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The peritoneal pseudotumor localization of tuberculosis is a rare clinical form, representing 1 to 3% of extrapulmonary site of tuberculosis. It represents the sixth most common extra pulmonary site of tuberculosis. It is a great mimicker with major overlapping clinical and imaging features. Differentiating peritoneal tuberculosis and peritoneal carcinomatosis in imaging remains challenging. We present a case of a 37-year old woman complaining of chronic abdominal pain and distension who has been diagnosed to have peritoneal carcinomatosis based on CT findings, histopathological study then revealed necrotizing, granulomatous inflammation consistent with tuberculosis. This case showed the interest to be aware of the common and uncommon imaging features of tuberculosis by radiologists to better assess for alternative differential diagnosis.

The orbital location of hemangiopericytoma is rare, marked by its slow and unpredictable evolution with malignant potential and a high rate of recurrence and distant metastasis, hence the need for regular and prolonged monitoring, we report a case of hemangiopericytoma at man of 38 years old.

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Introduction: Merkel cell carcinoma (MCC) is an aggressive skin tumor of neuroendocrine origin that derives from Merkel cells and occurs predominantly on the head or neck of elderly individuals at an average age of 69 years old. Its main risk factors are immunosuppression and ultraviolet exposure. The diagnosis is established on the histological aspect and completed by immunohistochemistry. Case Report: We report the case of a 65-year-old female patient, with no particular antecedents, who had right axillary swelling. Thoracic computed tomography (CT) showed a large right axillary mass of irregular contours, lobulated, heterogeneously enhanced after CP injection with central hypodense zone of necrosis. The confrontation of the morphological aspect and the results of the immunohistochemistry carried out made it possible to retain the diagnosis of Merkel cell carcinoma. Conclusion: Merkel cell carcinoma is a very aggressive cancer of the elderly. In case of doubt, a biopsy for histological confirmation should be performed. The therapy is usually based on a radical surgery followed by adjuvant radiotherapy.

Atypical breast hyperplasia is a precancerous lesion with a high risk of invasive carcinoma. The atypical character of hyperplasia is confirmed by the absence of anti Ck5/6 immuno-marking in the immunohistochemical study. These lesions are difficult to identify on breast ultrasound. Magnetic reasoning imaging shows non-mass enhancement which can have focal or regional distribution. We report the case of a 53-year-old woman, with a history of infiltrating lobular carcinoma of the right breast treated, in which the senological findings were in favor of atypical ductal hyperplasia of the left breast.

Abdominal wall hernias are a common imaging finding. Their most common complications include bowel obstruction, incarceration, strangulation and trauma. We report an exceptional case of spigelian hernia in 55 years old women complicated by perforation and massive subcutaneous emphysema which was correctly diagnosed by CT scan. This case showed the interest of CT scan with multiplanar reconstructions in the confirmation of the diagnosis.

Resume Il s’agit d’un homme âge de 38 ans presentant une tumefaction mammaire droite douloureuse, ayant rapidement augmente de taille. La mammographie et la tomodensitometrie ont montre une masse de densite calcique. L’examen anatomopathologique a conclu a un carcinome metaplasique du sein avec differentiation osseuse.

Résumé L´occlusion radique est une complication grave de l´entéropathie radique. Elle survient chez les patients sous radiothérapie suivis pour cancer gynécologique ou du rectum. Sa prise en charge nécessite une attention particulière pour améliorer la survie de ces patients. A partir d´un cas ayant été opéré pour cancer du rectum et qui a présenté une occlusion sur sténose serrée post-radique du canal anal et de la partie distale du sigmoïde, nous allons décrire la physiopathologie de cette entité rare et illustrer la valeur de l´imagerie dans la prise en charge de cette pathologie. English abstract Post-radiation occlusion is a serious complication of radiation enteropathy. It occurs in patients undergoing radiotherapy for gynecologic or rectal cancer. Accurate management is essential to improve patients' survival. We here report the case of a patient undergoing surgery for rectal cancer. He had post-radiation stricture due to tight stenosis of the anal canal and of the distal end of the sigmoid colon. This study describes the pathophysiology of this rare entity and highlights the role of imaging tests in the management of this disorder.

