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Triple barreled dissection is an extremely rare form of aortic dissection with only a few cases reported in the literature. It is characterized by 3 lumens separated by 2 intimal flaps, resembling the appearance of the ‘Mercedes Benz’ sign. We present an unusual case of triple barreled aortic dissection in a 71-year-old patient with history of hypertension. Chest radiography showed a widened mediastinum. The CT images showed a thoraco-abdominal type B aortic dissection with three lumens giving the appearance of the ‘Mercedes Benz’ sign. As the CT-scan showed no complications of the aortic dissection, the patient received medical conservative treatment.

Hydatid cyst of the liver is a zoonosis caused by parasite Echinococcus granulosus, which remains highly prevalent in Morocco. Current medical imaging modalities, particularly ultrasonography (US) and computed tomography (CT), facilitate rapid and accurate diagnosis, enable effective treatment possibilities and allow for easy follow-up. Complications are typically dominated by infection and rupture, especially in the bile ducts, peritoneal cavity, and chest. Dissemination and development within vascular structures, especially the portal vein, are much less common. This underscores the significance of our case, which illustrates this rare complication of hydatid cyst of the liver.

Rhabdomyosarcoma is a malignant tumor in children that might mimic a benign tumor, such as infantile hemangioma, particularly when detected early. Although rhabdomyosarcoma rarely occurs in the hand, its prognosis is generally poor, and successful treatment relies on a complete and radical surgical excision. We present a case of rhabdomyosarcoma located in the palm of an infant's hand, initially presenting clinical and radiological features suggestive of a vascular tumor. The resection of this mass was radical, and histological analysis and immunohistochemistry returned in favor of embryonic rhabdomyosarcoma. In similar cases recorded in the literature, the diagnosis may be first mistaken for that of a hemangioma, then confirmed by histology. This underlines the importance of a systematic anatomopathological examination of all tissues removed surgically.

Hypoplasia of the internal carotid artery is a rare congenital abnormality that can present with an ischemic stroke or transient ischemic attacks. We present the case of a 17-year-old male who presented with right hemiparesis and dysarthria. The imaging revealed hypoplasia of the left internal carotid artery and narrowing of the left carotid duct. The patient was managed conservatively. This case highlights the importance of considering ICA hypoplasia as a cause of ischemic stroke in patients with a narrowed osseous canal. Early diagnosis and management can help prevent recurrent strokes.

Medulloblastoma is a frequent and aggressive pediatric tumor. It causes intracranial hypertension, necessitating ventriculoperitoneal shunting with surgical resection. Intraperitoneal metastases are rare and result from the migration of neoplastic cells through the shunt and into the peritoneal cavity. This metastatic form involving the ventriculoperitoneal shunt has a poor prognosis, making therapeutic management even more difficult. We report the case of a 14-year-old boy with a history of medulloblastoma of the cerebellum who was initially treated with complete resection of the tumor with placement of a ventriculoperitoneal shunt, followed by radiotherapy and chemotherapy, with good progression until he presented to the emergency department with acute abdominal symptoms. Imaging revealed multiple peritoneal masses with intra- and retroperitoneal lymphadenopathies. An ultrasound-guided biopsy revealed a metastatic medulloblastoma in the peritoneal cavity, and the patient underwent chemotherapy. The placement of the ventriculoperitoneal shunt in the tumor dissemination is therefore to blame.

Squamous cell carcinoma of the eyelid is a rare but severe tumor that causes functional and aesthetic damage and poses a significant threat to life through metastatic spread. It typically affects elderly individuals with fair skin and often develops from pre-existing lesions. Diagnosis is confirmed by biopsy. Imaging, using CT and MRI, is critical for assessing local and distant extension, guiding treatment, and monitoring progress. Primary treatment is surgical, aiming for complete resection and restoration of eyelid function, with radiotherapy or chemo-radiotherapy considered for metastatic cases on an individual basis. This report presents a case of unusual localization of eyelid SCC metastasis, showing the importance of performing a cross sectional imaging, particularly a CT NCAP, for distant extension assessment.

