Renal agenesis associated with contralateral ectopic ureter and hydroureteronephrosis.

Congenital anomalies of the kidney and the urinary tract such as renal agenesis and ectopic ureter have complex development. These anomalies have variable presentations and associations. In this report, we highlight the case of a young man with congenital renal agenesis presenting for a urinary tract infection. Abdominal and pelvic computed tomography imaging revealed the rare association of renal agenesis with contralateral ectopic ureter and subsequent hydroureteronephrosis. A urinary tract infection can be the presenting complication of such association, and a long follow-up is needed to anticipate the management.

Axumin Positron Emission Tomography: Novel Agent for Prostate Cancer Biochemical Recurrence.

Prostate cancer remains one of the top common cancers in terms of incidence and cancer-related deaths. Approximately 1/3rd cases develop biochemical recurrence during surveillance post-definite therapy. Multiple imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI) (including multiparametric prostate MRI), bone scan, and positron emission tomography (PET) using different tracers are being used for the characterization of the prostate cancer recurrence. CT and MRI do not provide physiological information, thus have lower sensitivity in detecting the metastasis. A bone scan has low sensitivity (depending on the prostate-specific antigen level) with low specificity as well. Among different PET tracers, Axumin PET appears to be the most promising tool. Axumin PET is Food and Drug Administration approved for the evaluation of prostate cancer biochemical recurrence. Several studies have shown that Axumin PET findings played a key role in treatment modification by finding otherwise undetected lesions. We briefly discuss the salient characteristics, imaging protocol and image interpretation criteria for Axumin PET in the workup of prostate cancer biochemical recurrence.

"The Great Masquerader": Sonographic Pictorial Review of Testicular Tuberculosis and its Mimics.

Testicular tuberculosis (TB) is an uncommon presentation of extrapulmonary TB. Although rare in incidence, it is a great masquerader and should be kept in consideration while assessing focal abnormalities involving the testis. Ultrasound findings alone may be non-specific and mimic other diagnoses including infection, inflammation, tumor, infarct, and trauma. The main objective of this sonographic pictorial review is to discuss the imaging findings, specific differentiating features against each differential and use of ancillary imaging findings whenever available. Concurrent involvement of epididymis, septated hydrocele, scrotal wall edema, and calcification of tunica vaginalis provides strong evidence in an appropriate setting. Available extratesticular ancillary imaging findings must be correlated for correct diagnosis due to non-specific imaging and clinical presentation. Misdiagnosis of scrotal TB may lead to otherwise avoidable epididymo-orchiectomy.

Usefulness of radium-223 in patients with bone metastases.

Castration-resistant prostate osseous metastases can be challenging to treat. There is a new era of clinical advancement with the Food and Drug Administration approval of radium-223 for use in these patients. Radium-223 is the only clinically used therapeutic radiopharmaceutical that emits alpha particles, making it extremely safe for therapeutic purposes for the patient as well as close contacts. This review discusses radium-223's mechanism of action, pharmacokinetics, indications, and safety profile, as well as findings of concluded clinical trials.

Do we really care about incidental lung nodules?-Review of atypical lung carcinoid and a proposal for systematic patient follow up.

Atypical lung carcinoids are intermediate-grade neuroendocrine tumors (NETs) with malignant potential. They are often detected incidentally on imaging done for non-related causes, as the patients are frequently asymptomatic. Histopathology is required to confirm the diagnosis with immunohistochemistry (IHC). Due to their indolent nature, these are often diagnosed only in the advanced stages. Treatment options include chemoradiation for widespread disease versus surgery for local or minimally invasive disease. This article describes a nonsmoker female with enlarging solitary pulmonary nodule who was initially lost to follow up, subsequently operated and with final pathology revealing atypical lung carcinoid. This case stress on the schematic follow up of these incidentally detected pulmonary nodules. Inspired from the mandatory lay mammography report letters recommended by ACR, this article proposes sending lay letters to patients for pulmonary nodule follow up, directly from the Radiology Department to reinforce the importance of timely follow up, which will complement the information provided to the patient from their primary care physician or pulmonologist's office.

Elastofibroma dorsi.

We present a 60-year-old man with biopsy-proven metastatic squamous cell carcinoma of the right inguinal and external iliac lymph nodes with unknown primary. Hypermetabolic soft tissue masses were identified in bilateral subscapular regions on follow-up positron emission tomography (PET)-computed tomography (CT) after completion of chemoradiation. The right subscapular mass was biopsied under CT guidance, and histopathology showed it to be elastofibroma dorsi. Elastofibroma dorsi is a benign tumor with no malignant potential; due to its ill-defined appearance and tracer uptake on PET-CT, it can be misdiagnosed as soft tissue sarcoma. This report describes the typical location and imaging features of this incidental hypermetabolic mass.

Poland Syndrome with Ipsilateral Hypoplasia of Gluteal Muscles and Contralateral Hidradenitis Suppurativa.

BACKGROUND: Poland syndrome (PS) is a rare congenital anomaly associated with absent or hypoplastic pectoralis major muscle and a wide spectrum of ipsilateral thoracic and upper extremity deformities. Hidradenitis suppurativa (HS) is a recurrent inflammatory follicular disease that commonly affects the apocrine-bearing skin and involves follicular occlusion and hyperkeratosis. CASE REPORT: We report a case of a 46-year-old male with a history of chronic recurrent hidradenitis suppurativa who was incidentally found to have a simple type of Poland syndrome with incidental hypoplasia of ipsilateral gluteal muscles. CONCLUSIONS: Not only can PS present with HS, which we describe for the first time, but it is also associated with a wide variability of symptoms such as previously unknown co-existence of gluteal muscles hypoplasia.

Neonatal testicular torsion with an unusual sonographic feature.

Neonatal testicular torsion is a rare entity, the exact etiology of which is not elucidated. Imaging is performed using color Doppler ultrasound and scintigraphic studies with typically diminished testicular flow on the side with torsion. We present a case of testicular torsion in a newborn with increased testicular vascularity demonstrated by ultrasound and suggesting a torsion-detorsion sequence. Management of patients with torsion involves assessing the risks of neonatal surgery versus the possibility of finding viable testicular tissue at surgical exploration.