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We describe a case of a 65-year-old woman affected by hemangiopericytoma/solitary fibrous tumor of the right shoulder—subclavian region. Hemangiopericytoma/solitary fibrous tumor is a rare tumor of uncertain malignancy. She reports shoulder pain and inability to abduct the arm and elevate the shoulder. Imaging showed erosion of the scapula. The patient underwent 5 sessions of “on demand” embolization in the previous 2 years scheduled for recurrence of symptoms-swelling of tissues. Further 2 treatments were achieved through embolization via 2 different microballoon catheter combined with percutaneous cryoablation with 5 probes. Images after the treatment demonstrate a marked reduction in the hypervascularized area and an increase in the necrosis area. So, this combined treatment is safety and reproducible also in extrahepatic tissue.

In this case report, we describe an incidental finding of interventricular septum lipoma in a 55-year-old man who came to our attention for chest pain. The ECG showed no changes compatible with ongoing ischemia. While laboratory tests documented increased troponin levels with normal D-dimer levels. Due to the technical difficulties encountered during the performance of the transthoracic echocardiogram, a cardiac CT scan was requested, which ruled out significant coronary artery disease and acute aortic syndromes and showed the presence of a circumscribed fat-dense mass located in the basal portion of the interventricular septum. Subsequent cardiac MRI confirmed the diagnosis of lipoma of the interventricular septum.

Erdheim-Chester disease is an uncommon non-Langerhans cell histiocytosis affecting multiple systems. There is limited knowledge on the imaging capabilities of this disease. We present an extremely rare case of Erdheim-Chester illness in a 67-year-old man with multisystem involvement, including the cardiovascular system, skeleton, retroperitoneum (renal and adrenal infiltration) and the neurologic system. The involvement of the various organs was thoroughly assessed using multimodal imaging modalities such as computed tomography, magnetic resonance imaging, positron emission tomography and bone scintigraphy. Erdheim-Chester illness was revealed by a bone biopsy. Especially when there is cardiac and cerebral involvement, Erdheim-Chester illness is a rare condition with a poor prognosis. Knowing the imaging characteristics of Erdheim-Chester disease may be helpful in understanding the radiological results of many organs affected by the disease as described and discussed in the current case report.

In this case report we describe an occasional finding of intrathoracic caudate lobe protruding through the diaphragm foramen in a 73-year-old woman who came to our attention for a screening for coronary artery disease, due to the presence of cardiovascular risk. The patient had no symptoms. The computed tomography showed, a circumscribed homogeneous soft tissue mass that protruding through the aortic diaphragmatic foramen that was as isodense as the liver. Moreover was revealed an abnormal artery emerging from the celiac tripod which, through the diaphragmatic foramen, ends in an inferior pulmonary vein creating an arteriovenous malformation.

In this case report, we describe a rare case of inter-atrial septal lipomatosis occasionally found in a PET-CT scan performed in an 81-year-old patient with a history of periprosthetic endocarditis post aortic prosthesis implantation. The patient reappeared in 2022 in the emergency department complaining of symptomatology of worsening asthenia, fever, and elevated inflammatory indices. He was hospitalized in Cardiology department on suspect of recurrence of endocarditis and underwent PET-CT examination that showed an increased metabolic finding at the interatrial septum. On possible suspicion of recurrence of infective endocarditis or cardiac tumor pathology, further diagnostic investigation by cardio-RM examination was requested. However, after radiologic consultation, the previous performed FDG-PET/TC examinations were re-evaluated and a misdiagnosed uptake at this level was revealed, which was assumed to be due to the endocarditis condition because of widespread uptake throughout the perivalvular area.

The presence of synchronous dual hematological diseases is an uncommon finding. We report an unusual case of coexistence of primary central nervous system lymphoma and primary breast lymphoma without systemic involvement in an immunocompetent patient. To our knowledge a similar case has not yet been reported in the literature. We especially focus on presenting the imaging features, the associated clinical findings and treatment management of each entity, with the aim of raising awareness on these two rare types of lymphomas and the possibility of their coexistence.

Jejunal varices are a rare cause of gastrointestinal bleeding. In most cases, they are due to portal hypertension related to liver cirrhosis, less frequently to superior mesenteric vein stenosis (SMV). In this article we describe an unusual case of a 61 year-old male patient who arrived at our emergency department with intermittent variceal bleeding due to jejunal varices causing melena and subsequent chronic anaemia. Patient was indeed discovered to have primary idiopathic superior mesenteric vein stenosis. We managed to treat this patient via SMV stenting through percutaneous transhepatic approach. In cases of upper-GI bleed with negative endoscopy for active bleeding, a contrast-enhanced CT scan should be performed to diagnose jejunal varices and their underlying cause, such as SMV stenosis which is best treated with percutaneous phlebography.

