Late Onset Temporal Lobe Epilepsy With Mri Evidence Of Mesial Temporal Sclerosis Following Acute Neurocysticercosis: Case Report.

The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with albendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T2 signal in this patient has not, to date, been associated with a poor seizure control. This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE.59255-

Acute bilateral vestibulo-cochlear dysfunction following occipital fracture

The case of a 57-year-old man who presented with acute bilateral deafness and vestibular dysfunction following occipital bone fracture is described. Plain radiographs and a CT scan of the head demonstrated a single fracture of the occipital bone. Complete loss of cochlear and vestibular function bilaterally was demonstrated and followed by partial recovery of auditory function over the following months. Review of the literature has not revealed a previously reported case

A False Positive 18F-FDG PET/CT Scan Caused by Breast Silicone Injection

We present here the case of a 40-year-old woman with a greater than 10 year prior history of bilateral breast silicone injection and saline bag implantation. Bilateral palpable breast nodules were observed, but the ultrasound scan was suboptimal and the magnetic resonance imaging showed no gadolinium-enhanced tumor. The 18F-FDG PET/CT scan showed a hypermetabolic nodule in the left breast with a 30% increase of 18F-FDG uptake on the delayed imaging, and this mimicked breast cancer. She underwent a left partial mastectomy and the pathology demonstrated a siliconoma

A patient with neurofibroma (schwannoma) in peri-sacral: A case report

Schwannomas are benign tumors of the nerve sheath and are usually single encapsulated and slow growing in peripheral or sympathetic nervous system. In this report a 49 year-old man is presented with one year complain of abdominal pain and intermittent hematospermia. The CT scan of the abdomen showed a 60 × 65 × 60 mm mass in anterior pelvic cavity with deviation to the sacral bone, originated from nerve. Several examinations revealed neurofibroma. Due to the large size of the tumor and it's position to the pelvic nerves, to remove the mass the patient only underwent laparotomy with partial resection. Pathology tests confirmed Ancient Schwannoma with degenerative changes. Radiotherapy was done with the aim of reducing the size of the rest of tumor. In our case, schwannoma was diagnosed incidentally. The size of the tumor indicated a relatively long period from the time that tumor was generated until the time of diagnosis. Despite using paraclinical findings, a definite diagnosis of the disease was made by histopathological tests. © 2015, Mazandaran University of Medical Sciences. All rights reserved

CYTOREDUCTIVE SURGERY AND HIPEC IN A 14 YEARS OLD PATIENT WITH PERITONEAL RECURRENCE OF ADENOCARCINOMA OF THE RIGHT COLON

Introduction Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is nowadays a feasible and effective treatment for peritoneal metastasis. We present a case of a 14 years old child with peritoneal metastasis from recurrent colorectal cancer. Presentation of case Colonoscopy and CT-scan were performed leading to the diagnosis of a stenosing adenocarcinoma of the right colon in 2015. Two pelvic lesions were found at the total body PET scan, suspected for peritoneal metastasis. Neoadjuvant chemotherapy was administered, and restaging CT-scan and magnetic resonance (MRI) highlighted a partial response. The patient underwent right laparoscopic hemicolectomy. The postoperative staging was T4 N1 G3. Seven months after the last cycle of adjuvant chemotherapy, CT-scan revealed two huge abdominal masses. The patient underwent explorative laparotomy and bilateral oophorectomy, positive for metastasis from colorectal cancer and peritoneal washing cytology was positive for neoplastic cells. A CT-scan was performed on December 2017 showed a suspect lesion below the anterior abdominal wall. The case was discussed at the tumour board and the indication for CRS and HIPEC was given. In January 2018 the child underwent complete CRS and HIPEC with no complications. No adjuvant chemotherapy was administered. After 11 months the follow up is negative for the recurrent disease. Discussion and Conclusion Cytoreduction and HIPEC can be performed even in children as a feasible and safe treatment with successful outcomes. As for adults, an appropriate multidisciplinary pre-operative work up and a correct cases selection is needed to have the best results even regarding the quality of life

An 11-year-old boy with pharyngitis and cough: Lemierre syndrome

The authors present the case of an 11-year-old boy with pharyngitis, treated with amoxicillin, that worsened on day 7, with cough, high fever and refusal to eat. Lethargy and respiratory distress were noted. Based on radiographic findings of bilateral infiltrates he was diagnosed with pneumonia and started on intravenous ampicillin and erythromycin. Two days later he complained of right-sided neck pain and a palpable mass was identified. An ultrasound showed partial thrombosis of the right internal jugular vein and a lung CT scan revealed multiple septic embolic lesions. Lemierre syndrome was diagnosed, antibiotic treatment adjusted and anticoagulation started. A neck CT-scan showed a large parapharyngeal abscess. His clinical condition improved gradually and after 3 weeks of intravenous antibiotics he was discharged home on oral treatment. This case illustrates the importance of diagnosing Lemierre syndrome in the presence of pharyngitis with localised neck pain and respiratory distress, to prevent potentially fatal complications

Intralobar pulmonary sequestration in an adult female patient mimicking asthma: a case report.

Pulmonary sequestration (PS) is a rare congenital broncho-pulmonary malformation. The main feature of this disease is that partial lung tissues separate from the main lung during the embryonic period, receiving blood supply from systemic circulation arteries. Pathogenesis of PS is not clear, and categorized into congenital and acquired PS. We report a case of a 38 year old woman smoker with medical history characterized by difficult to treat asthma with frequent exacerbations and infections since childhood. CT scan showed a partial PS of left lower lobe, supplied by an abnormal artery arising from supradiaphragmatic aortic diverticulum. Surgical treatment through a lung sequestrectomy and laterobasal segment resection was performed

A rare cause of generalized seizures: agenesis and Lipoma of the corpus Callosum

An 18 years old young patient with no history presented to the emergency department suffering from episodes of generalized seizures and atypical headache without fever, the onset of symptoms dated back to two months. The clinical examination was normal. CT scan showed an inter hemispheric fat density ovoid formation, measuring about 40x30cm along major axis, compressing the ventricular junctions on both sides with suspected partial agenesis of the corpus callosum (figure 1a,b,c,d). MRI confirmed the partial agenesis of the corpus callosum (body and splenium); the lipoma was in high fat signal in T1 and T2 and was not modified by injection of gadolinium. This lesion showed arcuate peripheral calcifications, it was also hypointense on SPT1FAT SAT . The patient was stabilized using antiepileptic drugs. Intra cranial lipomas are rare benign tumors, its association with the agenesis of corpus callosum is also rare; the pathogenesis of such malformation is the premature disjunction of the neural ectoderms and skin before the closure of the neural tube. Epilepsy is the most common presentation of the Lipoma of the Corpus Callosum. It can reveal as a generalized seizures as for our patient but also as status epilepticus, partial motor or complex partial seizures. CT scan and especially MRI are the gold standard to diagnose these tumors. Surgical treatment has no place in this case, because of the anatomical relationship with adjacent structures especially with the anterior cerebral arteries which can be damaged