{"title":"Cranio-cervical conundrum; Enigmatic complete atlanto-occipital assimilation with Chairi I malformation","authors":"Khurram Khaliq Bhinder, Mariam Shah, Madiha Saeed Wahla, Nasir Khan, Amna Mehboob, Sabiyal Saghir, Alishbah Ziad","doi":"10.1016/j.radcr.2025.04.086","DOIUrl":"10.1016/j.radcr.2025.04.086","url":null,"abstract":"<div><div>Atlanto-occipital assimilation is extremely rare congenital anomaly, characterized by partial or complete fusion of atlas and occipital bone leading to altered cranio-cervical junction anatomy. In our patient, basilar invagination resulted in acute angulation and narrowing of foramen magnum. Crowding of structures at foramen magnum was seen with tonsillar herniation and compression of brain stem. Edema signal in proximal cervical cord was also seen. Bilateral atlanto-occipital assimilation with increased atlas to dens distance seen suggestive of atlanto-axial instability. Overall findings were suggestive of Chiari I malformation with atlanto-occipital assimilation.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3832-3835"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Philip K. Angelides MD , Oriana Salamo MD , Sujith V. Cherian MD , Eduardo Yepez Guevara MD , Carlos A. Jimenez MD , Saadia A. Faiz MD
{"title":"A 65-year-old man with cough, hypercalcemia, and diffuse opacities","authors":"Philip K. Angelides MD , Oriana Salamo MD , Sujith V. Cherian MD , Eduardo Yepez Guevara MD , Carlos A. Jimenez MD , Saadia A. Faiz MD","doi":"10.1016/j.radcr.2025.04.058","DOIUrl":"10.1016/j.radcr.2025.04.058","url":null,"abstract":"<div><div>Respiratory infections in patients with cancer are common. A low threshold for bronchoscopy with bronchoalveolar lavage (BAL) should be maintained in immunocompromised patients with pulmonary opacities on chest imaging to evaluate for opportunistic infections. In those with unresolving symptoms, transbronchial biopsies may add significant diagnostic value. Concomitant hypercalcemia in patients with cancer is typically related to underlying malignant disease. However, in those with persistent respiratory symptoms or atypical infiltrates then granulomatous inflammatory diseases should be considered. Diagnosing histoplasmosis in immunocompromised patients can be difficult. Antigen testing is often more sensitive, but tissue biopsy or culture may be needed. We describe a case of histoplasmosis with persistent pulmonary opacities and hypercalcemia diagnosed via transbronchial biopsy, with subsequent clinical and radiographic improvement after treatment.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3836-3839"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From rupture to recovery: A case report on a multidisciplinary approach to arteriovenous malformation (AVM)-associated intracerebral hemorrhage","authors":"Ibrahim Khalil MBBS , Md. Imran Hossain MBBS , Mahmuda Akter MBBS","doi":"10.1016/j.radcr.2025.04.042","DOIUrl":"10.1016/j.radcr.2025.04.042","url":null,"abstract":"<div><div>Arteriovenous malformations (AVMs) are rare congenital vascular anomalies that increase the risk of severe complications, such as intracerebral hemorrhage (ICH), necessitating complex, multidisciplinary management. This case report describes the successful treatment of a 30-year-old male who presented to the emergency department with an acute, severe headache, nausea, and neurological deficits due to a ruptured AVM causing ICH. Initial neuroimaging revealed a significant right parietal lobe hemorrhage, and digital subtraction angiography (DSA) confirmed a Spetzler-Martin Grade II AVM, indicating moderate surgical complexity; the patient underwent staged interventions, starting with endovascular embolization using the Onyx liquid embolic system to reduce nidus perfusion, followed by microsurgical resection with intraoperative neuromonitoring, resulting in complete AVM removal and near-normal neurological recovery at discharge. The integration of neurosurgery, interventional radiology, and neuro-anesthesiology expertise facilitated a tailored approach, leveraging advanced imaging and therapeutic techniques to minimize procedural risks and optimize outcomes. This case highlights the importance of early diagnosis, precise imaging with tools like DSA, and a collaborative, staged treatment strategy in achieving favorable results in AVM-associated ICH. It also emphasizes the value of personalized care plans and continuous postoperative follow-up to ensure long-term success and detect potential recurrence. Lessons learned include the efficacy of combining embolization and resection for moderate-complexity AVMs and the need for ongoing research to refine protocols and improve prognosis, reinforcing that multidisciplinary coordination is essential for managing such intricate vascular anomalies effectively.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3811-3819"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khadija F. Hamdulay, Sunil Kumar, Sourya Acharya, Varun Daiya, Nishtha Manuja, Manjeet Kothari, Akshay M. Padwal
