Case Reports in Radiology https://www.hindawi.com The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Spontaneous Hematoma of the Rectus Sheath: Urgent Embolization with Squidperi Liquid Embolic Device Thu, 13 Jul 2017 09:14:25 +0000 http://www.hindawi.com/journals/crira/2017/3420313/ We treated a 78-year-old female affected by nontraumatic spontaneous rectus sheath hematoma. We decided to perform the embolization with the new liquid agent Squidperi. Complete exclusion of the bleeding vessel was obtained without complications. Its use should be considered for treatment of nontraumatic rectus sheath hematoma. Pierluca Torcia, Umberto G. Rossi, Silvia Squarza, and Maurizio Cariati Copyright © 2017 Pierluca Torcia et al. All rights reserved. Primary Osteosarcoma of the Breast Arising in an Intraductal Papilloma Wed, 21 Jun 2017 06:34:11 +0000 http://www.hindawi.com/journals/crira/2017/5787829/ Introduction. Primary osteosarcoma of the breast is extremely rare, and an osteosarcoma arising from an intraductal papilloma is exceptional. Case Presentation. A 72-year-old Saudi Arabian woman presented with a solid, bone-containing breast mass that was diagnosed as primary osteosarcoma of the breast on biopsy. She had a history of untreated intraductal papilloma. Treatment was completed with a modified mastectomy after excluding extramammary metastases. However, she subsequently developed multiple recurrent lesions at the same site. Conclusion. Primary osteogenic sarcomas of the breast are very rare. Although the main treatment is resection the optimal management remains uncertain and prognosis is poor. Khalefa Ali Alghofaily, Musab Hamoud Almushayqih, Muhannad Faleh Alanazi, Abdullah Abdulrahman Bin Salamah, and Halldor Benediktsson Copyright © 2017 Khalefa Ali Alghofaily et al. All rights reserved. Magnetic Resonance Enterography Findings of Intestinal Behçet Disease in a Child Wed, 24 May 2017 07:45:32 +0000 http://www.hindawi.com/journals/crira/2017/8061648/ Behçet’s disease (BD) is a multisystem disorder of unknown aetiology, characterized by recurrent oral ulcers, genital ulcers, uveitis, skin lesions, and pathergy. Gastrointestinal disease outside the oral cavity is well recognized and usually takes the form of small intestinal ulcers, with the most significant lesions frequently occurring in the ileocaecal region. Symptoms usually include nausea, vomiting, colicky abdominal pain, and change in bowel habit and it is not unusual that patients may present late, with life-threatening complications requiring surgery. Diagnosis has been hindered for many years by limitations in imaging the small bowel and it is usually achieved by means of endoscopy and CT of the abdomen. Magnetic resonance enterography (MRE) is a relatively new technique, which has a high diagnostic rate in patients with Crohn’s disease (CD). Although many similarities between CD and intestinal BD have already been described in literature, the role of MRE in the evaluation of intestinal BD has never been defined up to now. We report a case of a 12-year-old female patient with diagnosis of BD who presented at our institution for recurrent colicky abdominal pain and diarrhoea. The patient underwent MRE that demonstrated the gastrointestinal involvement. Tommaso D’Angelo, Romina Gallizzi, Claudio Romano, Giuseppe Cicero, and Silvio Mazziotti Copyright © 2017 Tommaso D’Angelo et al. All rights reserved. Chronic Dialysis Dependent Renal Failure Resulting from a Massive Bladder Containing Inguinal Hernia Sun, 07 May 2017 07:43:24 +0000 http://www.hindawi.com/journals/crira/2017/2368237/ Bladder involvement in inguinal hernia is relatively rare, 1–4%, although the incidence is increased to 10% with advancing age or obesity. There are several previously reported cases presenting with obstructive uropathy and renal failure, but all reversed with urinary diversion and hernia repair. We believe this to be the first reported case of bladder hernia leading to dialysis dependent chronic renal failure. Michael M. Herskowitz, Jamel Reid, and Robert F. Leonardo Copyright © 2017 Michael M. Herskowitz et al. All rights reserved. Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery for the Treatment of Symptomatic Uterine Fibroids Wed, 03 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/crira/2017/2520989/ Uterine fibroids, the most common benign tumor in women of childbearing age, may cause symptoms including pelvic pain, menorrhagia, dysmenorrhea, pressure, urinary symptoms, and infertility. Various approaches are available to treat symptomatic uterine fibroids. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) represents a recently introduced noninvasive safe and effective technique that can be performed without general anesthesia, in an outpatient setting. We review the principles of MRgFUS, describing patient selection criteria for the treatments performed at our center and we present a series of five selected patients with symptomatic uterine fibroids treated with this not yet widely known technique, showing its efficacy in symptom improvement and fibroid volume reduction. Laura Geraci, Alessandro Napoli, Carlo Catalano, Massimo Midiri, and Cesare Gagliardo Copyright © 2017 Laura Geraci et al. All rights reserved. Skeletal Muscle Involvement in B-Cell Lymphoma: Two Cases Illustrating the Contribution of Imaging to a Clinically Unsuspected Diagnosis Sun, 30 Apr 2017 08:31:30 +0000 http://www.hindawi.com/journals/crira/2017/2068957/ Skeletal muscle lymphoma is rare, comprising only a very small subset of lymphoma cases. There are characteristic imaging features which, if recognized, can prevent delay in diagnosis and treatment, particularly when not suspected clinically. Herein, we report two cases of skeletal muscle lymphoma with nearly identical imaging features; the first is an example of primary muscle lymphoma in a 17-year-old boy with back and thigh pain, and the second represents lymphoma recurrence in a 55-year-old man with HIV. Characteristic features seen on MRI were key in raising suspicion for the disease and helped prevent a delay in pathologic diagnosis. Elijah Burton, Kristian Schafernak, Elaine Morgan, and Jonathan Samet Copyright © 2017 Elijah Burton et al. All rights reserved. Port Placement via the Anterior Jugular Venous System: Case Report, Anatomic Considerations, and Literature Review Mon, 10 Apr 2017 00:00:00 +0000 http://www.hindawi.com/journals/crira/2017/2790290/ We report on a patient who was referred for port implantation with a two-chamber pacemaker aggregate on the right and total occlusion of the central veins on the left side. Venous access for port implantation was performed via left side puncture of the horizontal segment of the anterior jugular vein system (AJVS) and insertion of the port catheter using a crossover technique from the left to the right venous system via the jugular venous arch (JVA). The clinical significance of the AJVS and the JVA for central venous access and port implantation is emphasised and the corresponding literature is reviewed. Gernot Rott and Frieder Boecker Copyright © 2017 Gernot Rott and Frieder Boecker. All rights reserved. Brain Herniation into Giant Arachnoid Granulation: An Unusual Case Tue, 14 Mar 2017 00:00:00 +0000 http://www.hindawi.com/journals/crira/2017/8532074/ Arachnoid granulations are structures filled with cerebrospinal fluid (CSF) that extend into the venous sinuses through openings in the dura mater and allow the drainage of CSF from subarachnoid space into venous system. Usually they are asymptomatic but can be symptomatic when large enough to cause sinus occlusion. We report a rare case of a brain herniation into a giant arachnoid granulation in an asymptomatic elderly male patient, which was discovered incidentally. Joana Ruivo Rodrigues and Gonçalo Roque Santos Copyright © 2017 Joana Ruivo Rodrigues and Gonçalo Roque Santos. All rights reserved. Giant Splenorenal Shunt in a Young Patient with Autoimmune Hepatitis/Primary Biliary Cholangitis Overlap Syndrome and Portal Vein Thrombosis Mon, 20 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/crira/2017/2167364/ We present a case of giant Splenorenal Shunt (SRS) associated with portal vein thrombosis in