Case Rep Radiol
· 2026 · PMID 41522263
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Proteus syndrome is an uncommon, sporadic disorder characterized by progressive and heterogeneous overgrowth of tissues, resulting in distorted and asymmetric development. In most individuals, Proteus syndrome has minima...Proteus syndrome is an uncommon, sporadic disorder characterized by progressive and heterogeneous overgrowth of tissues, resulting in distorted and asymmetric development. In most individuals, Proteus syndrome has minimal to no manifestations at birth but progresses during childhood and adolescence. Clinical manifestations of the disease include isolated asymmetric hemihyperplasia, isolated asymmetric macrodactyly, subcutaneous masses, plantar and palmar cerebriform fibrous overgrowth, exostoses, epidermal nevi, and scoliosis. Cardiothoracic structures are less commonly involved, and the manifestations include cystic lung changes, pulmonary thromboembolism and varicosities, and pulmonary nodules. Patients with Proteus syndrome have an increased risk of early death due to deep venous thrombosis and pulmonary embolism. We report a case of an adult female who was diagnosed with Proteus syndrome at the age of 5 years who had multiple pulmonary manifestations of the disease.
Case Rep Radiol
· 2025 · PMID 41323310
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Xanthogranulomatous pyelonephritis (XPN) is a rare chronic renal infection associated with obstructive nephrolithiasis and recurrent urinary tract infections. Emphysematous pyelonephritis (EPN) is an even rarer necrotizi...Xanthogranulomatous pyelonephritis (XPN) is a rare chronic renal infection associated with obstructive nephrolithiasis and recurrent urinary tract infections. Emphysematous pyelonephritis (EPN) is an even rarer necrotizing infection characterized by intrarenal gas, most commonly seen in patients with uncontrolled diabetes mellitus. Concurrent presentation of XPN and EPN is exceedingly uncommon, with only a few cases reported. We present a case of a 61-year-old female with no history of diabetes who presented with left flank pain, systemic symptoms, and laboratory evidence of infection and microcytic anemia. Abdominal CT revealed imaging features consistent with XPN-including hydronephrosis, a staghorn calculus, and the classic "bear paw" sign-alongside intrarenal gas, consistent with EPN. Urine culture grew . The patient underwent nephrectomy and recovered uneventfully with antimicrobial therapy. This case is notable for the rare co-occurrence of XPN and EPN in a euglycemic patient, supporting the hypothesis that chronic obstruction and infection may be sufficient to induce gas-forming infections, even in the absence of hyperglycemia. Awareness of atypical presentations is essential, as early recognition and surgical management are critical to reducing morbidity in these severe renal infections.
Raynor WY, Ranpariya M, Kempf JS
… +2 more, Saraiya B, Weiss SA
Case Rep Radiol
· 2025 · PMID 41210275
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Positron emission tomography (PET) radiotracers targeting prostate-specific membrane antigen (PSMA) are now widely used in the evaluation of prostate cancer. However, PSMA activity has also been described in several nonp...Positron emission tomography (PET) radiotracers targeting prostate-specific membrane antigen (PSMA) are now widely used in the evaluation of prostate cancer. However, PSMA activity has also been described in several nonprostatic malignancies, where PSMA is primarily expressed in tumor neovasculature. Here, we describe to the best of our knowledge the first case of a PSMA-avid Merkel cell carcinoma (MCC) inguinal lymph node metastasis, detected incidentally in an 80-year-old man with advanced metastatic prostate adenocarcinoma. Clinical history and disease distribution prompted the need for a diagnostic biopsy, confirming PSMA-avid metastatic MCC. This case highlights the importance of recognizing nonprostatic causes of PSMA uptake, as synchronous malignancies can alter diagnostic interpretation and treatment planning.
