BJR Case Reports最新文献

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Pancreatic hydatid cyst with a characteristic "water-lily" sign. 胰腺包虫病具有典型的“睡莲”征。
IF 0.6
BJR Case Reports Pub Date : 2026-10-13 eCollection Date: 2026-09-01 DOI: 10.1093/bjrcr/uaag042
Aminreza Abkhoo, Niloufar Ayoobi, Seyed Mohammad Amin Dashti, Faeze Salahshour
{"title":"Pancreatic hydatid cyst with a characteristic \"water-lily\" sign.","authors":"Aminreza Abkhoo, Niloufar Ayoobi, Seyed Mohammad Amin Dashti, Faeze Salahshour","doi":"10.1093/bjrcr/uaag042","DOIUrl":"10.1093/bjrcr/uaag042","url":null,"abstract":"<p><strong>Background: </strong>Cystic echinococcosis rarely involves the pancreas and may mimic common cystic neoplasms. Recognition of characteristic imaging signs is central to diagnosis; the \"water-lily\" sign (floating detached endocyst) is a rare and highly characteristic finding in favor of transitional-stage hydatid cyst and, when recognized, can prevent inappropriate cyst puncture and guide stage- and anatomy-based management.</p><p><strong>Case: </strong>A 34-year-old woman from Iran, an endemic region for cystic echinococcosis, presented with intermittent epigastric/right upper quadrant pain. At an outside institution, endoscopic ultrasound-guided fine-needle aspiration had been performed before referral; cyst-fluid amylase was 20 U/L and carcinoembryonic antigen was not detected, arguing against pseudocyst and mucinous neoplasm. Ultrasound and MRI/MRCP performed after EUS showed a unilocular pancreatic head cyst with a floating internal membrane (\"water-lily\"/\"serpent\" appearance) and mild upstream pancreatic duct dilatation. Our multidisciplinary team favored pancreatic cystic echinococcosis. The patient underwent surgical cyst excision with avoidance of scolicidal instillation into the biliary tree. Albendazole (400 mg twice daily, ∼ 10-15 mg/kg/day) was given perioperatively and continued for 6 months. Pathology confirmed laminated membranes and protoscolices. She remains asymptomatic on surveillance MRI without recurrence.</p><p><strong>Conclusion: </strong>In an endemic region, a pancreatic cyst with a floating membrane and low cyst-fluid amylase should raise suspicion for cystic echinococcosis. Anchoring the diagnosis to WHO staging and resisting routine EUS-FNA can avert spillage and caustic cholangiopathy from scolicidal agents. Radiologists play the key role in making this distinction.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 5","pages":"uaag042"},"PeriodicalIF":0.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Presumed hepatic pseudolipoma detected as a small hepatic surface lesion: multimodality imaging findings. 假定肝假性脂肪瘤为肝表面小病变:多模态影像学表现。
IF 0.6
BJR Case Reports Pub Date : 2026-10-01 eCollection Date: 2026-09-01 DOI: 10.1093/bjrcr/uaag040
Koichi Soga, Ou Takagi, Kohei Inaba, Mikako Masuda, Ikuhiro Kobori, Katsutoshi Sugimoto
{"title":"Presumed hepatic pseudolipoma detected as a small hepatic surface lesion: multimodality imaging findings.","authors":"Koichi Soga, Ou Takagi, Kohei Inaba, Mikako Masuda, Ikuhiro Kobori, Katsutoshi Sugimoto","doi":"10.1093/bjrcr/uaag040","DOIUrl":"https://doi.org/10.1093/bjrcr/uaag040","url":null,"abstract":"<p><p>Hepatic pseudolipomas are uncommon benign lesions located on or near the liver capsule which are thought to arise from a detached epiploic appendage that becomes trapped near Glisson's capsule. Because these lesions may appear as small hepatic or perihepatic nodules, they can mimic primary or metastatic hepatic tumors on screening imaging. Here, we report the case of a 55-year-old asymptomatic man with no relevant medical history who was referred after routine health-screening ultrasonography revealed a 10 × 8-mm hyperechoic lesion adjacent to the surface of liver segment VI. Liver function tests were normal, hepatitis B and C viral markers were negative, and tumor markers, including carcinoembryonic antigen, carbohydrate antigen 19-9, alpha-fetoprotein, and protein induced by vitamin K absence or antagonist-II, were within the normal ranges. Dynamic ultrasonography demonstrated that the lesion was located along the hepatic capsule, rather than within the deep hepatic parenchyma. Computed tomography showed a well-demarcated hepatic surface lesion with central calcification and surrounding fat attenuation, without any arterial, portal venous, or delayed enhancement. Gadoxetate disodium-enhanced magnetic resonance imaging revealed fat-containing signal characteristics, no hepatobiliary-phase uptake, and no diffusion restriction. The integrated multimodal imaging findings supported a diagnosis of presumed hepatic pseudolipoma, likely originating from a detached epiploic appendage. Recognition of this benign hepatic tumor mimic may help to avoid unnecessary biopsy or surgery.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 5","pages":"uaag040"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disseminated peritoneal leiomyomatosis post-laparoscopic myomectomy. 腹腔镜子宫肌瘤切除术后弥散性腹膜平滑肌瘤病。
