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Giant splenic artery pseudoaneurysm fistulizing to the colon: A case report and focused literature review 巨脾动脉假性动脉瘤致结肠瘘:1例报告及重点文献复习
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-01-27 DOI: 10.1016/j.radcr.2025.12.047
Tom Simon MSc , Nicolas Brassart MD
Splenic artery pseudoaneurysm (SAP) is a rare but dangerous visceral arterial lesion, and fistulization into the gastrointestinal tract is an exceptional and life-threatening complication. We report the case of a 73-year-old woman presenting with acute lower gastrointestinal bleeding caused by a giant SAP that had eroded into the splenic flexure of the colon. Proximal embolization using coils and Onyx achieved initial hemostasis. Although the patient was clinically stabilized, she later developed delayed septic and inflammatory complications requiring splenectomy, colonic resection, partial gastrectomy, and removal of the aneurysmal sac. This case, together with our focused review of published SAP fistula cases, highlights that embolization should be considered a temporizing measure when gastrointestinal fistulization is present; early surgical management remains essential to prevent severe infection and multi-organ complications.
脾动脉假性动脉瘤(SAP)是一种罕见但危险的内脏动脉病变,而进入胃肠道的瘘管是一种罕见且危及生命的并发症。我们报告的情况下,一个73岁的妇女提出急性下消化道出血引起的一个巨大的SAP已经侵蚀到结肠脾弯曲。近端栓塞使用线圈和玛瑙实现初步止血。虽然患者临床稳定,但后来出现迟发性脓毒症和炎症并发症,需要脾切除术、结肠切除术、部分胃切除术和切除动脉瘤囊。本病例,连同我们对已发表的SAP瘘病例的重点回顾,强调当存在胃肠道瘘时,栓塞应被视为一种暂时措施;早期手术治疗对于预防严重感染和多器官并发症仍然至关重要。
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引用次数: 0
The role of multimodal imaging in diagnosis in the diagnosis of epididymal metastasis from prostate carcinoma: A case report 多模态影像在前列腺癌附睾转移诊断中的作用:1例报告
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.radcr.2026.01.005
Valentina Testini MD , Laura Eusebi MD , Giuseppe Sortino MD , Mobin Safi MD , Giuseppe Guglielmi
Prostate cancer is a common malignancy in men, typically metastasizing to bones, lymph nodes, and visceral organs. Epididymal metastasis, however, is extremely rare, with a reported prevalence of less than 4% and usually identified incidentally. We report the case of a 72-year-old male with a history of high-risk prostate adenocarcinoma previously treated with radical prostatectomy. During follow-up, the patient presented with a painless right scrotal nodule and a concurrent rise in serum PSA levels. Scrotal ultrasound and contrast-enhanced ultrasound (CEUS) revealed a solid, hypervascularized lesion in the right epididymis. PSMA PET-CT confirmed intense radiotracer uptake at the same site, consistent with metastatic disease. No other distant metastases were detected. The patient was treated with hormonal therapy and monitored through imaging and PSA levels, showing partial response. This case underscores the importance of considering atypical metastatic sites in prostate cancer follow-up. Multimodal imaging, especially CEUS and PSMA PET-CT, plays a pivotal role in the detection and characterization of rare metastatic localizations.
前列腺癌是男性常见的恶性肿瘤,通常转移到骨骼、淋巴结和内脏器官。然而,附睾转移极为罕见,据报道患病率不到4%,通常是偶然发现的。我们报告的情况下,一个72岁的男性与历史的高风险前列腺腺癌先前治疗根治性前列腺切除术。在随访期间,患者表现为无痛性右阴囊结节,同时血清PSA水平升高。阴囊超声和造影增强超声(CEUS)显示右侧附睾有实性血管充血病变。PSMA PET-CT证实同一部位有强烈的放射性示踪剂摄取,与转移性疾病一致。未发现其他远处转移。患者接受激素治疗,并通过影像学和PSA水平监测,显示部分反应。这个病例强调了在前列腺癌随访中考虑非典型转移部位的重要性。多模式成像,特别是超声造影和PSMA PET-CT,在罕见转移定位的检测和表征中起着关键作用。
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引用次数: 0
Bizarre parosteal osteochondromatous proliferation of the temporal bone: A case report 颞骨怪异骨旁软骨瘤增生1例
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-01-31 DOI: 10.1016/j.radcr.2026.01.020
Mohammed M. Kanani MS , Sara Haseli MD , Majid Chalian MD , Kelsey V. Maher MD
Bizarre parosteal osteochondromatous proliferation (BPOP), or Nora’s lesion, is a rare benign surface bone lesion typically arising in the hands and feet. We report an unusual case involving the temporal bone in a 63-year-old woman, presenting with progressive external auditory canal obstruction and hearing-related symptoms. Imaging revealed a well-circumscribed osseous mass without corticomedullary continuity, and surgical excision with canaloplasty led to complete symptom resolution. This case expands the recognized anatomical spectrum of Bizarre parosteal osteochondromatous proliferation (BPOP) and underscores the importance of including it in the differential diagnosis of surface bone lesions in the craniofacial region, where even benign processes may result in significant functional impairment due to local anatomy.