Case Rep Radiol
· 2025 · PMID 41200464
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Clear cell renal cell carcinoma (ccRCC) is typically prostate-specific membrane antigen (PSMA)-avid, likely related to PSMA expression in the tumor neovasculature, suggesting a potential role for evaluation by PSMA PET/C...Clear cell renal cell carcinoma (ccRCC) is typically prostate-specific membrane antigen (PSMA)-avid, likely related to PSMA expression in the tumor neovasculature, suggesting a potential role for evaluation by PSMA PET/CT. We describe a 77-year-old patient with prostate cancer who was incidentally found to have ccRCC on imaging with PSMA PET/CT, with subsequent staging by FDG PET/CT. He was diagnosed with prostate cancer 17 years prior and treated with radical prostatectomy and radiation therapy within a year of diagnosis. Biochemical recurrence with PSA of 1.0 ng/mL prompted imaging with PSMA PET/CT, which showed an unexpected finding of abnormal uptake within the right renal vein and inferior vena cava (IVC), suggesting possible tumor thrombus (SUVmax 8.8), with mild uptake corresponding to a suspected right renal mass. In addition, there was a PSMA-avid right paratracheal nodal metastasis measuring 3.3 cm (SUVmax 8.4). Subsequent FDG PET/CT again showed the renal mass, tumor thrombus (SUVmax 3.6), and only low-level uptake in the right paratracheal mass (SUVmax 2.3). Right nephrectomy was performed, confirming the presence of ccRCC in the right kidney with tumor thrombus extending to the right renal vein and IVC. FDG PET/CT restaging showed no recurrence in the nephrectomy bed and a stable FDG-avid right paratracheal mass. After stereotactic body radiation therapy (SBRT) directed to the right paratracheal mass, follow-up PSMA PET/CT showed decreased uptake (SUVmax 4.8), suggesting its usefulness for detecting and monitoring ccRCC.
Angmorterh SK, Amoussou-Gohoungo MM, Inusah A
… +8 more, Palm B, Kekessie KK, van de Venter R, Aboagye S, Yarfi C, Nsor-Atindana J, Angmorterh PM, Dzefi-Tettey K
Case Rep Radiol
· 2025 · PMID 41103454
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BACKGROUND: Cherubism is a rare genetic disorder characterised by multilocular cystic lesions in the mandible and/or maxilla, which result in the typical cherub-like face. Two forms of cherubism exist-hereditary (familia...BACKGROUND: Cherubism is a rare genetic disorder characterised by multilocular cystic lesions in the mandible and/or maxilla, which result in the typical cherub-like face. Two forms of cherubism exist-hereditary (familial) and nonhereditary (nonfamilial)-and it usually occurs amongst children aged 2-7 years. The disorder is caused by a mutation in the SH3BP2 gene on Chromosome 4p16.3, essential for jaw development. The prognosis of cherubism shows that lesions increase in size and plateau at puberty, after which the lesions begin to regress and become undetectable. We present the first case of cherubism to be reported from Ghana. CASE PRESENTATION: Our case is a nonhereditary (nonfamilial) cherubism in a 21-year-old Ghanaian woman. The patient presented with bilateral asymmetrical facial swelling, jaw pain, trismus, toothache, tooth mobility and tooth loss. Also, the patient had facial disfigurement, weight loss, cough, headache, seizures and dizziness. Her family history was noncontributory. The results of a head computed tomography (CT) scan indicated chronic left sphenoid sinusitis and an enlargement of the entire mandible, with multilocular expansile lytic (soap bubble) appearance. The mandibles had ground glass matrix areas associated with subtle cortical destruction and dental deformities suggestive of Grade III cherubism. DISCUSSION AND CONCLUSION: Our patient had the onset of the disorder at age 12 but presented to the hospital at the age of 21. The reason why our patient did not seek medical help beforehand could be attributed to sociocultural beliefs, financial constraints and/or limited access to healthcare amenities. Treatment protocols for cherubism may include observation, surgery and medical therapy. Our patient resorted to the use of traditional medicine and spiritual/religious consultations for treatment. Our patient experienced discrimination due to the disease and had lost job, friendship and romantic relationship opportunities because of cultural beliefs, stereotypes and stigmatisation. Her facial disfigurement and the deformities are associated with bad omens and negative spirits in Ghana. When diagnosed, patients suffering from cherubism must be encouraged to seek information, education and appropriate individualised evidence-based management from hospitals. Treatment of the disease should be supported with psychological counselling and community sensitisation wherever possible.