Pulmonary sequestration (PS) is a congenital anomaly characterized by a lung region that is isolated from its normal bronchial and vascular connections. It typically receives blood supply from an aberrant systemic artery. An aneurysm of that aberrant artery is extremely rare. We report the case of a 55-year-old female patient who was incidentally diagnosed with intralobar PS after experiencing severe hemoptysis. The diagnosis was set by a chest contrast-enhanced computed tomography (CT), which also revealed an aneurysm of the aberrant systemic artery. A left lower lobectomy was successfully performed which confirmed the diagnosis. PS is characterized by a mass of lung tissue that lacks connection to the normal bronchial tree and is supplied with blood from the systemic circulation. There are 2 primary types: intralobar (ILS), located within a lung lobe, and extralobar (ELS), situated outside the lobes with abnormal vascular connections typically originating from the thoracic or abdominal aorta. In ILS, drainage usually occurs through pulmonary veins, whereas ELS often drains via the azygos or portal venous system. CT and magnetic resonance imaging (MRI) are preferred for diagnosing PS. They can also reveal complications such as an aneurysm of the aberrant artery, as in our case. PS is a rare yet significant anomaly to consider in cases of recurrent pneumonia or persistent consolidative opacities, especially when involving the lower lobe of the left lung. CT and MRI are highly valuable for pinpointing the lesion and identifying the feeder blood vessel associated with it.

Diastatic perforation corresponds to a bursting of the cecal wall caused by excessive distension resulting from a remote obstruction of the low large bowel. This perforation could be explained by Laplace's physical law, and by the particular vascular anatomy of the cecal wall. We report the case of a 75-year-old man admitted for peritonitis with an abdominal CT scan highly suggestive of a diastatic perforation of the cecum complicating colonic distension upstream of a stenosing tumor of the rectosigmoid junction. To our surprise, surgical exploration revealed the defect to be in the transverse colon and not in the cecum. Diastatic perforation of the transverse colon is exceptional, and would require other pathophysiological explanations than those for classical cecal perforation.

Abdominal aortic aneurysm has been described as a rare condition touching 1% of the population over the age of 50 years with a high percentage of mortality. Aneurysms progress in size, causing deadly complications such as ruptures and fistulas. Computed tomography angiography is considered the gold standard imaging exam for the evaluation of abdominal aortic aneurysms and their complications. We report the case of an elderly patient admitted to the emergency room due to recurrent gastrointestinal bleeding. The computed tomography imaging findings were in favor of an abdominal aortic aneurysm complicated with a primary aortoduodenal fistula.

Sternal tuberculosis is a rare and challenging diagnosis. We present a case of a 63-year-old woman who presented with a progressively enlarging anterior chest wall mass and nonspecific symptoms. Imaging studies revealed a destructive sternal lesion. A biopsy confirmed the tuberculosis diagnosis. The patient responded well to anti-tuberculosis treatment. This case highlights the importance of considering tuberculosis when making a differential diagnosis of sternal masses and emphasizes the need for early diagnosis and treatment.

Toxic leukoencephalopathy (TL) refers to damage to the brain white matter following exposure to toxic agents. Multiple agents are incriminated in this condition, including chemotherapy drugs. 5-Fluorouracil, widely used in oncology, is responsible for neurotoxicity in less than 5% of cases. We report the case of a 54-year-old male patient who presented with neurological symptoms following 5-FU-based chemotherapy for gastric adenocarcinoma, and whose MRI scan revealed signs suggestive of toxic leukoencephalopathy. We also report on the evolution of the abnormalities described on his MRI after 1 year.

Cerebral actinomycosis is a rare, chronic, but curable bacterial brain infection. We report the case of an 18-year-old male patient with a history of facio-cranial trauma, admitted in our institution with severe headaches and behavioral disorders. Magnetic resonance imaging (MRI) was performed showing the presence of contiguous multiple small round and ovoid lesions in the right frontal lobe with “the dot in circle” appearance. The diagnosis of cerebral actinomycosis was confirmed by histological study of the biopsy sample. Despite it being a rare condition, it is important to consider this diagnosis in patients with atypical post-traumatic neurological symptoms.

Pneumosinus dilatans (PSD) is an abnormal dilatation and enlargement of one or more paranasal sinuses, extending beyond the anatomic bony boundaries, without defect or thinning of its bony walls. It is documented by only a few reports. Usually asymptomatic, it is in general found incidentally on imaging. It is important for radiologists to recognize the diagnosis and rule out eventual associated conditions such as meningiomas, orbital tumors, arachnoid cysts, and fibrous dysplasia. We report the case of PSD diagnosed incidentally in a 51-year-old female patient who presented to the emergency department with confusion.