{"title":"Rare case of hard palate mucomycosis complicated by peri-orbital swelling: A diagnostic challenge","authors":"Khadija F. Hamdulay, Sunil Kumar, Sourya Acharya, Varun Daiya, Nishtha Manuja, Manjeet Kothari, Akshay M. Padwal","doi":"10.1016/j.radcr.2025.04.037","DOIUrl":"10.1016/j.radcr.2025.04.037","url":null,"abstract":"<div><div>Mucormycosis is a rare but aggressive fungal infection predominantly affecting immunocompromised individuals. It presents significant diagnostic and therapeutic challenges, particularly when involving uncommon sites such as the hard palate and peri-orbital region. A 61-year-old male with a history of type II diabetes mellitus presented with peri-orbital swelling of the left eye, fever, and oral discomfort. His symptoms began following a dental extraction complicated by alveolar osteitis. Physical examination revealed a lesion on the hard palate, and laboratory tests indicated an underlying infection. MRI of the brain and orbits showed signal abnormalities consistent with an infectious process involving the preseptal and peri-orbital regions, with extension to the optic nerve and orbital muscles. Based on clinical, imaging, and medical history findings, a diagnosis of hard palate mucormycosis with peri-orbital involvement was established. The patient received intravenous meropenem, fluconazole, and insulin for diabetes management alongside symptomatic treatments. Gradual clinical improvement was noted, including a reduction in peri-orbital swelling and better oral intake. The patient was discharged with a continued plan for antifungal therapy and close diabetic monitoring. This case underscores the importance of early recognition and aggressive treatment of mucormycosis, especially in immunocompromised patients. A multidisciplinary approach, incorporating advanced imaging and comprehensive management of underlying conditions, is crucial in improving outcomes and reducing the high morbidity and mortality associated with this infection.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3744-3747"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chaimae Abourak, Aya Laridi, Ouafaa Chahboune, Siham Oukassem, Asmae Guennouni, Soukaina Bahha, Lina Belkouchi, Nazik Allali, Latifa Chat, Siham El Haddad
{"title":"Mammary Paget’s disease in a young woman: A rare occurrence","authors":"Chaimae Abourak, Aya Laridi, Ouafaa Chahboune, Siham Oukassem, Asmae Guennouni, Soukaina Bahha, Lina Belkouchi, Nazik Allali, Latifa Chat, Siham El Haddad","doi":"10.1016/j.radcr.2025.04.062","DOIUrl":"10.1016/j.radcr.2025.04.062","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3733-3737"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isma Azam Zico MBBS, MRCS, MS(Neurosurgery) , Jahinul Anam MBBS , Ibrahim Khalil MBBS
{"title":"Discrepancy between MRI and intraoperative findings in a rare intramedullary epidermoid cyst: A case report and literature review","authors":"Isma Azam Zico MBBS, MRCS, MS(Neurosurgery) , Jahinul Anam MBBS , Ibrahim Khalil MBBS","doi":"10.1016/j.radcr.2025.04.049","DOIUrl":"10.1016/j.radcr.2025.04.049","url":null,"abstract":"<div><div>Intramedullary epidermoid cysts are rare, benign spinal tumors originating from ectodermal tissue during embryogenesis, comprising less than 1% of intraspinal lesions and posing diagnostic challenges due to their variable presentation and imaging overlap with other spinal pathologies. This case report describes a 22-year-old female who presented with progressive bilateral lower limb weakness, mid-back pain, and bowel-bladder incontinence, with preoperative MRI revealing a well-circumscribed intradural cystic lesion at the T5-T6 level exhibiting mixed-intensity patterns and a “shouldering effect,” initially suggesting an extramedullary location. Surgical exploration, however, confirmed an intramedullary position, and the lesion—characterized intraoperatively as a white, waxy, flaky mass—was excised en-bloc, with histopathology verifying an epidermoid cyst; the patient showed significant neurological recovery by her 12-month follow-up with no recurrence. This case highlights a critical discrepancy between MRI and intraoperative findings, emphasizing the need to integrate clinical, radiological, and surgical observations for accurate diagnosis and management of such rare spinal lesions. It underscores that intramedullary epidermoid cysts, though uncommon, should remain in the differential diagnosis for young adults with progressive neurological deficits, particularly in the thoracic spine, and that complete surgical resection is essential to prevent recurrence. Early diagnosis, meticulous surgical planning, and long-term follow-up are vital for optimizing outcomes, illustrating the importance of adaptability when imaging misaligns with operative reality and reinforcing the value of detailed case reporting to advance understanding of this rare pathology.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3755-3760"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diagnostic dilemma of seminal vesicle abscess: A serious case with a nonspecific clinical presentation","authors":"Hicham Benramdane , Karim Haddar , Hamid Ziani , Siham Nasri , Imane Kamaoui , Imane Skiker","doi":"10.1016/j.radcr.2025.04.051","DOIUrl":"10.1016/j.radcr.2025.04.051","url":null,"abstract":"<div><div>Seminal vesicle abscesses are a rare condition, and their diagnosis is challenging with nonspecific clinical presentation. Diagnosis is based on medical imaging (ultrasound, CT scan) and laboratory tests. Treatment involves broad-spectrum antibiotics and abscess drainage.