOI placement method excluding cystic, calcified, hemorrhagic, and necrotic portions in measuring HA parameters. Using this VOI segmentation, maximum ADC performed best in discriminating benign and malignant testicular lesions, followed by ADC variance and skewness.

A rare case of duodenal adenocarcinoma.

Duodenal adenocarcinoma is very rare. Its clinical picture is nonspecific and the diagnosis is often accidental. The factors that affect survival are difficult to determine because the number of patients is not high. The common site of duodenal tumors and surgical removal are also debatable. The treatment guidelines published so far have mostly been evaluated in retrospective studies conducted over a 20-year period with relatively small sample sizes. The author presents a case of duodenal adenocarcinoma in a 62-year-old male patient with a clinical manifestation of melena. Duodeno-cephalo-pancreatectomy was the surgical option.

Small-cell cancer of the perihilar bile duct with bleeding esophageal varices: A report of a rare case.

Small-cell cancer is an uncommon histological subtype of neuroendocrine carcinoma. It frequently has a poor prognosis because of distant metastasis. It is diagnosed using histopathological and immunohistochemical tests. We report the case of a 29-year-old female with small-cell cancer in the perihilar bile duct who presented with bleeding esophageal varices. This case report aims to improve physicians' understanding of small-cell cancer, thereby helping to reduce the frequency of missed clinical diagnoses.

A rare case of perineal synovial sarcoma.

Synovial sarcoma is a malignant mesenchymal neoplasm that is frequently misdiagnosed due to its slow growth and small size. This tumor presents as a nonspecific heterogeneous mass on cross-sectional imaging. Biopsy and histopathological assessments are required to differentiate synovial sarcoma from other sarcoma subtypes and to define the tumor grade. This article presents the case of a 17-year-old male patient with perineal synovial sarcoma.

Acinic cell carcinoma of parotid gland.

Acinic cell carcinoma (ACC) is a rare malignant tumor of the salivary glands that accounts for 6%-10% of all salivary gland malignancies. It has a propensity to considerably recur, metastasize to the lung or cervical lymph nodes. In addition, ACC can potentially be fatal. The parotid gland is where ACC most frequently begins. The purpose of this paper was to describe an unusual case of parotid gland ACC in a 58-year-old Vietnamese adult female. Before surgery, a fine-needle aspiration biopsy revealed the existence of tumor cells with acinar differentiation. Following that, she underwent successful surgery without complications. The existence of ACC was verified by the postoperative final histologic results.

Adenoid cystic carcinoma of the parotid gland.

Adenoid cystic carcinoma (ACC) is a slowly progressing malignant tumor of the salivary glands that mostly affects minor salivary glands. ACC of parotid gland is exceptionally rare. In this article, we aimed to provide a case report of parotid gland ACC in a 55-year-old female that was misdiagnosed as benign mixed tumor. The patient was successfully treated by surgery without any complications. We recommend that ACC of parotid gland should be considered in differential diagnosis of benign mixed tumor since there still existed overlapped imaging characteristics.

Carcinosarcoma of uterus.

Uterine carcinosarcoma, which is categorized as high-grade endometrial cancer, is an uncommon kind of malignant gynecological neoplasms. Clinically, this tumor frequently affects menopausal women and the main symptom is abnormally postmenopausal vaginal bleeding. Surgery continues to be the main treatment for carcinosarcoma. In this study, we wanted to discuss 2 cases of uterine carcinosarcoma in 2 women who were in menopause and who had been evaluated by ultrasound and magnetic resonance imaging.

Vestibular schwannoma with fluid-fluid levels mimicking aneurysm bone cyst.

Of 6%-8%, cerebral tumors are intracranial schwannomas, also known as neurinomas, which frequently arise from the nerve sheath. Eighth cranial nerve (CN VIII), also known as the vestibulocochlear nerve, is the site of genesis of the majority of schwannomas, which account for 80%-90% of cerebellopontine angle tumors. In this paper, we intended to describe an uncommon cystic vestibular schwannoma with multiple fluid-fluid levels. Surgical excision was performed using the translabyrinthine approach. The report highlights schwannomas' adherence to and invasion of adjacent anatomical structures. We discuss a number of differential diagnoses, the pathophysiology of fluid-fluid levels, and the imaging features of cystic vestibular schwannomas.

A rare case of breast invasive cribriform carcinoma.