Ishikawa S, Takamatsu A, Yoshida K
… +2 more, Okuda M, Kobayashi S
Case Rep Radiol
· 2025 · PMID 40995231
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We report a case of a 55-year-old woman diagnosed with sarcoidosis involving multiple intrapulmonary lymph nodes that were clearly visualized on vessel-suppressed CT imaging. Intrapulmonary lymph node involvement in pati...We report a case of a 55-year-old woman diagnosed with sarcoidosis involving multiple intrapulmonary lymph nodes that were clearly visualized on vessel-suppressed CT imaging. Intrapulmonary lymph node involvement in patients with sarcoidosis has been reported less frequently and has not been well discussed. This may be attributed to the fact that intrapulmonary lymph nodes present as small nodular lesions located along pulmonary vessels, making them difficult to detect on conventional imaging. Vessel-suppressed CT enhances visualization of pulmonary lesions by selectively suppressing vascular structures. This case highlights the clinical utility of vessel-suppressed CT for improved detection of intrapulmonary lymph node lesions in the diagnosis of sarcoidosis.
Alimova S, Tlaiss Y, Youness S
… +4 more, Tleis A, Evgeny B, Truten V, Guseva T
Case Rep Radiol
· 2025 · PMID 40937007
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Aesthetic facial and neck procedures increasingly rely on radiographic imaging for surgical planning and complication management. Cone-beam computed tomography (CBCT) offers high-resolution, three-dimensional imaging, bu...Aesthetic facial and neck procedures increasingly rely on radiographic imaging for surgical planning and complication management. Cone-beam computed tomography (CBCT) offers high-resolution, three-dimensional imaging, but foreign materials such as cosmetic fillers and metallic implants can mimic pathology, generate artifacts, and complicate surgery. This case report with an integrated literature review highlights the radiographic identification of such materials and their implications for aesthetic procedures, illustrated by a patient case where CBCT revealed high-density inclusions in the submental region, correlating with intraoperative fibrosis and extended surgical time. CBCT proved superior in visualizing foreign bodies with lower radiation exposure than conventional CT, emphasizing the need for standardized imaging protocols and AI-driven artifact reduction to enhance diagnostic accuracy and optimize surgical outcomes.
Case Rep Radiol
· 2025 · PMID 40791606
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A 40-year-old female with estrogen receptor-positive breast cancer underwent an initial staging using a technetium-99m methylene diphosphonate (Tc-99m MDP) bone scan, which revealed abnormal uptake in the femur without a...A 40-year-old female with estrogen receptor-positive breast cancer underwent an initial staging using a technetium-99m methylene diphosphonate (Tc-99m MDP) bone scan, which revealed abnormal uptake in the femur without a patient history of prior trauma or associated symptoms. Subsequently, an MRI confirmed the presence of a well-defined lesion in the upper left femur. To rule out metastatic disease, an 18F-fluoroestradiol (FES) PET/CT was performed, demonstrating no ER expression. Following the PET/CT, a biopsy confirmed the presence of an enchondroma. This case underscores the importance of early utilization of 18F-FES PET/CT in breast cancer staging to minimize unnecessary additional procedures/imaging.
Reyhanoglu G, Moscicka D, Guirguis G
… +1 more, Mousa MS
Case Rep Radiol
· 2025 · PMID 40718641
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Cerebral air embolism is a rare and potentially fatal medical condition that requires prompt recognition and management. Iatrogenic causes such as laparoscopic procedures, hysteroscopy, or central venous catheter (CVC) m...Cerebral air embolism is a rare and potentially fatal medical condition that requires prompt recognition and management. Iatrogenic causes such as laparoscopic procedures, hysteroscopy, or central venous catheter (CVC) manipulation are well-documented etiologies. This article presents a case of an 80-year-old female who developed iatrogenic air emboli from CVC manipulation leading to left middle cerebral artery (MCA) syndrome due to suspected right-to-left shunt from pulmonary arteriovenous malformation (pulmonary AVM) or patent foramen ovale (PFO). Preexisting neurological deficits, elevated lactate levels, and sepsis with evidence of systemic hypoperfusion on admission hindered the early detection and treatment of air emboli. This case highlights the need for heightened awareness of CVC-related iatrogenic air embolism, particularly in patients with predisposing conditions such as pulmonary AVM and PFO. Comprehensive treatment strategies, including hyperbaric oxygen therapy, remain critical for achieving better outcomes.