Leptomeningeal carcinomatosis is extremely rare in colorectal adenocarcinoma, its incidence is far less than 1%. The neurological symptoms are pleomorphic. The most common symptoms included Headache, ataxia, cranial nerve palsies, meningismus, focal weakness or numbness. MRI is the most sensitive and specific imaging method for screening, positive diagnosis and pre-treatment of leptomeningeal carcinomatosis. The presence of appropriate neuroimaging abnormalities in a patient with typical clinical features and history of colorectal adenocarcinoma enables to make the diagnosis of leptomeningeal metastases. As well as a biological confirmation is necessary. Treatment usually comprises site-specific radiation therapy in addition to intrathecal and systemic chemotherapy. The case aims to describe the MRI characteristics of leptomeningeal metastases so as to formulate the diagnosis and the subsequent treatment.

Objectifs (1) Comprendre le principe de la spectroscopie par resonance magnetique. (2) Savoir realiser l’examen de facon pratique. (3) Connaitre les principales indications de cet examen. (4) Simplifier les resultats de la spectroscopie dans la pratique neuroradiologique. Discussion La spectroscopie consiste a quantifier les differentes molecules presentes dans les tissus, grâce a leur frequence de resonance differente, apres avoir supprime le signal de l’eau ; les principaux metabolites utilises sont le N-acetyle aspartate (NAA), la creatine/phosphocreatine (Cr), la choline/phosphtidylecholine (Cho), le myoinositol (mI), les lipides libres (Lip), le lactate et les acides amines. Elle permet de differencier une lesion tumorale d’une lesion non tumorale (en particulier un abces a pyogenes) ; caracteriser et determiner la nature tumorale d’une lesion et de son suivi therapeutique et de realiser un bilan d’extension locale necessaire pour les decisions therapeutiques. Dans ce travail nous allons simplifier cette technique et expliquer de facon pratique les differents resultats en fonction des differentes lesions cerebrales tumorales et non tumorales. Conclusion La spectroscopie par resonance magnetique est un complement tres important de l’imagerie conventionnelle, son utilisation doit etre largement integrer dans la strategie diagnostique en neuro-imagerie pour une meilleure caracterisation des lesions cerebrales.

Biliary cystadenoma is a rare benign hepatobiliary cystic tumor, more common in middle-aged women. The clinical manifestation is variable. It can be asymptomatic or symptomatic presenting with abdominal pain, nausea, vomiting, or a palpable mass. We report a case of a 36-year-old female patient, with a biliary cystadenoma mimicking a hydatid cyst (HC) complicated by local recurrence. The radiological diagnosis can be difficult and may present a problem of differential diagnosis with the HC and complicated liver cyst. Surgical management is based on complete resection given the high risk of recurrence and malignant degeneration.

Introduction: Adenoid cystic carcinoma (ACC) of the lacrimal sac is a rare entity characterized by poor prognosis, because of the high rate of local recurrence and metastasis after treatment. Case Report: A 45-year-old male patient was seen at our institution for epiphora, pain, and swelling of the internal angle of the left eye evolving for three months. The clinical examination revealed a fixed mass above the medial canthus of the left eye with blood discharge from the lacrimal punctum at the pressure of the mass. Orbital magnetic resonance imaging (MRI) showed a left lacrimal sac mass. Incisional biopsy disclosed adenoid cystic carcinoma. Conclusion: This is a rare case of lacrimal sac malignant tumor. Adenoid cystic carcinoma can develop in the salivary or lacrimal glands; however, its occurrence in the lacrimal drainage apparatus is extremely rare. Imaging plays a key role in the diagnosis, thanks to computed tomography (CT) scan and magnetic resonance imaging (MRI) which allow a detailed analysis of the local and distant extension, as well as in post-treatment follow-up.