IF 0.6
BJR Case Reports Pub Date : 2026-08-26 eCollection Date: 2026-09-01 DOI: 10.1093/bjrcr/uaag039
Dana AlNuaimi, Shareefa Abdulghaffar, Reem AlKetbi, Badr Ahmed
{"title":"Disseminated peritoneal leiomyomatosis post-laparoscopic myomectomy.","authors":"Dana AlNuaimi, Shareefa Abdulghaffar, Reem AlKetbi, Badr Ahmed","doi":"10.1093/bjrcr/uaag039","DOIUrl":"10.1093/bjrcr/uaag039","url":null,"abstract":"<p><p>Disseminated peritoneal leiomyomatosis (DPL) is a rare benign condition in which scattered smooth muscle nodules resembling leiomyomas grow in multiple extrauterine sites within the peritoneal cavity, mimicking malignant processes like peritoneal carcinomatosis. The etiology of this condition is unclear, but it is thought to be due to either iatrogenic or hormonal factors, as studies have found that DPL is more common in females of reproductive age and in those who have undergone laparoscopic surgery with morcellation of uterine leiomyomas, as seen in the present case. Diagnostic imaging plays an important role in the preoperative diagnosis and in accurately delineating the extent of the disease. Nevertheless, histopathology remains the gold standard for a definitive diagnosis. We report a case of a 38-year-old female patient with a prior history of laparoscopic myomectomy who presented 2 years later with nonspecific left flank pain. Contrast-enhanced CT of the abdomen and pelvis and MRI revealed multiple enhancing nodular lesions scattered within the abdominal cavity. Given the prior history of laparoscopic myomectomy and radiological findings, DPL was suspected, which was confirmed later by histopathological examination.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 5","pages":"uaag039"},"PeriodicalIF":0.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dual-target lymphatic embolization for refractory chylous ascites after nephroureterectomy. 双靶点淋巴栓塞治疗肾输尿管切除术后难治性乳糜腹水。
IF 0.6
BJR Case Reports Pub Date : 2026-08-25 eCollection Date: 2026-09-01 DOI: 10.1093/bjrcr/uaag038
Ryoma Kobayashi, Kohei Hamamoto, Emiko Chiba, Soichiro Kojima, Tatsuya Ogawa, Hiroyuki Fujii, Mitsuru Matsuki, Masayuki Kurokawa, Toru Sugihara, Satoshi Ando, Tetsuya Fujimura, Harushi Mori
{"title":"Dual-target lymphatic embolization for refractory chylous ascites after nephroureterectomy.","authors":"Ryoma Kobayashi, Kohei Hamamoto, Emiko Chiba, Soichiro Kojima, Tatsuya Ogawa, Hiroyuki Fujii, Mitsuru Matsuki, Masayuki Kurokawa, Toru Sugihara, Satoshi Ando, Tetsuya Fujimura, Harushi Mori","doi":"10.1093/bjrcr/uaag038","DOIUrl":"10.1093/bjrcr/uaag038","url":null,"abstract":"<p><p>We report a case of refractory chylous ascites following nephroureterectomy and para-aortic lymphadenectomy for renal pelvic carcinoma, which was successfully treated with percutaneous lymphatic embolization. An 83-year-old man underwent nephroureterectomy with para-aortic lymph node dissection for renal pelvic carcinoma. Postoperatively, >1000 mL/day of chylous ascites was continuously drained. Despite conservative management, high-output ascites persisted. Transnodal lymphangiography via the inguinal lymph nodes and post-lymphangiographic CT revealed lymphatic leakage at the nephroureterectomy site. Percutaneous lymphatic embolization was planned as a minimally invasive procedure. Under CT guidance, embolization of a lymphopseudoaneurysm and para-aortic lymph nodes near the leakage site was successfully performed using N-butyl cyanoacrylate. Ascitic fluid output decreased significantly postoperatively, and the drainage tube was removed the following day. This case highlights the importance of post-lymphangiographic CT in identifying actionable lymphatic targets and demonstrates that an anatomically tailored dual-target embolization strategy can achieve effective sealing when central duct access is not feasible.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 5","pages":"uaag038"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypofractionated palliative radiotherapy for advanced ethmoid sinus squamous cell carcinoma: a case report. 低分割姑息性放疗治疗晚期筛窦鳞状细胞癌1例。