Uterine scar pregnancy is a rare form of ectopic pregnancy that is life-threatening and functionally compromising due to complications such as hemorrhage or early uterine rupture. We report the case of a 41-year-old patient admitted for metrorrhagia at 13 weeks' amenorrhea. Transvaginal ultrasound allowed early diagnosis of pregnancy on uterine scar and MRI-guided therapeutic management indicating hysterectomy. This study and literature review aims to highlight the importance of imaging features in the diagnosis and management of this rare condition, knowledge of which may improve prognosis.

Even though it is an uncommon presentation of tuberculosis, tuberculous meningitis is one of the most deadly manifestations. We report a case of a 6-year-old female who presented to the emergency room for left hemiparesis. Cerebral CT and MRI showed a right ischemic stroke with severe leptomeningitis in the medial cranial fossa. Numerous miliary tuberculomas were demonstrated, as well as a moderate hydrocephalus. Lumbar puncture revealed meningitis, and the mycobacterium tuberculosis polymerase chain reaction from CSF was positive. Pulmonary micronodules on chest CT were suggestive of tuberculosis. The clinical and radiological features, as well as the management approaches of this unusual disease complex, are addressed.

Ortner's syndrome refers to vocal cord paralysis resulting from compression of the left recurrent laryngeal nerve by abnormal mediastinal vascular structures. We present a case of an 89-year-old man who was an active smoker, with a clinical history of hypertension, who presented hoarseness of voice with chronic evolution. Neck and Thoracoabdominal CT angiography was performed revealing a thrombosed aneurysm of the aortic arch.

Congenital duodenal obstruction is a common cause of bowel obstruction. It is relatively easy to diagnose in the neonatal period. However, if the obstruction is due to a duodenal diaphragm, diagnosis may be delayed until later in infancy or even adulthood, depending on the size of the aperture in the diaphragm. Congenital duodenal obstruction may be associated with other gastrointestinal and biliary anomalies. The association of a duodenal diaphragm and a partial annular pancreas is a rare clinical entity. We present an unusual case of late presentation of duodenal diaphragm with partial annular pancreas in a 10-year-old girl with a 3-month history of abdominal distension and vomiting. The plain abdominal X-ray showed the classic picture of a double bubble. The CT images showed narrowing of the third duodenal portion and dilatation of the stomach and duodenum. The pancreatic tissue incompletely surrounded the second part of the duodenum. Intraoperatively, both the duodenal diaphragm and the partial annular pancreas were confirmed. Excision of the diaphragm and duodenoplasty were performed. A duodenal diaphragm should be suspected in patients with a history of abdominal distension and vomiting, even in late childhood. Associated gastrointestinal and biliary anomalies should always be excluded.

The dysplastic gangliocytoma of the cerebellum, also known as Lhermitte-Duclos disease, is an uncommon hamartomatous lesion in the posterior fossa with some distinctive neuroradiological characteristics. It can happen in combination with Cowden syndrome or sporadically. Cowden disease, or multiple hamartoma-neoplasia syndrome, is a rare autosomal dominant condition which is characterized by mucocutaneous lesions and systemic malignancies. We present a case of Lhermitte-Duclos disease and Cowden disease occurring in adult patients. The clinical and radiological features as well as the management approaches of this unusual disease complex are addressed.

Hydatid disease is a worldwide public health problem, especially in endemic countries, caused by the larval stage of Echinococcus granulosis. The pancreatic location of this disease is exceptional, representing only 1% of all possible locations, making this a widely misdiagnosed entity. We report a case of a 42-year-old man with a history of alcoholism and recurring abdominal pain, who presented to the emergency department with acute pancreatitis revealing a hydatid pancreatic cyst mimicking as a pseudocyst of the pancreas. The diagnosis was established using computed tomography and magnetic resonance imaging.

We report a case of a 43-year-old woman admitted to the emergency's department for an externalized mass through the vulva. The exploration by magnetic resonance imaging shows complete uterine inversion caused by a giant leiomyoma. Non-puerperal uterine inversion is a rare condition that is usually difficult to diagnose clinically. The role of imaging, specifically magnetic resonance imaging, is essential for the diagnosis, to establish the classification and to adapt the management.