a 37-year-old woman with a twelve-year history of autoimmune hepatitis/primary biliary cholangitis overlap syndrome. At the moment of the CT examination laboratory tests showed creatinine 1.5 mg/dl, bilirubin 1.5 mg/dl, INR 3, and Na 145 mmol/l and the Model End-Stage Liver Disease score was 24. Extensive calcified thrombosis causing complete occlusion of the portal vein lumen and partially occluding the origin of the superior mesenteric vein was present and a small calcified thrombus in the Splenic Vein lumen was also evident. SRS was located among the spleen hilum and the left kidney with a maximum diameter of 3.25 cm and was associated with dilatation of left renal vein and inferior vena cava. After a multidisciplinary evaluation the patient was put on the Regional Liver Transplant waiting list and liver transplantation was performed successfully. Although portal vein thrombosis and SRS are common occurrences in cirrhotic patients, the impact in the natural history of the disease is still unclear. Careful management and accurate imaging protocols are essential in the evaluation of those patients. F. Chegai, A. U. Cavallo, M. Forcina, V. Giuricin, F. Castellani, L. Greco, M. Manuelli, T. M. Manzia, and G. Sergiacomi Copyright © 2017 F. Chegai et al. All rights reserved. Thrombosis of the Azygos Anterior Cerebral Artery Sun, 12 Feb 2017 12:39:32 +0000 http://www.hindawi.com/journals/crira/2017/5409430/ The azygos anterior cerebral artery is a rare variant, characterized by the absence of the anterior communicating artery and the union of two proximal segments of the anterior cerebral artery, forming a single trunk and ascending through the interhemispheric fissure. The incidence in the population varies from 0.3 to 2%. The presence of occlusion for this vessel causes bifrontal infarcts, with potentially devastating functional consequences, hence the importance of recognizing this anatomical variation in imaging exams. Camila Soares Moreira de Sousa, Carla Lorena Vasques Mendes de Miranda, Marcelo Coelho Avelino, Breno Braga Bastos, Rafael Soares Moreira de Sousa, and Carla Valéria Vasques Mendes de Miranda Copyright © 2017 Camila Soares Moreira de Sousa et al. All rights reserved. CT and MRI Features of Pediatric-Aged Colloid Cysts: Report of Two Cases Tue, 31 Jan 2017 07:13:41 +0000 http://www.hindawi.com/journals/crira/2017/2467085/ A 10-year-old boy with the history of headache, anorexia, and vomiting was referred to our department to undergo a brain CT scan. CT images demonstrated a well-defined, rounded, hyperdense lesion at the level of the foramen of Monro causing moderate dilatation of the lateral ventricles. An 11-year-old girl with a long history of a headache was also referred to undergoing a brain MRI. MR images demonstrated a well-defined round abnormal signal intensity lesion at the level of the foramen of Monro causing moderate dilatation of lateral ventricles. The findings from imaging perspective were consistent with the colloid cyst of the third ventricle. Therefore, the diagnosis of the colloid cyst was made. Hidayatullah Hamidi, Fazel Rahman Faizi, Najibullah Rasouly, and Mer Mahmood Shah Hoshang Copyright © 2017 Hidayatullah Hamidi et al. All rights reserved. Ectopic Thyroid Tissue in the Mediastinum Characterized by Histology and Functional Imaging with I-123 SPECT/CT Mon, 30 Jan 2017 09:31:21 +0000 http://www.hindawi.com/journals/crira/2017/9084207/ Ectopic thyroid tissue is a rare entity and when discovered it is typically along the pathway of embryologic migration of the thyroid. We present a case of incidental finding of ectopic thyroid tissue within mediastinum in a 61-year-old female patient with a history of total thyroidectomy for thyroiditis and nodules. The patient presented to emergency room with cough and right chest pain and underwent a chest computed tomographic angiogram (CTA) to exclude pulmonary embolism as part of chest pain workup. One right paratracheal mediastinal soft tissue nodule was visualized on the images of CTA. This right paratracheal soft tissue mass was found to be ectopic benign thyroid tissue by