In this paper, we describe a rare case of coronary artery aneurysms occasionally found on a pre interventional Coronary Computed Tomography Angiography performed on a 67-year-old man with a history of aneurysm of the ascending aorta previously treated with Bentall surgery, who arrived at our hospital to have a percutaneous valve-in-valve implantation procedure. Even though the patient was considered not eligible for the procedure, due to his many comorbidities, and conservatively managed, at 1-year followup his angiographic condition remained stable.

Graft-versus-host disease (GVHD) is an immune triggered process leading to severe immune dysregulation and organ dysfunction until death and it is one of the worst medical complications after a transplant. Patients with GVHD may have several neurological alterations: during this acute severe phase there is coexistence of various and nonspecific neurological symptoms. We are reporting a case of a 53 year old woman with severe GVHD after bone marrow transplant with acute neurological signs and symptoms. MRI study showed findings consistent with Posterior reversible encephalopathy syndrome and Wernicke encephalopathy. Keywords: Acute graft-versus-host disease, Posterior reversible encephalopathy syndrome, Wernicke encephalopathy, Magnetic resonance imaging

Osteoid osteoma represents 10%-12% of all benign bone tumors, and is composed by osteoid tissue and reticular and immature bone tissue. Acetabular involvement is very rare (≤1%).In this case report, we describe the treatment of an osteoid osteoma of the acetabulum of a young man using cryotherapy under fluoroscopic guide with the new XperGuide system which is used to reduce X-ray radiation dose and to have a more accurate localization of the lesion compared to computed tomography-guided or surgical ablation. Keywords: Osteoid osteoma, XperGuide, Fluoroscopy, Cryotherapy

Renal reversed rotation is a congenital abnormality due to anomalous kidney rotation around its long axis, resulting in faced laterally renal hilum; this condition is associated with several vascular variants. The aim of this report is to describe the case of a 47-year-old male with renal reversed rotation who came to our attention after ultrasound exam. The association of renal rotation and vascular anomalies increases long-term complications as kidney lithiasis, hydronephrosis, colic pain, hematuria, and renal failure. We decided to study the anatomy and renal function of the reversed rotated kidney by multiphasic computed tomography and renal dimercaptosuccinic acid-scintigraphy. It is critical for urologists and radiologists to recognize this abnormality in order to plan the best treatment and follow-up. Keywords: Congenital renal anomalies, Renal reversed rotation, Computed tomography, DMSA scintigraphy

Nowadays tuberculosis has become a reemerging infectious disease due to the many forms of immunodeficiency. Patients with eating disorders like anorexia nervosa and bulimia are a susceptible group due to the immune impairment correlated with severe malnutrition and their prevalence and incidence is growing.We describe the case of a 31-year-old woman, with long-standing history of anorexia nervosa and bulimia, diagnosed with advanced pulmonary tuberculosis. This case underlines the importance on never neglecting even the slightest symptoms in patients with malnutrition and never excluding this pathology without a proper investigation. Keywords: Tuberculosis, Anorexia nervosa, Paucisymptomatic

We present the case of an adult male who arrived to our emergency room with progressive dyspnea that had been ongoing for 2 months. During the radiological investigation, we found a large intracardiac mass, which invaded the pericardium, pulmonary trunk, pulmonary arteries, and left ventricle. Studies done with the 18FDG-PET/CT scan helped us to determine the malignant nature of the mass and to suspect the diagnosis of rhabdomyosarcoma. Keywords: Cardiac Sarcoma, Computed Tomography, PET/CT

Renal artery stenosis commonly manifests with hypertension refractory to medical treatment. We report a case of renal artery stenosis occurring in a 19-year-old female patient who presented with extremely high blood pressure and bilateral renal stenosis at the duplex ultrasound. Renal angiography confirmed the bilateral and irregular stenosis due to fibromuscular dysplasia, associated to extent collaterals suppling the poststenotic right renal artery. Therefore, angioplasty with drug-eluting balloon was performed in order to obtain a good vessel patency and to improve patency in the long term follow-up. After the endovascular treatment the blood pressure improved markedly, maintaining this result at 12 months follow-up at clinical examination and duplex ultrasound. Keywords: Bilateral renal artery stenosis, Fibromuscular dysplasia