Case Rep Radiol
· 2025 · PMID 40641738
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This case study presents an 87-year-old female patient with a history of chronic abdominal pain and NSAID use who was admitted with symptoms of hematemesis and melena, indicative of upper gastrointestinal bleeding. Upon...This case study presents an 87-year-old female patient with a history of chronic abdominal pain and NSAID use who was admitted with symptoms of hematemesis and melena, indicative of upper gastrointestinal bleeding. Upon examination, she was found to be hemodynamically stable but exhibited signs of moderate protein-calorie malnutrition. Imaging studies, including a multiphasic CT angiogram, revealed a contained rupture in the distal stomach, and a cystic artery pseudoaneurysm measuring 4.2 mm. Despite the presence of a perforated ulcer, there was no significant pneumoperitoneum or hemoperitoneum, leading to a diagnosis of contained perforation. The management plan included conservative treatment with IV antibiotics, proton pump inhibitors, and monitoring of hemodynamic status. On the third day of admission, the decision was made to embolize the cystic artery, as the risk of gallbladder ischemia was deemed low. This case underscores the critical need for prompt diagnosis and intervention in patients presenting with upper GI bleeding, particularly in the elderly, where the mortality rate can be significantly high. The findings emphasize the importance of imaging in localizing the source of bleeding and guiding appropriate management strategies.
Case Rep Radiol
· 2025 · PMID 40599877
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Leiomyosarcoma of inferior vena cava is a rare sarcoma subtype of vascular origin. It has a spectrum of clinical manifestations depending on the affected segment of inferior vena cava, which also determines the treatment...Leiomyosarcoma of inferior vena cava is a rare sarcoma subtype of vascular origin. It has a spectrum of clinical manifestations depending on the affected segment of inferior vena cava, which also determines the treatment and prognosis. We present a patient with metastatic leiomyosarcoma of inferior vena cava. Clinical presentation, radiological findings and management are discussed. In particular, we highlight the key features to consider on imaging to assist with preoperative planning.
Case Rep Radiol
· 2025 · PMID 40529386
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Wandering spleen is a rare condition resulting from the absence or laxity of peritoneal attachments, allowing the spleen to migrate within the abdominal cavity. While some patients may remain asymptomatic, others can dev...Wandering spleen is a rare condition resulting from the absence or laxity of peritoneal attachments, allowing the spleen to migrate within the abdominal cavity. While some patients may remain asymptomatic, others can develop life-threatening complications such as splenic torsion, infarction, and bowel obstruction. This case report highlights one of the complications of wandering spleen and the importance of timely diagnosis and intervention.
Case Rep Radiol
· 2025 · PMID 40503061
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Primary poorly differentiated liposarcoma of the spine represents an exceptionally rare clinical entity. We present a 68-year-old patient with a poorly differentiated liposarcoma originating in the thoracic paraspinal re...Primary poorly differentiated liposarcoma of the spine represents an exceptionally rare clinical entity. We present a 68-year-old patient with a poorly differentiated liposarcoma originating in the thoracic paraspinal region that was initially misdiagnosed as spinal tuberculosis. Although surgical decompression and subsequent biopsy confirmed the diagnosis of liposarcoma, the patient declined adjuvant chemotherapy and experienced disease recurrence within 2 months. This case underscores the critical consideration that differentiated spinal sarcomas may be radiologically indistinguishable from spinal tuberculosis, necessitating histopathological confirmation for accurate diagnosis.
Case Rep Radiol
· 2025 · PMID 40496548
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Tumefactive demyelinating lesions and brain neoplasms often present as a diagnostic challenge due to overlapping radiographic features among conventional imaging modalities ultimately resulting in uncertainty if a biopsy...Tumefactive demyelinating lesions and brain neoplasms often present as a diagnostic challenge due to overlapping radiographic features among conventional imaging modalities ultimately resulting in uncertainty if a biopsy is warranted to establish a definitive diagnosis. Synthetic MRI (SyMRI) is a novel imaging technique providing myelin maps to aid with diagnosis, yet its use in pediatric patients remains largely unexplored. Therein, we report a pediatric case utilizing SyMRI to assist in differentiating tumefactive demyelination from a recurrent glioma. This 16-year-old female with a history of ganglioglioma, presented with sudden left-sided weakness. The initial MRI suggested either a glial neoplasm or a demyelinating lesion, prompting consideration of a biopsy. SyMRI revealed a unique "rim of decreased myelination," challenging the initial diagnosis. Within 1 week from admission, the patient's symptoms resolved without recurrence. Immunotherapy resolved the demyelinating lesion, supporting the initial SyMRI finding. The case demonstrates the potential of SyMRI in pediatric neuroradiology, highlighting a distinct "rim of demyelination" and its comparison to gliomas aiding in the diagnostic process.