Objectifs Savoir evoquer le diagnostic d’encephalopathie de Gayet et Wernicke en dehors du cadre habituel de l’intoxication ethylique. Materiels et methodes Patient de 62 ans, ayant comme antecedent une gastrectomie totale pour adenocarcinome gastrique, admis dans un tableau de trouble de conscience febrile a PL normale, avec paralysie faciale associee, une IRM cerebrale a ete demandee pour eliminer une thrombophlebite cerebrale. Resultats L’IRM cerebrale montrait des hypersignaux T2, flair et diffusion, autour de l’aqueduc du Sylvius, du V3, s’etalant de facon symetrique sur les talami ; sans foyer recent d’hemorragie ou tumoral. Le diagnostic d’encephalopathie de Gayet–Wernicke etait evoque et confirme par le dosage de la vitamine B1 qui etait abaissee. Le patient a beneficie d’un traitement a base de vitamine B1 avec amelioration de la conscience au bout de 6 jours. Conclusion L’encephalopathie de Gayet–Wernicke est une complication neuropsychiatrique aigue secondaire a une carence en thiamine. L’IRM constitue l’examen de reference avec dosage vitaminique. Le traitement precoce permet d’avoir une evolution favorable.

Introduction: The nasogastric tube (NGT) is frequently used in oncology in patients with tumors of the oral cavity. Often mild in the adults, this technique can lead to a gastric perforation which is a rare emergency surgery and of poor prognosis. Case Report: We report an interesting case of an old lady, tracheotomized for recurrent oral tumor, and got a NGT at his admission. After five days, computed tomography (CT) scan requested for extension assessment, discovered a gastric perforation by nasogastric intubation in the absence of clinical signs on physical examination. On CT scan, we have found evidence of gastric perforation, sign of the falciform ligament, ligamentum teres sign, and pneumoperitoneum. Finally, the patient has undergone a surgical repair. Conclusion: Computed tomography scan allows rapid diagnosis of gastric perforation though it is silent by showing pneumoperitoneum. Clinicians should systematically detect the favoring factors before insertion of NGT and think of any patient with tracheostomy with NGT and developing or not an acute abdomen in the continuations of the intubation.

Introduction: Ovarian vein thrombosis (OVT) is an uncommon but potentially serious clinical disorder, which mostly present in the postpartum period but can also occur with malignant and inflammatory conditions in the non-obstetrical patient. The diagnosis is mainly based on imaging techniques, in particular computed tomography (CT) and magnetic resonance, for their sensitivity and specificity. Case Report: We present a case of a 59-year-old female who was diagnosed with endometrial carcinoma. Her abdominal contrast-enhanced CT revealed an expanded right ovarian vein with soft tissue attenuation material in its lumen extending into the inferior vena cava, reaching the right atrium and ventricle. Conclusion: We describe this case of OVT, because, even though rare, it is a diagnosis to consider. Prompt recognition and treatment are crucial to avoid more severe outcomes.

Clinical History Image Findings Discussion Find Diagnosis Differential Diagnosis, female, 43 years, Clinical History: A 43-year-old woman without particular medical history presented with unstable angina. The physical examination found a diastolic murmur of an aortic regurgitation. The electrocardiogram showed inverted T waves in lateral leads. Final Diagnosis: non specific inflammatory aortitis.

Clinical History Image Findings Discussion Find Diagnosis Differential Diagnosis, male, 82 years, Clinical History: A 82-year-old man patient presented with a history of right parietal meningioma low grade operated 18 years ago. He accused since one year rebel headache with recent worsening of symptoms by installing left hemiplegia and painless progressive exophtalmos ... Final Diagnosis: Multiple intra-cranial meningiomas

Clinical History Image Findings Discussion Find Diagnosis Differential Diagnosis, male, 50 years, Clinical History: A 50 old year male presented to the emergency department with a 6-days history of left inguinal pain, and Urinary symptom such as dysuria and urinary frequency. Final Diagnosis: Inguinal bladder hernia