</div><div>We report the case of a 60-year-old diabetic male who presented with a 15-day history of painful perineal swelling. Imaging studies revealed a seminal vesicle abscess, which was treated with intravenous broad-spectrum antibiotics and surgical drainage. Culture of the pus revealed <em>Escherichia coli</em>. The patient demonstrated a favorable clinical course.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3777-3779"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A large pedunculated subserosal myoma with cystic and red degeneration: A case report with literature review","authors":"Siham Oukassem , Chaimae Abourak , Asmae Guennouni , Lina Belkouchi , Nazik Allali , Latifa Chat , Siham El Haddad , Khaoula Laaboud , Samia Bennaceur , Nada Douraidi , Maakoul Rachid , Zaki El Hanchi","doi":"10.1016/j.radcr.2025.04.050","DOIUrl":"10.1016/j.radcr.2025.04.050","url":null,"abstract":"<div><div>Uterine fibroids, although common and benign, may occasionally present with atypical features, including rare forms of degeneration, which can obscure their clinical and radiological identification. These unusual presentations may simulate adnexal or ovarian neoplasms, posing a significant diagnostic challenge. Pelvic imaging particularly magnetic resonance imaging (MRI) plays a pivotal role by offering high-resolution characterization of the lesion’s composition, origin, and relationship to adjacent structures, thus guiding appropriate therapeutic strategies. We report a clinical case that underscores this diagnostic complexity and emphasizes the importance of a multidisciplinary approach, integrating advanced imaging modalities to establish an accurate diagnosis.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3770-3776"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Round ligament fibroid: A case report and literature review","authors":"Rime Ezzeldin MD, Daniela Kerguelen Murcia BS, Siddharth Kumar MBBS, Mohamed Qayati MD, Peeyush Bhargava MD, MBA","doi":"10.1016/j.radcr.2025.04.041","DOIUrl":"10.1016/j.radcr.2025.04.041","url":null,"abstract":"<div><div>Round ligament fibroids are rare, particularly in postmenopausal women, and can pose a diagnostic challenge due to their uncommon location and nonspecific presentation. We report the case of a 66-year-old postmenopausal woman in whom a right-sided round ligament fibroid was incidentally discovered during evaluation for rectal bleeding. CT angiography and MRI revealed a 3.5 cm lesion arising from the right round ligament; the patient had a history of hormone replacement therapy but no prior uterine fibroids. This case underscores the importance of including extrauterine fibroids in the differential diagnosis of pelvic masses in postmenopausal women and highlights the value of MRI in accurately localizing and characterizing such lesions.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3806-3810"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Calcified intracranial epidermoid cyst presented during pregnancy: A case report","authors":"Parisa Pishdad MD , Amirhossein Soltani MD , Amirmehdi Ghanbarzadeh MD , Shakiba Houshi MD , Mohsen Salimi MD","doi":"10.1016/j.radcr.2025.04.103","DOIUrl":"10.1016/j.radcr.2025.04.103","url":null,"abstract":"<div><div>We present the case of a 29-year-old female with a history of an intracranial tumor, initially diagnosed at age 22, who presented during her first pregnancy at 23 weeks with a seizure episode. MRI revealed a nonenhancing mass in the middle cranial fossa with high T1-weighted signal intensity. Despite concerns regarding the potential for eclampsia, the patient was conservatively managed with seizure prophylaxis, and a cesarean section was performed at 38 weeks’ gestation. Over the following years, the patient experienced stable imaging findings and mild headaches but later developed worsening symptoms due to mass effect, requiring a Ventriculoperitoneal shunt and subsequent tumor resection. Pathology confirmed the diagnosis of an epidermoid cyst. This case highlights the importance of a multidisciplinary approach to managing intracranial lesions in pregnancy, as early diagnosis and careful coordination between obstetrics, neurology, and neurosurgery teams are crucial to ensuring optimal maternal and fetal outcomes. Additionally, it underscores the need for long-term follow-up in patients with brain lesions during pregnancy, as complications may arise years later, necessitating timely interventions. Notably, this case also demonstrates unique characteristics of an epidermoid cyst with high T1-weighted signal and hyperdensity on CT that remained unchanged over time, favoring the diagnosis of a calcified epidermoid cyst—a rare entity.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 8","pages":"Pages 3738-3743"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}