IgG4-related disease revealed by acute pancreatitis: A case report and literature review

IgG4-related disease is a systemic autoimmune disorder characterized by multiorgan involvement, often presenting with pancreatic, renal, biliary, and salivary gland abnormalities. Diagnosis relies on clinical, serological, imaging, and occasionally histological findings. This report describes a 65-year-old male presenting with acute pancreatitis, bilateral renal lesions, and biliary strictures. Elevated serum IgG4 levels (3.76 g/L) confirmed the diagnosis using the 2019 ACR/EULAR and 2020 Comprehensive Diagnostic Criteria despite the lack of histological confirmation. Corticosteroid therapy led to rapid clinical and biochemical improvement, underscoring the importance of integrating multiple diagnostic modalities in managing IgG4-related disease and demonstrating the effectiveness of early intervention

A rare case of right aortic arch with mirror-image branching and vascular ring in an adult patient

A right-sided aortic arch with mirror-image branching is a rare vascular anomaly, often associated with congenital heart defects. However, its occurrence with a vascular ring in the absence of cardiac abnormalities is extremely rare. We report the case of a 62-year-old male presenting with acute dyspnea, in whom CT angiography revealed a right-sided aortic arch with a vascular ring formed by an aortic diverticulum and the left brachiocephalic artery, causing mild tracheal and esophageal compression. Echocardiography confirmed the absence of cardiac anomalies. This case highlights a rare presentation of a right-sided aortic arch with a vascular ring in an adult patient. While often asymptomatic, such anomalies may contribute to airway or esophageal compression, warranting careful imaging evaluation and tailored management

A rare cause of high intestinal obstruction: Wilkie’s syndrome associated with a suprarenal abdominal aortic aneurysm

Wilkie’s syndrome, or superior mesenteric artery (SMA) syndrome, is a rare cause of duodenal obstruction due to extrinsic compression between the SMA and the abdominal aorta. We report the unusual case of a 45-year-old patient presenting with Wilkie’s syndrome associated with a suprarenal abdominal aortic aneurysm (AAA). The diagnosis was confirmed by an abdominal CT angiography, revealing a fusiform AAA of the suprarenal abdominal aorta, associated with a marked reduction in the aorto-mesenteric angle and compression of the third portion of the duodenum. A multidisciplinary approach was implemented, including initial conservative management with nasogastric decompression, followed by endovascular repair of the aneurysm. The postoperative course was favorable, with no complications. This case highlights a rare etiology and emphasizes the importance of precise diagnosis and a coordinated therapeutic approach, preventing severe complications

Ischemic stroke due to tuberculosis in an uncommon arterial territory: A case report and literature review

Tuberculous meningitis (TBM) is a severe form of tuberculosis that can lead to complications such as stroke, occurring in 13%-57% of cases. This report describes a 21-year-old man with no prior medical history who presented with headache, fever, and vomiting, followed by visual hallucinations, impaired alertness, and speech disturbances. Initial CT imaging revealed bilateral hypodense frontal lesions with poor contrast enhancement, and cerebrospinal fluid analysis indicated lymphocytic meningitis. MRI demonstrated bilateral parasagittal frontal signal abnormalities extending to the knee of the corpus callosum with leptomeningeal enhancement, while angiographic sequences showed occlusion of the left anterior cerebral artery and thinning of the distal right anterior cerebral artery, leading to a diagnosis of ischemic stroke secondary to TBM. Stroke in TBM patients may be asymptomatic or present with focal neurological deficits, and MRI with angiographic sequences is essential for identifying ischemic changes and vascular involvement suggestive of vasculitis. Although no targeted therapy exists for stroke in TBM, timely diagnosis and initiation of standard anti-tuberculosis treatment with supportive care are crucial. This case highlights the need for early neuroimaging in TBM to detect stroke and mitigate long-term neurological complications

Ruptured cerebral epidermoid cyst : A rare cause of chronic headache

Intracranial epidermoid cysts are rare, benign congenital tumors of the central nervous system that originate from ectodermal inclusions during embryogenesis. This case describes a spontaneous rupture of an epidermoid cyst in a 53-year-old male patient who presented with severe, treatment-resistant headaches. Diagnosis was confirmed through non-contrast computed tomography (CT), and magnetic resonance imaging (MRI) which showed an extra-axial lesion with fat density and lipid droplet dissemination within the subarachnoid spaces. Surgical resection was performed, and the patient had a favorable postoperative outcome. Although rare, rupture of an epidermoid cyst with lipid dissemination is a clinically significant event with characteristic imaging features; early recognition on computed tomography (CT) and MRI is essential for accurate diagnosis and timely management

Mammary Paget’s disease in a young woman: A rare occurrence

Mammary Paget's disease (MPD) is a rare intraepithelial carcinoma involving the nipple-areolar complex, often linked to underlying ductal carcinoma. We report a case of a 47-year-old woman presenting with progressive swelling of the left nipple, without pain, discharge, or inflammatory signs. Imaging revealed ductal dilation and nipple thickening, classified as BI-RADS 4, with MRI confirming additional suspicious findings. Histopathological analysis of a biopsy confirmed MPD associated with underlying ductal carcinoma in situ. This case underscores the importance of multimodal imaging and histopathology in diagnosing and managing this uncommon breast malignancy