histological analysis of the biopsied tissue samples. The function of this ectopic thyroid tissue was characterized by I-123 radioiodine uptake and single photon emission computed tomography/computed tomography (SPECT/CT) imaging. This case illustrates that ectopic thyroid tissue should be included for differential diagnosis of a hyperdense soft tissue mass located within mediastinum. I-123 SPECT/CT is useful for guiding tissue biopsy of ectopic thyroid tissue distant from orthotopic thyroid gland and functional and anatomic characterization of mediastinal ectopic thyroid tissue for surgical resection when it is medically necessary. Jed Hummel, Jason Wachsmann, Kelley Carrick, Orhan K. Oz, Dana Mathews, and Fangyu Peng Copyright © 2017 Jed Hummel et al. All rights reserved. Testicular Vasculitis: A Sonographic and Pathologic Diagnosis Thu, 26 Jan 2017 09:38:22 +0000 http://www.hindawi.com/journals/crira/2017/8923621/ Very little has been published about single-organ vasculitis of the testicle in the radiological literature. Consequently, it is a diagnosis that is unfamiliar to most radiologists. This case report describes the sonographic, pathologic, and laboratory findings of testicular vasculitis and reviews the available literature with regard to this subject. Anuj Dixit, Cameron Hague, and Simon Bicknell Copyright © 2017 Anuj Dixit et al. All rights reserved. Cystic Echinococcosis: A Case of Extrahepatic Intra-Abdominal Involvement Tue, 17 Jan 2017 08:27:13 +0000 http://www.hindawi.com/journals/crira/2017/8919546/ Hydatid disease, or echinococcal disease, is a parasitic infestation caused by the larval stage of the Echinococcus tapeworm and it primarily affects the liver and lung but involvement of other organs is also possible secondary to peritoneal seeding or hematogeneous dissemination. We describe a rare case of extensive abdominal disease, with lesions affecting the liver, peritoneum, and lesser omentum, requiring aggressive surgical intervention. Complementary diagnostic exams were crucial to reach the diagnosis and evaluate the extension of the disease. Patrícia Leitão, André Carvalho, Teresa Fernandes, and José Gonçalves Copyright © 2017 Patrícia Leitão et al. All rights reserved. A Rare Case of Diffuse Hemangiomatosis of the Spleen with Splenic Rupture following Aortic Valve Replacement Thu, 12 Jan 2017 08:08:41 +0000 http://www.hindawi.com/journals/crira/2017/9164749/ In this paper we present a rare case of splenic rupture that occurred after an open aortic valve replacement in a male patient with hemangiomatosis of the spleen and the liver. The patient was treated with an emergency splenectomy. He showed no other sings of associated systemic disorder, such as Klippel-trénaunay syndrome or Proteus syndrome. F. Capilli, M. Weinbeck, M. Czerny, M. Siepe, and T. Krauss Copyright © 2017 F. Capilli et al. All rights reserved. Tubular Carcinoma of the Breast: Advantages and Limitations of Breast Tomosynthesis Mon, 26 Dec 2016 11:32:51 +0000 http://www.hindawi.com/journals/crira/2016/3906195/ Tubular carcinoma of the breast is a rare variant of invasive ductal carcinoma. We report a case of 42-year-old asymptomatic female with a histopathological proven multifocal tubular carcinoma, studied by mammography, Tomosynthesis, Ultrasound, and Magnetic Resonance. Herein, we discuss the advantages and limitations of Tomosynthesis, an emerging imaging technique, in this particular case. Filipa Vilaverde, Ana Rocha, and Alcinda Reis Copyright © 2016 Filipa Vilaverde et al. All rights reserved. Diffuse Gallium-67 Accumulation in the Left Atrial Wall Detected Using SPECT/CT Fusion Images Tue, 20 Dec 2016 14:36:18 +0000 http://www.hindawi.com/journals/crira/2016/6374584/ Gallium-67 scintigraphy is useful for detecting active inflammation. We show a 66-year-old female patient with atrial fibrillation and diffuse thickening of the left atrial wall due to acute myocarditis, who presented diffuse abnormal accumulation of gallium-67 in the left atrium on single photon emission computed tomography/computed tomography (SPECT/CT) fusion images. In the second gallium-67 