奇异骨旁软骨瘤增生(BPOP),或诺拉病变,是一种罕见的良性表面骨病变,通常发生在手和脚。我们报告一个不寻常的病例涉及颞骨的63岁妇女,表现为进行性外耳道阻塞和听力相关症状。影像学显示一个界限清晰的骨性肿块,没有皮质-髓质连续性,手术切除与椎管成形术导致症状完全解决。本病例扩展了奇异骨旁软骨瘤增生(BPOP)的解剖学范围,并强调了将其纳入颅面区表面骨病变鉴别诊断的重要性,在颅面区,即使是良性病变也可能由于局部解剖而导致严重的功能损伤。
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引用次数: 0
A case of prune belly syndrome with patent urachus: Pediatric surgical aspects of a rare case report 梅干腹综合征伴尿管未闭:儿科外科方面一例罕见病例报告
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-01-21 DOI: 10.1016/j.radcr.2025.12.028
Mutasem Sayyed Ahmad , Taha Mahmoud AlBaik , Hossam Salameh , Nasim Abukaresh , Masa Al-shareef , Mosaikah Anati
Prune belly syndrome (PBS), or Eagle–Barrett syndrome, is a rare congenital disorder defined by a triad of abdominal wall hypoplasia, urinary tract anomalies, and bilateral cryptorchidism. It is associated with high perinatal morbidity and mortality. A male infant born at 37 weeks via vaginal delivery presented with abdominal distension, thin wrinkled abdominal skin, urine discharge from the umbilicus, and bilateral cryptorchidism. Imaging revealed severe bilateral hydronephrosis and a patent urachus, confirming Prune Belly Syndrome. The urachus was surgically closed without complications, and the patient remains stable, with planned further interventions including orchidopexy, abdominal wall reconstruction, and renal functional assessment. Prune Belly Syndrome a rare congenital disorder, presents diagnostic and management challenges particularly with patent urachus requiring early recognition, timely surgery, and multidisciplinary follow-up to optimize renal function and long-term outcomes.
梅干腹综合征(PBS),或Eagle-Barrett综合征,是一种罕见的先天性疾病,由腹壁发育不全、尿路异常和双侧隐睾三联症定义。它与围产期高发病率和死亡率有关。37周阴道分娩的男婴表现为腹胀,腹部皮肤薄皱,脐尿排出,双侧隐睾。影像学显示严重的双侧肾积水和尿管未闭,证实梅干腹综合征。手术关闭尿管,无并发症,患者保持稳定,计划进一步干预,包括睾丸切除术、腹壁重建和肾功能评估。梅干腹综合征是一种罕见的先天性疾病,其诊断和治疗具有挑战性,特别是尿管未闭,需要早期识别、及时手术和多学科随访以优化肾功能和长期预后。
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引用次数: 0
Rasmussen aneurysm: A rare complication of pulmonary tuberculosis case report 拉斯穆森动脉瘤:一罕见的肺结核并发症
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-01-24 DOI: 10.1016/j.radcr.2025.12.031
Harry Galuh PhD , Dian Komala Dewi MD , Pramesti Indri MD , Ferdy Ferdian MD , Shindy Octaviana MD
Rasmussen’s aneurysm is a rare but potentially fatal complication of pulmonary tuberculosis (TB), characterized by the development of a pseudoaneurysm in the pulmonary arterial system due to chronic inflammation and weakening of the vessel wall. This condition arises from tuberculous destruction of lung parenchyma, leading to erosion of adjacent pulmonary arteries and subsequent aneurysm formation. Clinically, it presents with life-threatening hemoptysis, often requiring prompt diagnosis and intervention. Imaging modalities such as contrast-enhanced computed tomography (CT) and digital subtraction angiography (DSA) play a crucial role in identifying the aneurysm and guiding treatment. Management options include transcatheter arterial embolization, which is the preferred intervention, or surgical resection in select cases. Early recognition and timely treatment of Rasmussen’s aneurysm are essential to prevent catastrophic hemorrhage and improve patient outcomes.