Choudhary PK, Meena AK, Wander A
… +2 more, Mahesan A, Singh P
Case Rep Radiol
· 2025 · PMID 40496547
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Neurofibromatosis (NF) is a common disorder that affects the nerves and skin. There are two main types: neurofibromatosis Type 1 (NF-1) (also called von Recklinghausen's disease) and neurofibromatosis Type 2 (NF-2) (prev...Neurofibromatosis (NF) is a common disorder that affects the nerves and skin. There are two main types: neurofibromatosis Type 1 (NF-1) (also called von Recklinghausen's disease) and neurofibromatosis Type 2 (NF-2) (previously known as bilateral acoustic NF or central NF). NF-1 makes up approximately 85% of cases, with a prevalence of 1 in 5000 in the general population. In 30%-50% of NF-1 cases, there is no family history, suggesting that these cases likely result from germ cell mutations, often from the father. Here, we present the case of a 7-year-old boy with skin and radiological features of NF-1. NF-1 is the most common neurocutaneous syndrome, requiring long-term monitoring for related complications. In this case, we aimed to highlight the typical clinical and radiological features of NF-1 in a child.
Case Rep Radiol
· 2025 · PMID 40433355
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Thoracic endometriosis syndrome (TES) is a rare form of endometriosis characterized by the presence of functioning endometrial tissue in the thoracic cavity. Patients are women of reproductive age, with a genetic link as...Thoracic endometriosis syndrome (TES) is a rare form of endometriosis characterized by the presence of functioning endometrial tissue in the thoracic cavity. Patients are women of reproductive age, with a genetic link as a significant risk factor. Patients present with long-standing chest symptoms and signs that mimic pulmonary tuberculosis (PTB). The crucial issue for establishing the diagnosis is the cyclicity of signs and symptoms which occur along with the menstrual cycle. A 34-year-old businesswoman had recurrent pelvic pain and heavy menses for 6 years, recurrent chest pain for 5 years, and recently coughing blood for 3 days. Symptoms peaked during menstruation. She reported a maternal grandmother with similar symptomatology. For the past 6 years, she was treated for recurrent pneumonia and PTB without improvement. Examination revealed right-sided pleural effusion and generalized pelvic tenderness. The catamenial nature of her symptoms led to a suspicion of TES, with PTB. Pleural fluid analysis showed exudative effusion, and Gene X-pert for MTB was negative. CA-125 was elevated, a nonspecific endometriosis marker. Pelvic ultrasound revealed features of pelvic endometriomas. Serial chest X-ray and CT scan showed right hydropneumothorax, lung mass, lung collapse, and pulmonary fibrosis. Multiple chest tubes were placed for the recurrent hydropneumothorax management. Exploratory laparotomy with bilateral ovarian cystectomy was done, and histology revealed ovarian hemorrhagic cysts and salpingitis. Hormonal suppression initiated as mainstay of treatment. She is monitored monthly as an outpatient to assess treatment efficacy and condition progression. TES is a form of endometriosis involving the thoracic cavity, affecting women of reproductive age. TES may mimic PTB but symptoms correlate with the menstrual cycle (catamenial in nature). In Tanzania, diagnostic challenges persist due to its nonspecific symptoms, inadequate clinicians' awareness, and lack of treatment guideline national wide.
Case Rep Radiol
· 2025 · PMID 40395359
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Ultrasound is the first-line and established imaging modality for the diagnosis of testicular masses and neoplasms, with high sensitivity. Conventional ultrasound can very reliably detect presence of an intratesticular m...Ultrasound is the first-line and established imaging modality for the diagnosis of testicular masses and neoplasms, with high sensitivity. Conventional ultrasound can very reliably detect presence of an intratesticular mass although it may not specifically characterize them as benign or malignant and neoplastic or nonneoplastic or classify the type or subtype of neoplasm in every case. Contrast-enhanced ultrasound (CEUS) is a technique in which injected intravenous microbubbles can supplement the characterization of focal testicular masses through observation of real-time perfusion of the testis and the target mass. Testicular masses have been documented to demonstrate unique enhancing patterns on CEUS. We report a unique case involving a young male presenting with a palpable testicular mass in which CEUS aided in the diagnosis of testicular germ cell tumor. The diagnosis was subsequently confirmed by histopathological examination after surgery. This case report highlights the utility of CEUS as a useful complementary adjunct in diagnosing and characterizing nonseminomatous germ cell tumors of the testes with a review of the literature.