scan 2 months after the first scintigraphy, the abnormal accumulation in the heart was no longer visible. Gallium-67 SPECT/CT images helped understanding the disease condition that temporary inflammation in the left atrium caused atrial fibrillation. Kohei Kotani, Joji Kawabe, Shigeaki Higashiyama, Atsushi Yoshida, and Susumu Shiomi Copyright © 2016 Kohei Kotani et al. All rights reserved. A Retroperitoneal Isolated Enteric Duplication Cyst Mimicking a Teratoma: A Case Report and Literature Review Mon, 19 Dec 2016 13:50:38 +0000 http://www.hindawi.com/journals/crira/2016/6976137/ Enteric duplication cysts lacking anatomic association with the gastrointestinal tract are called isolated enteric duplication cysts (IEDCs). We present an atypical case of a retroperitoneal IEDC with a tortuous tubular complex shape that enfolded the surrounding retroperitoneal fat and mimicked a retroperitoneal teratoma. Multiplanar reconstruction images should be used to evaluate such a lesion correctly. A tortuous tubular complex shape could be a key finding to differentiate from other retroperitoneal cysts. Daichi Momosaka, Yasuhiro Ushijima, Akihiro Nishie, Yoshiki Asayama, Kousei Ishigami, Yukihisa Takayama, Daisuke Okamoto, Nobuhiro Fujita, Tetsuo Ikeda, Keiichiro Uchida, Masaaki Sugimoto, Kenichi Kohashi, and Hiroshi Honda Copyright © 2016 Daichi Momosaka et al. All rights reserved. Gliosarcoma with Primary Skull Base Invasion Thu, 08 Dec 2016 08:36:52 +0000 http://www.hindawi.com/journals/crira/2016/1762195/ Gliosarcoma is an uncommon variant of glioblastoma, which commonly demonstrates dural attachment. However, skull base invasion is rarely seen with this entity. Herein, we report a 44-year-old female patient diagnosed with primary intracranial gliosarcoma extensively invading the skull base and muscles of mastication. She presented to our institution with a three-month history of difficult right jaw opening and retro-orbital pressure and one week of severe right-sided postauricular headache. Head CT demonstrated a 6 cm mass with marked bony erosion. Brain MRI at a one-week interval more clearly characterized tumor extension through the right orbit and muscles of mastication, with overall growth to 7 cm and worsening midline shift. The patient underwent a right frontotemporal craniotomy for gross total resection. Pathology confirmed the diagnosis of gliosarcoma, IDH-wildtype (WHO grade IV). Her postoperative course was uneventful and she was discharged at preoperative neurologic baseline. To our knowledge, this is the third reported case of a primary intracranial gliosarcoma with direct invasion of skull base, brain parenchyma, and extracranial compartment. However, this is the first report case of primary GS invading the surrounding musculature and orbit. This case report highlights the rapid aggressiveness of gliosarcomas and further a prior undescribed radiographic and anatomic finding of skull base invasion with this entity. Quoc-Bao D. Nguyen, Avital Perry, Christopher S. Graffeo, Cody L. Nesvick, Aditya Raghunathan, Mark E. Jentoft, Brian P. O’Neill, Padraig P. Morris, Jonathan M. Morris, and Jamie J. Van Gompel Copyright © 2016 Quoc-Bao D. Nguyen et al. All rights reserved. Untreated Superior Vena Cava Aneurysm: Radiological Significance and Review of the Literature Mon, 05 Dec 2016 09:38:47 +0000 http://www.hindawi.com/journals/crira/2016/6960757/ Superior vena cava (SVC) aneurysms are a rare entity. The majority of the literature is in the form of case reports. SVC aneurysms are often an incidental finding with iatrogenic, congenital, or idiopathic etiologies. Treatment goals focus on preventing theoretical rupture or thrombus formation. Management options include observation, conservative medical management, surgical excision, and thrombin injection. We present a 73-year-old female with an incidental SVC aneurysm discovered on computed tomography (CT) of the thorax. The patient was observed without intervention for greater than 6 years. No complications were attributable to the SVC aneurysm during follow-up or over the course of the patient’s life. Abhinav