拉斯穆森动脉瘤(Rasmussen’s动脉瘤)是肺结核(TB)的一种罕见但可能致命的并发症,其特征是由于慢性炎症和血管壁削弱而在肺动脉系统中形成假性动脉瘤。这种疾病是由肺实质的结核性破坏引起的,导致邻近肺动脉的侵蚀和随后的动脉瘤形成。临床上,它表现为危及生命的咯血,通常需要及时诊断和干预。成像方式,如增强计算机断层扫描(CT)和数字减影血管造影(DSA)在识别动脉瘤和指导治疗方面起着至关重要的作用。治疗方案包括经导管动脉栓塞,这是首选的干预措施,或在某些情况下手术切除。早期识别和及时治疗拉斯穆森动脉瘤是必不可少的,以防止灾难性出血和改善患者的预后。
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引用次数: 0
Budd-Chiari syndrome in a young adult: Failed hepatic venoplasty and refusal of liver transplantation 一例年轻成人Budd-Chiari综合征:肝静脉成形术失败并拒绝肝移植
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-01-19 DOI: 10.1016/j.radcr.2025.12.034
Mujtaba Jamal Qureshi , Areeba Batool , Suleman Anser MBBS , Muhammad Afzal Chaudhry FCPS, MD , Mohammad Akram Randhawa PhD
This case report details the diagnostic workup, therapeutic interventions, and clinical decision-making in the management of a 23‐year-old engineering student diagnosed with Budd‐Chiari syndrome (BCS). This report highlights the use of advanced imaging studies and laboratory investigations, outlines the interventional approach, including an unsuccessful attempt at hepatic venoplasty, and discusses the patient’s subsequent refusal of liver transplantation. The patient remained clinically stable for 2 years under anticoagulant therapy. Such refractory cases underscore the need for personalized and multidisciplinary treatment strategies for BCS management.
本病例报告详细介绍了一位23岁的工程专业学生诊断为Budd - Chiari综合征(BCS)的诊断检查、治疗干预和临床决策。本报告强调了先进影像学研究和实验室调查的应用,概述了介入方法,包括一次不成功的肝静脉成形术尝试,并讨论了患者随后拒绝肝移植的情况。患者在抗凝治疗下保持临床稳定2年。这些难治性病例强调了BCS管理需要个性化和多学科治疗策略。
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引用次数: 0
Artery of percheron infarction and a very rare finding of ping pong gaze: A case report 乒乓球凝视中发现的非常罕见的动脉梗死1例。
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI: 10.1016/j.radcr.2026.01.004
Md. Deluwar Hussen MBBS, Zareen Tabassum MBBS
The Artery of Percheron (AP) is a rare anatomical variation where both paramedian thalami and the rostral midbrain receive a supply from a single perforating artery that branches off the posterior cerebral artery. When this artery becomes infarcted, this results in a unique phenomenon of bilateral thalamic as well as midbrain ischemia. A 70-year-old male showed up in the emergency department following a fall. He was oriented and awake with abnormal, slow, conjugate horizontal gaze abnormalities typical of ping pong gaze. The rest of the neurological exam was normal. Cranial computed tomography (CT) was normal initially. Magnetic resonance imaging (MRI) of the brain showed bilateral hyperintensities in the paramedian thalami. Magnetic resonance angiography (MRA) showed only 1 perforating artery originating on the P1 segment of the right posterior cerebral artery, which is consistent with an artery of Percheron infarction. Although vertical gaze palsy is frequently reported, ping-pong gaze is unusual and uncommon in this context. The unusual clinical finding of ping pong gaze can be a valuable additional feature of artery of Percheron infarction. Early MRI and MRA are critical for early diagnosis and proper treatment of this disease despite negative CT scan for better outcome.