IF 0.6
BJR Case Reports Pub Date : 2026-08-22 eCollection Date: 2026-09-01 DOI: 10.1093/bjrcr/uaag037
Osamu Tanaka, Naoki Isobe, Takuya Taniguchi, Takuji Kiryu, Chihiro Ikemoto, Chiyoko Makita, Masayuki Matsuo
{"title":"Hypofractionated palliative radiotherapy for advanced ethmoid sinus squamous cell carcinoma: a case report.","authors":"Osamu Tanaka, Naoki Isobe, Takuya Taniguchi, Takuji Kiryu, Chihiro Ikemoto, Chiyoko Makita, Masayuki Matsuo","doi":"10.1093/bjrcr/uaag037","DOIUrl":"10.1093/bjrcr/uaag037","url":null,"abstract":"<p><p>Ethmoid sinus cancer is a rare malignancy, that is, often diagnosed at an advanced stage, making surgical intervention challenging. Herein, we report a case of advanced ethmoid sinus squamous cell carcinoma in a female patient in her 90s. The patient presented with right-sided proptosis, ptosis, diplopia, and nasal obstruction. She was considered unfit for radical surgery or chemoradiotherapy because of her age and other comorbidities. She underwent hypofractionated palliative radiotherapy (35 Gy in 5 fractions) targeting the clinical tumor volume only. Clinically meaningful symptom relief and substantial tumor shrinkage were observed post-treatment, with minimal acute toxicities, although conclusions regarding treatment efficacy should be interpreted cautiously given the single-patient nature of this report. This case illustrates the potential of hypofractionated radiotherapy as a palliative option for patients deemed unsuitable for radical treatments.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 5","pages":"uaag037"},"PeriodicalIF":0.6,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bilateral primary adrenal lymphoma presenting with chylothorax: imaging findings and diagnostic challenges. 双侧原发性肾上腺淋巴瘤表现为乳糜胸:影像学表现和诊断挑战。
IF 0.6
BJR Case Reports Pub Date : 2026-08-18 eCollection Date: 2026-09-01 DOI: 10.1093/bjrcr/uaag036
Ubeyde Telli Oner, Nigar Erkoc, Musa Atay
{"title":"Bilateral primary adrenal lymphoma presenting with chylothorax: imaging findings and diagnostic challenges.","authors":"Ubeyde Telli Oner, Nigar Erkoc, Musa Atay","doi":"10.1093/bjrcr/uaag036","DOIUrl":"10.1093/bjrcr/uaag036","url":null,"abstract":"<p><p>Primary adrenal lymphoma is a rare and aggressive subtype of extranodal lymphoma with nonspecific clinical presentation. The coexistence of chylothorax and imaging findings suspicious for intratumoral hemorrhage in primary adrenal lymphoma is exceedingly rare and poorly understood. Herein, we report a case of bilateral primary adrenal diffuse large B-cell lymphoma (DLBCL) presenting with chylothorax secondary to lymphatic obstruction and imaging findings suspicious for intratumoral hemorrhage, highlighting the underlying pathophysiological mechanisms, multimodality imaging findings, and diagnostic challenges. A 67-year-old male patient presented with complaints of fever, night sweats, fatigue, and cough. Contrast-enhanced CT of the thorax and abdomen revealed pleural effusion in the left hemithorax. Thoracentesis was performed, and the patient was diagnosed with chylothorax. Concurrently, large bilateral adrenal masses with heterogeneous attenuation and focal hyperattenuating areas were identified. These hyperattenuating regions were considered suspicious for intratumoral hemorrhage. Subsequent PET/CT demonstrated intense hypermetabolic activity in both adrenal masses. An image-guided tru-cut biopsy was performed, and histopathological evaluation confirmed the diagnosis of diffuse large B-cell lymphoma. This case highlights that primary adrenal lymphoma may present with atypical manifestations such as chylothorax and imaging findings suspicious for intratumoral hemorrhage, emphasizing the importance of multimodality imaging, clinicopathological correlation, and consideration of this entity in the differential diagnosis of bilateral adrenal masses.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 5","pages":"uaag036"},"PeriodicalIF":0.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Carotid web: an underrecognized cause of ischemic stroke in a young patient. 颈动脉网:一个未被认识的缺血性中风的原因在一个年轻的病人。
IF 0.6