Patel, Ryan Cobb, Victor Rivera, and Scott Simpson Copyright © 2016 Abhinav Patel et al. All rights reserved. Thymic Epidermoid Cyst: Clinical and Imaging Manifestations of This Rare Anterior Mediastinal Mass Thu, 24 Nov 2016 12:17:33 +0000 http://www.hindawi.com/journals/crira/2016/5789321/ Thymic epidermoid cysts are an extremely rare entity. These arise from epidermal cells that migrate to the thymus. The radiologic diagnosis of this rare lesion is challenging. We describe a case of an otherwise healthy 35-year-old woman who presented with an acute onset of chest pain and shortness of breath. She was found to have an anterior mediastinal mass. The imaging findings were, however, not characteristic for any single diagnostic entity. Since the imaging was inconclusive, surgical resection was performed for definitive diagnosis. The mass was found to be a thymic epidermoid cyst. This case underlines the significance for radiologists to be aware that epidermoid cysts can occur in the thymus and should be considered in the differential diagnosis for a heterogeneous anterior mediastinal mass. Jawad M. Qureshi, Brian Pagano, Jeffrey Mueller, Lana Schumacher, Claudia Velosa, and Matthew S. Hartman Copyright © 2016 Jawad M. Qureshi et al. All rights reserved. Occipital Hypometabolism on FDG PET/CT Scan in a Child with Hodgkin’s Lymphoma Mon, 14 Nov 2016 12:06:07 +0000 http://www.hindawi.com/journals/crira/2016/5476108/ It is known that Fluorodeoxyglucose (FDG) Positron Emission/Computed Tomography (PET/CT) images may be helpful for evaluation of brain function in newborns. Here we described the fluorine-18 [18-F] FDG PET/CT imaging findings of encephalomalacia due to perinatal asphyxia in a child with refractory Hodgkin’s Lymphoma (HL) who underwent PET/CT scan to stage the primary disease. Prominent hypometabolism was incidentally detected in the occipital regions bilaterally apart from the FDG uptakes in the malign lymphatic infiltrations. This case highlights the potential coexistence of a malignancy and a functional brain disorder. Inci Uslu Biner, Ebru Tatci, Ozlem Ozmen, Atila Gokcek, Haci Ahmet Demir, and Nadide Basak Gulleroglu Copyright © 2016 Inci Uslu Biner et al. All rights reserved. Rare Case of Posterior Reversible Leukoencephalopathy Syndrome Secondary to Acute Chest Syndrome Thu, 10 Nov 2016 08:41:00 +0000 http://www.hindawi.com/journals/crira/2016/4346953/ We present a case of 29/m with a history of sickle cell disease who presented to the emergency department with sudden onset of chest, trunk, extremity, and back pain, consistent in quality and severity with the patient’s usual pain crises. Soon after admission to the medical unit for acute chest syndrome (ACS), the patient developed sudden onset of hypertension associated with left sided hemiplegia, lethargy, dysarthria, aphasia, and left sided facial droop. Neuroimaging revealed that on MRI Brain there was multifocal extensive signal abnormality and a small focal areas of hemorrhage compatible with posterior reversible leukoencephalopathy syndrome (PRES). Patient was treated with levetiracetam and phenytoin and improved soon afterwards, with resolution seen on follow-up MRI two months later. Rohit Aiyer, Daniel Klein, and Yasir El-Sherif Copyright © 2016 Rohit Aiyer et al. All rights reserved. Internal Jugular Vein Thrombosis in Isolated Tuberculous Cervical Lymphadenopathy Wed, 09 Nov 2016 13:11:21 +0000 http://www.hindawi.com/journals/crira/2016/5184196/ Tuberculosis is a common infectious disease with a high prevalence in developing countries and presents a major public health issue. Internal jugular vein (IJV) thrombosis is a rare complication in tuberculous cervical lymphadenopathy. We report a case of 26-year male patient with a history of low-grade evening rise in fever, dry cough, loss of appetite, and loss of weight with swelling in lower neck on right side. Ultrasonography (USG) neck showed well-defined hypoechoic lymph nodes posterior to right IJV and common carotid artery in the lower neck at level IV and in the right supraclavicular region showing central necrotic areas with