Dibaba AD, Ljani N, Mustafa A
… +6 more, Khanbhai H, Ntungi A, Secha A, Bezabih NA, Waktola MG, Ramadhani SS
Case Rep Radiol
· 2025 · PMID 40343110
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In this case, we describe a rare presentation of a uterine myoma in a 42-year-old female patient who presented with a progressively enlarging abdominopelvic mass and heavy menstrual bleeding for 1 month. Initial work sho...In this case, we describe a rare presentation of a uterine myoma in a 42-year-old female patient who presented with a progressively enlarging abdominopelvic mass and heavy menstrual bleeding for 1 month. Initial work showed that the patient has a low hemoglobin count and elevated CA-125 tumor marker. A pelvic ultrasound revealed a cystic pelvic lesion with an undetermined origin. Subsequent follow-up after 6 weeks showed significant enlargement of the mass, prompting a pelvic MRI to be performed; the MRI showed a large, completely cystic uterine myoma arising from the anterior myometrium. This case highlights the atypical presentation of a common gynecological condition that can result in a diagnostic dilemma and the importance of advanced imaging such as MRI to be a problem-solving tool.
Hélage S, Laponche C, Homps M
… +5 more, Buy JN, Just PA, Jacob D, Ghossain M, Dion É
Case Rep Radiol
· 2025 · PMID 40322071
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Uterine sarcomas are uncommon malignant tumors with a grim prognosis, accounting for less than 1% of all gynecologic malignancies. Radiological series often include a limited number of patients, and diagnostic approaches...Uterine sarcomas are uncommon malignant tumors with a grim prognosis, accounting for less than 1% of all gynecologic malignancies. Radiological series often include a limited number of patients, and diagnostic approaches can vary. While the presence of low T2 signal intensity in leiomyomas on MRI has been proposed as a criterion to exclude sarcoma, exceptions to this rule exist. We present two cases that challenge this notion. The first patient was a 48-year-old woman presenting with metrorrhagia. MRI revealed a large intramural leiomyoma characterized by extensive hypointensity on T2-weighted imaging (T2WI) and a small intraleiomyoma focus with intermediate signal intensity. Histopathological examination confirmed leiomyosarcoma. The second patient was a 51-year-old woman presenting with menometrorrhagia. MRI showed a subserosal myoma with zones of T2WI hypointensity interspersed with a region of intermediate signal intensity. Histopathological examination confirmed low-grade endometrial stromal sarcoma. In both cases, diffusion-weighted imaging (DWI) revealed an intratumoral zone of restricted diffusion, with an apparent diffusion coefficient (ADC) value ≤ 0.86 × 10 mm/s. MRI is crucial for distinguishing leiomyomas from sarcomas. We propose combining T2WI and DWI with ADC for this purpose, noting limitations in each sequence's reliability. Suggestive MRI criteria for malignancy in sarcomas are identified, emphasizing the need for comprehensive imaging analysis. In characterizing uterine smooth muscle tumors, particularly when analyzing leiomyoma variants, DWI emerges as the dominant sequence, with T2WI serving as a secondary sequence. ADC values aid in histopathological hypothesis, but caution is warranted due to overlap with benign lesions. This approach may refine preoperative diagnosis and guide therapeutic management.
Sukin Z, Moffett E, Wulfeck M
… +2 more, Lindfors D, Szilagyi S
Case Rep Radiol
· 2025 · PMID 40276594
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Situs ambiguous is a rare congenital condition characterized by the abnormal arrangement of thoracoabdominal organs along the left-right axis. This condition often presents as either left or right isomerism, leading to c...Situs ambiguous is a rare congenital condition characterized by the abnormal arrangement of thoracoabdominal organs along the left-right axis. This condition often presents as either left or right isomerism, leading to complex anatomical variations and associated clinical challenges. We present the case of a 44-year-old female who was incidentally discovered to have situs ambiguous with polysplenia and left atrial appendage isomerism during the evaluation of abdominal pain and urinary symptoms caused by a ureteral calculus. Notably, the patient exhibited normal bronchopulmonary anatomy. The patient underwent a ureteroscopy, laser lithotripsy, stone extraction, and right ureteral stent placement. The patient was discharged shortly thereafter. We believe our case underscores the critical importance of recognizing the potential dissociation between thoracic and abdominal isomerism. It also highlights the need for further investigation into the embryological processes that contribute to these unusual presentations.