Spontaneous neonatal gastric perforation is rare. We report a case of a newborn from a pregnancy and birth with no complications, who presented on day 5 of life with sudden severe abdominal distension, and subsequently bilious vomiting. The radiography of the abdomen without preparation showed a massive pneumoperitoneum. The CT scan showed a pneumoperitoneum more accentuated at the supra-mesocolic level with a defect in the anterior wall of the stomach. The laparotomy found a perforation in the anterior gastric wall, which was sutured in one plane. The postoperative course was simple. The evolution of spontaneous gastric perforations in newborns is usually favorable. The key to avoiding complications is obviously to make a good diagnosis and perform the correct surgical treatment as soon as possible.

Low-grade fibromyxoid sarcoma (LGFMS) is a rare tumor characterized by bland histological features and aggressive clinical course, it is a distinctive variant of fibrosarcoma with high metastasizing potential and sometimes a long interval between tumor presentation and metastasis, the most common anatomic locations of occurrence are the lower extremities, thorax, inguinal area, and upper limbs, Here, we present the case of a 29-year-old patient with a deceptively benign-appearing mass arising in the mediastinum that had been discovered on computed tomography, a biopsy under cervicotomy was performed and histopathological examination revealed low-grade fibromyxoid sarcoma. In conclusion, LGFMS can arise in the mediastinum, and physicians should consider this entity as a differential diagnosis in the presence of such mass.

Extraskeletal Ewing sarcoma is a rare tumor mainly affecting young people, of poor prognosis with very high mortality rates especially in metastatic forms. It can affect different locations, without specific clinical signs, which delays the diagnosis. Imaging plays an important role for diagnosis, staging, preoperative assessment and surveillance. The diagnosis should be set early to a better management. We report a case of a 30-year-old man with a large extraskeletal Ewing sarcoma of the left thigh. The patient was initially treated with chemotherapy. Unfortunately, the tumor has increased in size making surgery impossible. The patient ultimately died of pulmonary metastases.

Aneurysmal bone cyst (ABC) is a benign bone tumor affecting mainly children and young adults. It occurs in the metaphysis of the long bones. The scapula is a very rare location. Imaging may be highly suggestive of ABC in cases of an osteolytic, expansive, and hemorrhagic lesion with fluid-fluid levels and thin septa. The diagnosis must systematically be confirmed by performing a biopsy, in order to adopt the best therapeutic strategy. There are several therapeutic means, but wide resection remains the gold standard. The evolution is very variable and can go from spontaneous healing to recurrence with the destruction of the bone. We report a rare case of aneurysmal bone cyst of the scapula in a young patient.

Primary synovial osteochondromatosis of the ankle is a rare and benign disease of the young adult. It is characterized by the formation of multiple nodules of hyaline cartilage under the synovium. It is usually asymptomatic but can sometimes be revealed by pain or joint mobility disorders. X-rays and CT scans can easily diagnose calcified osteochondromas, but ultrasound and MRI can provide a quicker diagnosis by visualizing non-calcified foreign bodies. Surgery under arthroscopy remains the best therapeutic choice, however, this pathology still causes recurrence in less than 1/3 of cases.

Intestinal malrotation in children is a rare aberration, due to a halt in the rotation and attachment of the primitive gut, it can be asymptomatic if the rotation terminates at 90 degrees, which manifests itself in unusual forms of appendicitis as in our observation, or dangerous in cases of inadequate common mesentery and worsened by small intestine volvulus. This 12-year-old boy experienced abdominal discomfort in the hypogastrium and left iliac fossa 4 days before admission. The pain had been developing in a feverish setting, and the clinical examination had revealed abdominal sensitivity. A biological inflammatory syndrome was detected throughout the biological workup, the CT scan allowed the diagnosis of acute appendicitis on a complete common mesentery, and the patient underwent a laparotomy appendectomy. Even though children frequently experience acute appendicitis in its conventional form, it is nevertheless highly challenging to identify in its atypical forms when intestinal malrotation is involved. An abdominopelvic CT scan is used to make the diagnosis, and appendectomy, preferably with laparoscopy, is the recommended course of action.