BJR Case Reports Pub Date : 2026-08-07 eCollection Date: 2026-07-01 DOI: 10.1093/bjrcr/uaag034
Salma Chenouni, Nada Adjou, Najwa Ech-Cherif Kettani, Meryem Fikri, Firdouas Touarsa
{"title":"Carotid web: an underrecognized cause of ischemic stroke in a young patient.","authors":"Salma Chenouni, Nada Adjou, Najwa Ech-Cherif Kettani, Meryem Fikri, Firdouas Touarsa","doi":"10.1093/bjrcr/uaag034","DOIUrl":"10.1093/bjrcr/uaag034","url":null,"abstract":"<p><p>Carotid web is an underdiagnosed cause of ischemic stroke, particularly in young and middle-aged patients without major atherosclerotic risk factors. It is characterized by a shelf-like intraluminal filling defect arising from the posterior wall of the carotid bulb, promoting thrombus formation through local hemodynamic disturbances. We report the case of a 45-year-old woman with a history of well-controlled hypertension who presented with acute right upper limb weakness. Brain imaging confirmed an acute ischemic stroke. CT angiography of the supra-aortic vessels demonstrated a carotid web at the left carotid bulb associated with a floating thrombus. No alternative embolic etiology was identified after a comprehensive cardiovascular and systemic evaluation. This case highlights the importance of considering a carotid web in cases of otherwise cryptogenic stroke, even in patients with well-controlled comorbidities. Early diagnosis is essential due to the high risk of recurrence, requiring timely and appropriate interventional management.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 4","pages":"uaag034"},"PeriodicalIF":0.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A rare case of thyroid cartilage chondroma: diagnostic challenges and the role of multimodal imaging and histopathology. 罕见的甲状腺软骨软骨瘤病例:诊断挑战和多模式成像和组织病理学的作用。
IF 0.6
BJR Case Reports Pub Date : 2026-08-03 eCollection Date: 2026-07-01 DOI: 10.1093/bjrcr/uaag032
Jitesh Arora, Zena A Ahmad
{"title":"A rare case of thyroid cartilage chondroma: diagnostic challenges and the role of multimodal imaging and histopathology.","authors":"Jitesh Arora, Zena A Ahmad","doi":"10.1093/bjrcr/uaag032","DOIUrl":"10.1093/bjrcr/uaag032","url":null,"abstract":"<p><p>Chondromas are rare benign cartilaginous tumours, typically arising in the small bones of the hands and feet. Laryngeal chondromas are exceptionally uncommon and account for a very small proportion of head and neck neoplasms. We present a case of a 72-year-old male referred with a painless, slowly enlarging right-sided neck mass. Multimodal imaging, including ultrasound, CT, and MRI, revealed a well-circumscribed lesion with internal calcification arising from the thyroid cartilage. Differential diagnoses included chondroma and low-grade chondrosarcoma. Initial cytological assessment was inconclusive, prompting expert histopathological review, which confirmed a well-differentiated benign chondroid lesion consistent with a chondroma. The patient underwent successful surgical excision, and follow-up imaging over a 4-year period has shown no evidence of recurrence. This case highlights the diagnostic challenges in distinguishing chondromas from malignant cartilaginous tumours in atypical locations, and emphasises the importance of a multidisciplinary approach, combining imaging, histology, and specialist input to guide management.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 4","pages":"uaag032"},"PeriodicalIF":0.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MRI in non-pregnancy-related decidualization of deep pelvic endometriosis: a case report and review of the literature. 非妊娠相关的深盆腔子宫内膜异位症的MRI诊断:1例报告及文献复习。
IF 0.6
BJR Case Reports Pub Date : 2026-07-31 eCollection Date: 2026-07-01 DOI: 10.1093/bjrcr/uaag031
Alessandra Iacono, Beatrice Morelli, Giacomo Avesani, Luca D'Erme, Floriana Mascilini, Anna Fagotti, Evis Sala, Benedetta Gui, Miriam Dolciami