Acute superior mesenteric vein thrombosis was first described in 1935 by Warren and Eberhardt. It is a potentially life-threatening condition, as it can lead to bowel ischemia and, ultimately, infarction. Its etiology may be primary or secondary to acquired prothrombotic conditions. Early recognition of mesenteric venous thrombosis is important, but can be challenging due to its nonspecific clinical presentation. Contrast-enhanced computed tomography is currently the gold standard for diagnosis. Systemic anticoagulation and surgical resection of the necrotic segment are the two main treatments. Here, we describe a case of acute post-traumatic superior mesenteric vein thrombosis, which was treated with systemic anticoagulation and resection of the ischemic bowel segment, with subsequent extension of the thrombosis to the portal vein. Keywords: Thrombosis, Mesenteric vein, Anticoagulation, Small intestine, Resection

Swelling of the inguinal region in a woman is a frequent finding in daily clinical practice. We focused our attention on the possible differential diagnoses, giving emphasis to the less common causes of this frequent female disorder and describing their characteristics in ultrasound and magnetic resonance imaging. The causes of swelling in this region may be multiple and in this paper, we will show a rare case of diagnosis of Nuck's canal cyst in a patient with Kniest Syndrome. Keywords: Cyst, Ultrasound, MRI, Canal of nuck

Soft-tissue hematomas are a common clinical entity often associated with trauma, surgery, and bleeding disorders. In the majority of cases, soft-tissue hematomas acutely appear and spontaneously resolve, but sometimes, they present as swellings that slowly expand and progressively increase with time. We present a case of a 70-year-old man with chronic expanding hematoma of the left flank without any history of recent trauma or other medical disease. The diagnosis could not be confirmed on imaging features alone, so the patient was taken to surgery for open biopsy and excision. In patients with slowly growing extremity masses without recent trauma or chronic medical disorders, the differential diagnosis becomes challenging, and chronic expanding hematoma should be considered in addition to soft-tissue sarcomas and other malignancies.

Gastrointestinal angiodysplasia represents the cause of 6% of lower gastrointestinal tract bleeding, particularly in the elderly. Because of the common presentation and age range of affected patients, often patients with occult or massive gastrointestinal bleedings are investigated with colonoscopy, in the suspect of colonic cancer. Other methods are capsule enteroscopy, angiography, double-contrast barium enema, computed tomography angiography, and radionuclide scanning. In this contribution, we describe a case of colonic angiodysplasia first suspected during computed tomography colonography performed after an incomplete colonoscopy in a patient with recent anemization. The purpose is to highlight the computed tomography colonography imaging characteristics of this rare finding during such examination performed due to suspected colon carcinoma as a complementary or substitutive method of colonoscopy.

Bifid sternum is a rare fusion anomaly of the chest wall that accounts for 0.15% of all chest deformities and may be associated with cardiac or vascular anomalies. It is usually diagnosed and surgically corrected at birth or within the first month of life. Being a diagnosis made during the neonatal period, computed tomography scan and magnetic resonance imaging are not often performed; not so many cases in literature have been studied with II level diagnostic imaging, such as computed tomography or magnetic resonance. We describe a case of bifid sternum, rarely diagnosed in adults, discovered in a 21-year-old woman who came to our Diagnostic Imaging Department to perform a chest magnetic resonance after a chest X-ray.

Well-differentiated retroperitoneal liposarcomas are slow growing and low-grade tumors, reaching usually huge size before being symptomatic and so diagnosed, therefore with increase of the surgical risk and of the probability of dedifferentiation. Inguinal location of these tumors is unusual and rarely diagnosed.

Penile metastasis from prostate cancer represents a rare condition, associated with poor prognosis. In the literature, authors have reported less than 500 cases of secondary penile cancers, and among these cases of metastases, only 33% are from prostate cancer. Overall reported rate of survival is about 1-24 months. Here, we present an uncommon case of penile metastasis from prostatic adenocarcinoma, with particular focus on the role of computed tomography and magnetic resonance imaging in diagnosis and follow-up.

We report a 26-year-old male patient who was admitted to our emergency department after a traffic accident and who suffered from neck pain. We have found accidentally a dorsal spinous process schisis, a very rare vertebral abnormality, that we recognized in the X-rays imaging performed for the study of the lung parenchyma.

Infective endocarditis can have peri-annular spread and involve the valvular annulus and adjacent cardiac structures, leading to tissue necrosis and peri-annular abscess. This process may cause pseudoaneurysm formation and other rare and potentially life-threatening complications, so their identification and correct diagnosis are crucial.We describe a case of an 81-year-old woman, with a history of aortic valve replacement and worsening of symptoms, that presents at the imaging a pseudoaneurysm of the aortic root complicated at the same time by 2 life-threatening conditions: fistulization in the Right Ventricular Outflow Tract (RVOT) and the compression of Right Coronary Artery (RCA).This case underlines the importance of imaging, especially Coronary Computed Tomography Angiography (CCTA), in the diagnosis and follow-up of infective endocarditis and its complications, especially in a patient not eligible for surgery.