The aim of this observation was to report an exceptional association of xeroderma pigmentosum and rhabdoid renal tumor in a 7-year-old girl, diagnosed with imaging and treated by adjuvant chemotherapy.

Reversible splenial injury syndrome (RESLES) is a rare clinicoradiological entity that defines a reversible lesion in the splenium of the callosum in magnetic resonance imaging.RESLES may be of infectious iatrogenic or metabolic origin. We report 2 cases of drug induced RESLES in our training.The presence of an isolated lesion of the corpus callosum in a context of polymedication by psychotropic drugs and the regression in less than 4 weeks suggests a toxic origin, in particular medicinal.The pathophysiology of these reversibles lesions of the splenium of callosum is not very clear, most often it is a phenomenon of vasogenic edema that is evoked, the clinical symptoms are very varied and nonspecific, and the prognosis is generally good in the absence of underlying disorder.

Desmoid tumors are benign fibroblastic neoplasms, with locally invasive features and a tendency of recurrence. They are considered an aggressive non-metastatic fibromatosis. The retroperitoneal location is extremely rare. Their exact mechanism of occurrence is still controversial, but could be related to a genetic predisposition, hormonal factors or traumatic factors, including surgery. This entity faces management difficulties due to its rarity, the variable circumstances of its discovery, and the non-specific clinical manifestations. Their sensitivity to chemotherapy and radiotherapy is limited and surgery remains the only curative treatment in symptomatic cases, however observational waiting could consist the most appropriate management in selected asymptomatic patients, moreover it could avoid unnecessary morbidity from surgery or radiotherapy, which makes the management of this condition a multidisciplinary decision and should be adapted to fit the patients individually. We report a case of a retroperitoneal desmoid tumor in a 31-year-old woman with a history of familial adenomatous polyposis, through which we will discuss this extremely rare neoplastic entity.

Penile neoplasms are rare. The main goal of our case report is to demonstrate the important role of imaging in local and regional cancer extension assessment, to guide the treatment plan. We report a case of penile epidermoid carcinoma in a 54 year old uncircumcised man, with a history of chronic smoking, presenting with a mass in the base of the penis.

Posterior reversible encephalopathy syndrome is a rare underestimated condition, that generally complicates a rise in blood pressure in an acute setting. This entity has been increasingly identified in patients with systemic lupus erythematosus disease. PRES is challenging to diagnose seeing as it presents with nonspecific neurological symptoms, such as head-aches, confusion, seizures, visual changes or a coma, and can mimic neuropsychiatric lupus. Imaging plays a necessary role in confirming this diagnosis, as it is characterized by vasogenic edema of the posterior white matter, in which the distribution is bilateral and symmetrical. Although this syndrome is rare, early diagnosis allows a prompt treatment and therefore a favorable outcome. We present a case report of PRES in a 14-year-old female previously diagnosed with lupus nephropathy, who presented to the emergency department with seizures and uncontrolled hypertension, that was unfortunately not reversible is this patient.

Os odontoideum is an unusual anatomic variant of the dens of C2 defined as an independent ossicle separated from the axis; the etiology is a topic of debate, with investigative studies supporting congenital and traumatic origins, clinical manifestations vary from asymptomatic forms, underlying C1-C2 instability to compression of the spinal cord or vertebrobasilar ischemia. We report a case of a patient with a history of minor trauma 5 years ago, she suffered from neck pain. The clinical examination was normal. Radiological examination including X-ray, CT, and MRI showed cervical myelopathy involving os odontoideum with C1-C2 instability and compressive retro-odontoid cyst. Imaging has an important role in the management of os odontoideum, from diagnosis to therapy.

Ganglioneuromas are benign tumors of the sympathetic nervous system, rarely found in the presacral region. In this study, we report the case of presacral ganglioneuroma in an 8-year-old girl, who complained of abdominal pain with diarrhea and abdominal distension. Ultrasound showed a large hypoechoic pelvic mass complicated by right ureter hydronephrosis. the CT and MRI confirm the presence of a presacral tissue mass with heterogeneous enhancement after contrast injection. The child underwent a complete surgical resection, and the anatomopathological study returned in favor of a ganglioneuroma. The presacral ganglioneuroma is an extremely rare tumor in that only twenty cases have been reported in the literature. 3 of which were less than 8-years-old. Through our case, we will review the epidemiological, clinical, radiological and therapeutic characteristics of this type of tumor.