Although invasive ductal carcinoma accounts for 75% of all primary breast cancers diagnosed, there are other, more uncommon kinds, including invasive cribriform carcinoma (ICC). Invasive cribriform carcinoma has 2 subtypes: pure and mixed. Ultrasonography and magnetic resonance imaging are the best imaging methods for assessing the characteristics of breast ICC (MRI). Our goal in this article was to report a rare instance of breast ICC in a 38-year-old Vietnamese woman. During a clinical examination, a spherical mass in the left breast without ipsilateral axillary lymph nodes was seen. On ultrasonography, the lesion was classified as BI-RADS 4C. The lesion was with an apparent diffusion coefficient value of 0.46 × 10-3 mm2/s. Lesion showed a quick initial increase on dynamic T1-weighted imaging with contrast enhancement, followed by a wash-out in the delayed phase. The final histopathological findings confirmed the presence of ICC.

Oncocytic carcinoma of parotid gland.

Of 0.5% all epithelial salivary gland malignancies are oncocytic cancers, a rare kind of parotid gland cancer. Clinical signs include discomfort and swelling in the cheek region, and the facial nerve is occasionally affected, leading to unilateral facial paralysis. Currently, surgery is the preferred choice of therapy. In this paper, we aimed to provide a case of an 84-year-old male who had an oncocytic carcinoma in the right parotid gland. A heterogeneous, poorly defined hypoechogenic lesion with minor vascular proliferation was seen by Doppler ultrasonography in the superficial lobe of the right parotid gland. On a computed tomography (CT) with contrast agent, an ill-defined mass filling the right parotid gland was evident. With the aid of the CT results of a heterogeneous enhancing mass with poorly defined boundary and expansion of adjacent lymph nodes, it may be able to differentiate between malignant lesions and benign parotid tumors.

Giant breast cavernous hemangioma.

Although breast vascular tumors are exceedingly rare, the benign group's most common tumor, the hemangioma, is frequently found in lumpectomy or mastectomy tissues during histological analyses. The 3 types of hemangiomas are capillary, cavernous, and venous. The most typical kind of hemangioma is cavernous. Cavernous hemangiomas are benign blood vessel tumors that arise from established blood vessels. The best imaging technique for examining the makeup of breast vessels is magnetic resonance imaging. In this article, we purposed to describe an exceptionally uncommon case of giant breast cavernous hemangioma.

A giant parapharyngeal space lipoma.

Parapharyngeal space (PPS) lipomas are incredibly uncommon. Prestyloid or poststyloid compartments are the only locations for PPS lipomas. Liposarcoma is a crucial differential to rule out. In order to treat PPS lipomas, the required radiological tests, including magnetic resonance imaging, a biopsy of the lesion if that is available, and lipoma removal surgery are all necessary. We intended to describe a unique giant PPS lipoma that affects both prestyloid and poststyloid compartments.

A rare, giant, lateral intraventricular gliosarcoma.

A peculiar subtype of glioblastoma multiforme is gliosarcoma. According to histological analysis, it possesses a biphasic shape that clearly distinguishes between glial and sarcomatous tissue. A gliosarcoma is often seen in the supratentorial region. Here, we describe a rare instance of giant left intraventricular gliosarcoma that manifested in a 1-year-old male. Advanced brain scan using magnetic resonance imaging identified a supratentorial tumor with radiological characteristics comparable to choroid plexus carcinoma. Histopathology determined that the tumor was a gliosarcoma. Despite its rarity, gliosarcoma should be taken into consideration when determining the differential diagnosis of intraventricular tumors in children who exhibit radiological signs of choroid plexus carcinoma.

Low apparent diffusion coefficient in an extracranial brain tumor: a case report.

BACKGROUND: Medulloblastoma is well known as the most common malignant brain tumor identified in children, frequently found at an intra-axial location in the posterior cranial fossa. Extra-axial medulloblastoma is uncommon and often misdiagnosed. We believe that a thorough understanding of atypical medulloblastoma cases is important in daily practice. CASE PRESENTATION: We present the unique case of a 39-year-old woman of Asian descent who suffered from headaches and right-sided hearing impairment. A right extra-axial medulloblastoma with an extremely low apparent diffusion coefficient of 0.404 × 10-3 mm2/second was detected on magnetic resonance imaging. The initial diagnosis suggested schwannoma or hemangioblastoma. However, the postoperative histopathologic findings indicated medulloblastoma (World Health Organization grade IV). Pre- and postoperative magnetic resonance imaging revealed no drop metastasis, but adjuvant radiation therapy was still required as a standard treatment therapy CONCLUSIONS: Extra-axial medulloblastoma is an uncommon tumor that is often mistaken for other cerebellopontine angle neoplasms. We describe a rare example of extra-axial medulloblastoma, characterized by a low apparent diffusion coefficient. When evaluating an atypical cerebellopontine angle neoplasm, the apparent diffusion coefficient should be considered a relevant indicator.