adjoining IJV thrombosis. The association between tuberculosis and deep vein thrombosis is rare. Awareness of IJV thrombosis in isolated cervical lymphadenopathy needs high diagnostic suspicion and prompt treatment to avoid fatal complication. Our case is rare as there was isolated tuberculous cervical lymphadenopathy with adjoining IJV thrombosis. Both USG and computed tomography (CT) are accurate and reliable radiological investigations for detecting IJV thrombosis along with cervical lymph nodes. They are useful in assessing surrounding soft tissue and fat planes and knowing the size and extent of cervical lymphadenopathy. USG is inexpensive and readily available for monitoring response to treatment. Sanjay Khaladkar, Avadhesh Chauhan, Arijit Ghosh, Kunaal Jain, and Surbhi Chauhan Copyright © 2016 Sanjay Khaladkar et al. All rights reserved. Cardiac Magnetic Resonance for Evaluating Catheter Related FDG Avidity Thu, 27 Oct 2016 12:54:45 +0000 http://www.hindawi.com/journals/crira/2016/5460727/ A 53-year-old female with a history of metastatic left arm melanoma presented for F(18) fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) which showed a moderately FDG avid focus at her port catheter tip near the cavoatrial junction. Although catheter tip related FDG avidity has previously been suggested to be bland thrombus or infection, melanoma can metastasize to unusual locations including the superior vena cava. In addition, the patient had an elevated risk of anticoagulation due to a history of hemorrhagic brain metastases. Therefore, confirmatory cardiac magnetic resonance (CMR) was obtained and findings were consistent with bland catheter-related thrombus. Daniel Jeong, Kenneth L. Gage, Claudia G. Berman, and Jaime L. Montilla-Soler Copyright © 2016 Daniel Jeong et al. All rights reserved. Bilateral Simultaneous Pseudoangiomatous Stromal Hyperplasia of the Breasts and Axillae: Imaging Findings with Pathological and Clinical Correlation Thu, 27 Oct 2016 11:23:34 +0000 http://www.hindawi.com/journals/crira/2016/9084820/ Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a pathology that is usually diagnosed by accident during pathological examination of other breast lesions. PASH is an uncommon and benign tumoral lesion of the mammary stroma that can be pathologically mistaken for other tumours, such as phyllodes, fibroadenoma, and sometimes even angiosarcoma. We report the case of a 45-year-old woman with complaints of huge bilateral breast enlargement. This is a rare case of PASH presenting with gigantomastia and involving bilateral breasts and axillae simultaneously. Mammography, ultrasonography, and MRI features are illustrated with histopathological correlation. Afsaneh Alikhassi, Fereshteh Ensani, Ramesh Omranipour, and Alireza Abdollahi Copyright © 2016 Afsaneh Alikhassi et al. All rights reserved. Congenital Vitelline Band Causing Intestinal Obstruction in an Adult with a Double Inferior Vena Cava Sun, 23 Oct 2016 08:09:17 +0000 http://www.hindawi.com/journals/crira/2016/4015408/ Introduction. Vitelline artery remnants are rare causes of intra-abdominal bands leading to bowel obstruction. These bands may be associated with Meckel’s diverticulum. Double inferior vena cava (IVC) is a rare presentation and is usually identified incidentally. Case Presentation. A sixty-year-old male presented with progressive vomiting for five days and he was clinically diagnosed with intestinal obstruction. Plain X-ray abdomen showed evidence of small bowel obstruction. CT scan of the abdomen revealed dilated small bowel loops with a small outpouching in the distal ileum with a band like structure attached to it. In the CT, left sided patent IVC draining into the left renal vein was identified. Left external iliac vein was in continuity with the left IVC. Left internal iliac vein was draining into the right IVC. Exploratory laparotomy revealed a Meckel’s diverticulum with a band identified as the vitelline remnant attached to its apex and inserting at the anterior abdominal wall near the umbilicus. Discussion. Meckel’s diverticulum with vitelline bands, although