The aim of this observation was to report a rare case of symptomatic and non-functional cystic parathyroid adenoma in a 52-year-old female, diagnosed with imaging and treated by surgical resection of the gland.

Pericallosal lipoma or lipoma of the corpus callosum is a rare congenital brain malformation that can be associated to dysgenesis or agenesis of the corpus callosum. It is usually asymptomatic, but can be revealed by epilepsy, paresis, paralysis, dementia, or headaches. CT and MR imaging play an important role in making this diagnosis. Lipoma of the corpus callosum can present as 2 different types: tubulonodular and curvilinear. Tubulonodular lipomas are the most common morphology. We report a case of 60-year-old woman, admitted for a seizure following a head trauma that benefited from a head CT revealing a curvilinear lipoma of the Corpus Callosum.

Many complications are known to occur in association with a diaphragmatic hernia. Acute pancreatitis occurring in this situation is very rare. In this paper, we report a case and describe the radiographic features of this complication. We report an unusual case of acute pancreatitis complicating a neglected post-traumatic diaphragmatic hernia in a 30-year-old male. This patient had a history of an abdominal trauma 5 years ago, and arrived at the emergency room with epigastria and left chest pain and vomiting. Serum lipase was elevated. Acute pancreatitis could be considered as an exceptional complication of diaphragmatic hernia. It is a serious diagnostic and therapeutic challenge. The fundamental roles of CT are to determine the diaphragmatic defect, the abdominal content involving, the Balthazar scoring of pancreatitis, and the presence of local complications. Even if a conservative approach is preferred when facing a diagnosis of pancreatitis, timing of surgery should be carefully considered.

The granular cell tumor or Abrikossoff's tumor is a rare tumor, most often benign in evolution. Malignant forms are exceptional. We report, here, a very rare case of granular cell tumor, localized in the perianal region, in a 54-year-old woman with lung metastases. CT and MRI with contrast showed a locally advanced tumor process in the right para-anal region associated with multiple ''balloon release'' lung lesions. The diagnosis was confirmed by immunostaining after surgical biopsy. Very few cases of malignant granular cell tumors with lung metastasis have been reported in the literature.

Leiomyosarcomas of the sigmoid colon are aggressive and extremely rare tumors representing less than 0.1% of all colorectal malignancies. Few cases have been reported in the literature and their imaging features need to be more detailed. We report the case of a 70 year old male patient, smoker, with a history of arterial hypertension, admitted for abdominal pain and hypogastric mass. Computed tomography has shown a voluminous heterogeneously enhancing tumor process with a necrotic center, attached to the sigmoid wall, with multiple secondary peritoneal and hepatic masses. The anatomopathological examination of the biopsy sample with immunohistochemistry allowed the diagnosis of leiomyosarcoma of the sigmoid colon. Clinical presentation and radiological features of leiomyosarcomas are non-specific, and the definitive diagnosis is only established after an anatomopathological examination.

Hydatidosis is a parasitic disease that is still prevalent in regions that rear farm animals, notably along the Mediterranean coast. The liver and lungs are most commonly involved. Cardiac hydatidosis has been reported infrequently even in countries in which hydatid disease is endemic. This entity must be known because when undiagnosed and untreated, the risk of fatal complications increases. We report 2 cases of cardiac echinococcal cysts in young men. The first case is an incidentaloma in a patient admitted for pancreatitis. The second case is about a patient admitted for dyspnea. CT scan and MRI were performed showing intraventrucular cystic mass with a calcified wall which was very suggestive of a hydatid cyst diagnosis. We would like to emphasize the relevance of imaging in this context and shade some light on imaging diagnostic tools.

Fibromatosis Colli also known as congenital torticollis is a rare cause of benign cervical pseudotumor in neonates, consisting of benign fibrous tissue proliferation within the sternocleidomastoid muscle, resulting in a fusiform enlargement. The cause of fibrosis is unknown; however it could be linked to trauma during pregnancy or at the time of birth, resulting in hemorrhage and, subsequently, fibrosis. Ultrasound plays a necessary role in confirming this diagnosis and follow-up. We Report a case of Fibromatosis colli in a four-week old newborn who was diagnosed using ultrasonography and treated with physiotherapy.