{"title":"MRI in non-pregnancy-related decidualization of deep pelvic endometriosis: a case report and review of the literature.","authors":"Alessandra Iacono, Beatrice Morelli, Giacomo Avesani, Luca D'Erme, Floriana Mascilini, Anna Fagotti, Evis Sala, Benedetta Gui, Miriam Dolciami","doi":"10.1093/bjrcr/uaag031","DOIUrl":"https://doi.org/10.1093/bjrcr/uaag031","url":null,"abstract":"<p><p>Decidual changes in deep pelvic endometriosis (DPE) are extremely rare. During pregnancy, endometriotic activity and symptoms diminish due to hormonal changes, whereas the endometrial lining undergoes decidualization in response to progesterone. In some cases, a significant hormonal boost can promote the decidualization of endometriotic implants, with endometriomas being the most common sites for such changes. Decidualized endometriosis at sites outside the ovaries is a rarer phenomenon, and the associated imaging features have been studied less. We present a case of non-pregnancy-related decidualization involving multiple sites of DPE. A 33-year-old woman exposed to ovarian stimulation before in vitro fertilization (IVF) presented with chronic pelvic pain and vaginal bleeding. Emergency CT demonstrated irregular solid tissue in the pouch of Douglas and along the bowel loops, raising concern for a neoplastic process. Tumor markers were negative. Transvaginal ultrasound showed a hypoechoic, irregular, hypervascular lesion, and ultrasound-guided biopsy demonstrated decidualized stromal endometriosis. MRI confirmed a solid mass centered in the posterior cul-de-sac with intermediate T2-weighted (W) signal intensity, hemorrhagic foci on fat-suppressed T1W images, marked diffusion restriction, and avid post-contrast enhancement. Similar solid components were also present at multiple pelvic sites, adjacent to DPE implants. Short-interval MRI follow-up showed size reduction; however, due to persistent pain, fertility-sparing surgery was performed, and histology confirmed decidualization of DPE at all sites. This rare case emphasizes that decidualization can also occur on DPE and outside pregnancy, potentially mimicking malignant transformation, highlighting the role of MRI in aiding diagnosis and guiding proper management for these patients.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 4","pages":"uaag031"},"PeriodicalIF":0.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inflammatory mass or malignancy? The radiology of fish bone phlegmon: a review of 3 cases. 炎性肿块还是恶性肿瘤?鱼骨痰3例放射学分析。
IF 0.6
BJR Case Reports Pub Date : 2026-07-28 eCollection Date: 2026-07-01 DOI: 10.1093/bjrcr/uaag030
Michel Alhilani, Larne Jones-Whiting, Sharmin Malekout, Abdelhamid Elshawarby, Andrew J Hayes, Eleanor Moskovic
{"title":"Inflammatory mass or malignancy? The radiology of fish bone phlegmon: a review of 3 cases.","authors":"Michel Alhilani, Larne Jones-Whiting, Sharmin Malekout, Abdelhamid Elshawarby, Andrew J Hayes, Eleanor Moskovic","doi":"10.1093/bjrcr/uaag030","DOIUrl":"10.1093/bjrcr/uaag030","url":null,"abstract":"<p><p>Soft-tissue sarcomas of the abdomen and abdominal wall are rare, and their imaging appearances can overlap with those of benign inflammatory conditions. Foreign body-related phlegmon caused by a migrated fish bone from the bowel represents an uncommon but important diagnostic mimic, often indistinguishable from malignancy on cross-sectional imaging. Although several single case reports describe this entity, no radiology-focused multi-case series has been previously published. We present 3 patients referred to a regional sarcoma service with abdominal wall masses initially suspected to represent soft-tissue sarcoma. All 3 underwent multimodality imaging, which demonstrated heterogeneous, enhancing abdominal-wall lesions with associated inflammatory change. In each case, thin-slice CT ultimately identified a subtle linear hyperdense structure, corresponding to a migrated fish bone traversing or lying adjacent to bowel, establishing the correct diagnosis of foreign-body-induced phlegmon. MRI appearances were non-specific and mimicked neoplastic processes. Management varied from conservative antibiotic therapy to incision and drainage, with all patients making a full recovery and no recurrence. This case series highlights a rare but significant radiologic pitfall in the assessment of abdominal wall masses. Key learning points include scrutinizing CT in thin slices and bone windows for linear calcified foreign bodies, recognizing that MRI and PET-CT may mislead toward malignancy, and maintaining foreign-body phlegmon within the differential diagnosis for atypical abdominal wall \"tumours.\" Awareness of this entity can prevent unnecessary biopsies, oncologic referrals, and radical surgeries.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":"12 4","pages":"uaag030"},"PeriodicalIF":0.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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