rare, should be borne in mind in adult patients with intestinal obstruction. Identification of this anomaly can be difficult in imaging studies. Presence of double IVC should be mentioned in the imaging findings to prevent possible catastrophic complications during surgery. Mihiri Wettasinghe, Kumari Pussepitiya, Bandula Samarasinghe, and Nuwan Wickramasinghe Copyright © 2016 Mihiri Wettasinghe et al. All rights reserved. Left-Sided Upper Partial Anomalous Pulmonary Venous Return through a Curved Vein Joining the Left Brachiocephalic Vein Sun, 09 Oct 2016 12:24:22 +0000 http://www.hindawi.com/journals/crira/2016/1780909/ The evaluation of pulmonary veins during cross-sectional imaging of the chest and the knowledge of their embryology and anatomy are useful for detecting congenital conditions that may be clinically significant. Moreover, with the spread of cross-sectional imaging it is very frequent to find anatomical variants; therefore the radiologist should easily recognize their appearances. This case report shows a left-side upper partial anomalous pulmonary venous return (PAPVR) through a “curved” vein that joins the left brachiocephalic vein, in a female patient who underwent whole-body computed tomography (CT) for staging endometrial cancer. This was an incidental finding, not related to any symptoms; however, we explain the anatomical aspects of this abnormality within the congenital condition of PAPVR and its possible clinical relevance. Eleonora Tricarico, Francesco Tricarico, and Carlo Florio Copyright © 2016 Eleonora Tricarico et al. All rights reserved. Diagnosis and Management of Spontaneous Lumbar Venous Retroperitoneal Hematoma in Setting of Deep Venous Thrombosis: A Case Report and Algorithm Mon, 03 Oct 2016 14:18:30 +0000 http://www.hindawi.com/journals/crira/2016/3183985/ Retroperitoneal hematoma is rare and benefits from a systematic approach to prevent morbidity and mortality. Management of such bleeds is based upon patient stability, the cause (spontaneous or posttraumatic), and source (arterial or venous). Herein, the authors describe a diagnostic and management algorithm for retroperitoneal hemorrhage with an example of a rare lumbar venous bleed under the complicated clinical setting of deep venous thrombosis. Joseph Tseng, Michael Leshen, Todd Chapman, Ryan Scott, and Olga Kalinkin Copyright © 2016 Joseph Tseng et al. All rights reserved. Atypical Growth Pattern of an Intraparenchymal Meningioma Mon, 26 Sep 2016 12:49:46 +0000 http://www.hindawi.com/journals/crira/2016/7985402/ Meningiomas are the most common primary nonneuroglial extra-axial neoplasms, which commonly present as spherical or oval masses with a dural attachment. Meningiomas without dural attachment are rare and, according to their locations, are classified into 5 varieties, including intraventricular, deep Sylvain fissure, pineal region, intraparenchymal, or subcortical meningiomas. To the best of our knowledge, intraparenchymal meningioma with cerebriform pattern has never been reported. In this paper, we report a 34-year-old Chinese male patient who presented with paroxysmal headaches and progressive loss of vision for 10 months and blindness for 2 weeks. A thorough physical examination revealed loss of bilateral direct and indirect light reflex. No other relevant medical history and neurologic deficits were noted. Computed tomography and magnetic resonance imaging scans showed an irregular mass with a unique cerebriform pattern and extensive peritumoral edema in the parietal-occipital-temporal region of the right cerebral hemisphere. The initial diagnosis was lymphoma. Intraoperatively, the tumor was completely buried in a sulcus in the parietal-occipital-temporal region without connecting to the dura. The histological diagnosis was intracranial meningioma based on pathological examination. Therefore, when an unusual cerebriform growth pattern of a tumor is encountered, an intraparenchymal meningioma should be considered as a differential diagnosis. Zhen Zeng, Tijiang Zhang, Yihua Zhou, and Xiaoxi Chen Copyright © 2016 Zhen Zeng et al. All rights reserved.