旁切隆动脉(AP)是一种罕见的解剖变异,其中丘脑旁正中部和吻侧中脑均由一条从大脑后动脉分支出来的穿通动脉供应。当这条动脉发生梗死时,会导致双侧丘脑和中脑缺血的独特现象。一名70岁的男性在跌倒后出现在急诊室。他是定向和清醒的异常,缓慢,共轭水平凝视异常典型的乒乓球凝视。其余的神经系统检查都正常。头颅计算机断层扫描(CT)最初正常。脑磁共振成像(MRI)显示双侧丘脑旁正中区高信号。磁共振血管造影(MRA)显示仅1条穿通动脉发源于右侧大脑后动脉P1段,符合Percheron梗死动脉。虽然垂直凝视麻痹经常被报道,但乒乓球凝视在这种情况下并不常见。乒乓球凝视的不寻常的临床表现可以作为Percheron动脉梗死的一个有价值的附加特征。早期MRI和MRA对于早期诊断和正确治疗这种疾病至关重要,尽管CT扫描阴性,但效果更好。
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引用次数: 0
Multifocal streptococcus intermedius abscess mimicking neurocysticercosis clinical and radiological findings: A case report and literature review 模拟神经囊虫病的多灶性中间链球菌脓肿临床及影像学表现:1例报告及文献复习
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI: 10.1016/j.radcr.2025.12.056
Shuang Xu MBBS, MSc , Dylan Khoo MD , Jorn Van der veken MD , Jamie Miller MD, MSc , Marc Agzarian BMBS(Hons), FRANZCR , Jie Ding BSc, MSc
Streptococcus intermedius is an opportunistic pathogen capable of causing rapidly progressive, life-threatening cerebral abscesses. Diagnosis can be difficult because clinical features are nonspecific, cerebrospinal fluid findings may be negative, and biopsy results take time. Neuroimaging therefore plays a crucial role. While most reported S. intermedius abscesses present as a single lesion, we describe an immunocompetent young man with unusual multifocal brain involvement initially mistaken for neurocysticercosis. A 33-year-old male presented with fever, headache, and rapidly progressive confusion. CT brain was unremarkable, whereas MRI demonstrated multiple ring-enhancing lesions with marked diffusion restriction across both hemispheres, the brainstem, and cerebellum. These were first interpreted as neurocysticercosis; however, stereotactic biopsy confirmed S. intermedius. Retrospective MRI review showed features favouring pyogenic abscess—uniform profound restricted diffusion, peripheral susceptibility from haemorrhage, and absence of a scolex. The patient was already receiving ceftriaxone for pneumonia, which also covers S. intermedius, and improved clinically with subsequent radiological resolution. This case highlights that S. intermedius abscesses may occur in immunocompetent hosts and closely mimic parasitic infection. Careful evaluation of MRI characteristics and early biopsy are essential for correct diagnosis. Prompt treatment with ceftriaxone and metronidazole can be lifesaving, and increased awareness may prevent future misdiagnosis.
中间链球菌是一种机会性病原体,能够引起迅速进展,危及生命的脑脓肿。诊断可能很困难,因为临床特征非特异性,脑脊液检查结果可能为阴性,活检结果需要时间。因此,神经影像学起着至关重要的作用。虽然大多数报道的中间棘球蚴脓肿表现为单一病变,但我们描述了一位免疫功能正常的年轻男性,异常多灶性脑受累,最初被误认为是神经囊虫病。一名33岁男性,表现为发热、头痛和迅速进行性意识不清。CT脑未见明显病变,而MRI显示多发环增强病变,双脑半球、脑干和小脑弥散受限。这些最初被解释为神经囊虫病;然而,立体定向活检证实为中间葡萄球菌。回顾性MRI检查显示化脓性脓肿的特征-均匀的严重扩散受限,周围出血易感性,无头节。该患者已接受头孢曲松治疗肺炎,其中也包括中间链球菌,并在随后的放射学消退中临床改善。本病例强调中间棘球绦虫脓肿可能发生在免疫正常的宿主中,并与寄生虫感染非常相似。仔细评估MRI特征和早期活检是正确诊断的必要条件。及时使用头孢曲松和甲硝唑治疗可以挽救生命,提高认识可以防止未来的误诊。
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引用次数: 0
A true trilobed gallbladder, an extremely rare gallbladder malformation 真正的三叶胆囊,一种极其罕见的胆囊畸形
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-02-05 DOI: 10.1016/j.radcr.2026.01.012
Bewuketu Kefyalew MD, Alamirew Beneberu MD
Congenital anomalies of gallbladder are very rare and a true trilobed anomaly of the gallbladder is extremely rare that there is only a single case report in the world literature. This case presents the second case of a true trilobed gallbladder, a different entity from the triple gallbladders, where 3 different lobes of the gallbladder are interconnected to each other by a narrow neck like communication and drains to a single cystic duct through one of the lobes.
