Case Reports in Radiology

A 65-year-old woman with a long surgical history was referred to our hospital’s Colorectal Unit for ileostomy management. The patient retained an ileostomy for almost a decade after a series of complicated operations she had undergone, which had several side effects such as electrolyte imbalances, high output, weight loss, and a parastomal hernia. Our hospital’s colorectal surgeon proposed to replace the ileostomy with a permanent sigmoidostomy and asked for an imaging evaluation of the parastomal hernia content before the surgery. A computed tomography of the abdomen was performed using our Computed Tomography Department’s 64-detector row CT scanner after oral administration of contrast media, without intravenous contrast media injection due to allergy. Concerning the parastomal ileostomal hernia, besides small bowel loops with intraluminal gastrografin, inside the parastomal hernial sac, there also was an almost rounded cystic lesion. Absence of the gallbladder at its typical position and no record of cholecystectomy raised suspicion for gallbladder projection inside the sac. Our suspicion was confirmed during the surgery. Nonexisting acute cholecystitis allowed easy reduction of the gallbladder along with the small bowel loops inside the peritoneal cavity, without proceeding to cholecystectomy at the same time. Finally, ileostomy was annulated and an end colostomy was established. Four days after the surgery, the patient was discharged from the hospital and was happy to live an almost normal life thereafter.

A rare case of recurrent basal cell carcinoma in the scalp that infiltrated multiple intracranial structures is presented. Basal cell carcinoma represents one of the most frequent malignant nonmelanotic skin neoplasms, but the majority of them have no aggressive and recurrent behaviour. The aim of this case report is to provide an overview of the main clinical and radiologic features of basal cell carcinoma, focusing on the conventional and advanced (tractography) MRI findings and providing an overview of treatment and prognosis.

Coalition is defined as abnormal bridging between two bones, and the connection can be osseous or nonosseous. Most coalitions in the foot involve the hindfoot. Intermetatarsal coalition is thought to be much rarer than the more common hindfoot coalitions and has only been reported sporadically in the orthopedic literature. We present two patients with nonosseous intermetatarsal coalition presenting with nonspecific dorsolateral foot pain and describe the imaging findings of intermetatarsal coalition with different modalities. We suspect that whilst rarely described, intermetatarsal coalition is quite likely a more common underrecognized entity than a rare entity. This report is aimed at increasing the awareness of coalition in this location, in the radiology community, particularly the nonosseous ones, given that this condition can be debilitating but treatable.

Neuroglial (glioependymal) cyst is a rare congenital tumor of the central nervous system usually found in childhood. It can be isolated or associated with other brain malformations. Magnetic resonance imaging is the technique of choice for making the diagnosis. We report the case of a 10-year-old child who presented with epileptic seizures revealing a neuroglial cyst and dysgenesis of the corpus callosum.

The arc of Buhler (AOB) is a rare anatomical variant. Rupture of an AOB aneurysm is exceedingly rare. In this study, we report a case of AOB aneurysm rupture, which was successfully treated by transcatheter coil embolization. A 74-year-old man presented with symptomatic AOB aneurysm rupture. A computed tomography scan and subsequent angiography revealed the aberrant connection between the common hepatic artery and the superior mesenteric artery. A fusiform AOB aneurysm with focus of active bleeding was detected. This was successfully treated through embolization and sacrifice of the AOB. This suggests that conventional embolization with sacrifice of AOB is a feasible and safe approach.

Computational tomography (CT) is a well-documented modality in the workup of proptosis. We present a case of proptosis due to increased orbital fat in an obese patient. We review the literature to discuss the most likely causes of increased orbital fat, and we discuss the utility of CT imaging in assessing this pathology.