先天性胆囊异常非常罕见,真正的三叶状胆囊异常极为罕见,在世界文献中只有一例报道。本例为真正三叶胆囊的第二例,与三叶胆囊不同,三叶胆囊的三个不同叶通过狭窄的颈状通道相互连接,并通过其中一个叶流入单个囊管。
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引用次数: 0
Shrinking hemangiomas amid advancing cirrhosis: A report of 2 cases 肝硬化进展期血管瘤萎缩2例报告
Q4 Medicine Pub Date : 2026-04-01 Epub Date: 2026-01-13 DOI: 10.1016/j.radcr.2025.12.020
Hari Movva MD , Christo Mathew MD , Shiv Patel BS , Jimmy George MD , Vikas Burugu BS , Peeyush Bhargava MD
Hepatic hemangiomas are the most common benign tumors of the liver. They typically display stable imaging features in non-cirrhotic livers. However, in the setting of cirrhosis, their imaging appearance may change dramatically, posing notable diagnostic challenges during hepatocellular carcinoma (HCC) surveillance. The shrinkage and altered imaging characteristics of hemangiomas in cirrhotic livers likely reflect fibrotic remodeling and changes in hepatic perfusion rather than true lesion involution. We highlight how fibrotic compression, vascular redistribution, and capsular retraction may cause hemangiomas to appear smaller or display atypical features on imaging, posing a diagnostic challenge. These changes can even mimic malignancy transformation, reducing clinical confidence and leading to potential misdiagnosis. Clinicians must remain aware of these potential pitfalls to avoid unnecessary intervention, maintain appropriate management, and approximate the true progression of hemangiomas in the setting of cirrhosis. Here, we report 2 cases of hepatic hemangiomas in patients with cirrhosis that demonstrated apparent regression on serial MRI. In both cases, hemangioma size decreased over time in conjunction with advancing parenchymal fibrosis, increased nodularity, and signs of portal hypertension. Despite the reduction in size, neither patient showed imaging features concerning for malignancy, and both remained stable with respect to liver function.
肝血管瘤是肝脏最常见的良性肿瘤。它们通常在非肝硬化肝脏中显示稳定的影像学特征。然而,在肝硬化的情况下,它们的影像学表现可能会发生巨大变化,这在肝细胞癌(HCC)监测中提出了显著的诊断挑战。肝硬化肝血管瘤的缩小和影像学特征改变可能反映了纤维化重塑和肝灌注的改变,而不是真正的病变复归。我们强调如何纤维化压缩,血管重新分布,和包膜缩回可能导致血管瘤看起来更小或显示非典型特征的影像学,提出了诊断的挑战。这些变化甚至可以模拟恶性转化,降低临床信心,导致潜在的误诊。临床医生必须意识到这些潜在的陷阱,以避免不必要的干预,保持适当的管理,并在肝硬化的情况下近似血管瘤的真实进展。在此,我们报告2例肝硬化患者的肝血管瘤,在连续MRI上表现出明显的消退。在这两种情况下,血管瘤的大小随着时间的推移而减小,同时伴有实质纤维化的进展,结节性增加和门静脉高压的迹象。尽管体积减小,但两名患者均未表现出与恶性肿瘤有关的影像学特征,并且两名患者的肝功能均保持稳定。
{"title":"Shrinking hemangiomas amid advancing cirrhosis: A report of 2 cases","authors":"Hari Movva MD ,&nbsp;Christo Mathew MD ,&nbsp;Shiv Patel BS ,&nbsp;Jimmy George MD ,&nbsp;Vikas Burugu BS ,&nbsp;Peeyush Bhargava MD","doi":"10.1016/j.radcr.2025.12.020","DOIUrl":"10.1016/j.radcr.2025.12.020","url":null,"abstract":"<div><div>Hepatic hemangiomas are the most common benign tumors of the liver. They typically display stable imaging features in non-cirrhotic livers. However, in the setting of cirrhosis, their imaging appearance may change dramatically, posing notable diagnostic challenges during hepatocellular carcinoma (HCC) surveillance. The shrinkage and altered imaging characteristics of hemangiomas in cirrhotic livers likely reflect fibrotic remodeling and changes in hepatic perfusion rather than true lesion involution. We highlight how fibrotic compression, vascular redistribution, and capsular retraction may cause hemangiomas to appear smaller or display atypical features on imaging, posing a diagnostic challenge. These changes can even mimic malignancy transformation, reducing clinical confidence and leading to potential misdiagnosis. Clinicians must remain aware of these potential pitfalls to avoid unnecessary intervention, maintain appropriate management, and approximate the true progression of hemangiomas in the setting of cirrhosis. Here, we report 2 cases of hepatic hemangiomas in patients with cirrhosis that demonstrated apparent regression on serial MRI. In both cases, hemangioma size decreased over time in conjunction with advancing parenchymal fibrosis, increased nodularity, and signs of portal hypertension. Despite the reduction in size, neither patient showed imaging features concerning for malignancy, and both remained stable with respect to liver function.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"21 4","pages":"Pages 1429-1432"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981674","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}
引用次数: 0
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Radiology Case Reports
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