Cases

65 year-old with lower extremity weakness and patient was afebrile. No appreciable reduced diffusion or hemorrhage/calcification. Post-contrast:  Pathology returned as demyelination.  The patient’s lesion resolved and months later another appeared on the contralateral side.  Treated as an outpt for presumed tumefactive plaque.

Jugular bulb diverticulum dehiscent into IAC – could it cause vertigo?

Unilocular, expansile cystic lesion of body with lingual cortex erosion.  There is no soft tissue component and the lesion extends anteriorly to the mental foramen. Roots of teeth minimally eroded, scalloping of cortex and unerupted 3rd molar tooth is within the posterior wall of the cyst. Keratocystic odontogenic tumor (current name according to Brian’s boss).  […] Read More >

22 year old with recent UTI, now with left flank pain. DX:  Renal vein thrombosis in a circumaortic left renal vein.

Nothing remarkable seen in initial Chest X-Ray. Follow-up C-spine MRI shows Degenerative Disk Disease, but no significant stenosis. Follow-up brachial plexus MRI shows probable Pancoast tumor involving R C8 and T1 nerve roots.  

41 year old female with right sided abdomen pain. CT:  Vague mass in the right adnexa.  Usually, but not always, on a contrast CT you can identify some normal ovarian tissue.  Here it is absent. ULTRASOUND:  Right adnexal mass without flow. TEACHING POINT:  Don't forget to raise the possibility of ovarian torsion when things just […] Read More >

Clinical:  38 year old man with 2nd MTP pain Findings:  OA of the 2nd MTP joint manifested by full thickness chondral loss, subchondral sclerosis, subchondral edema, and joint effusion.  Secondary AVN of the 2nd metatarsal head noted.  Intact plantar plate.

42 yo with intractable sz’s and L eye blindness with an afferent pupillary defect.  Works a desk job and does not drive due to the sz’s.  Has normal mentation and right eye vision without endocrine abnormalities. This is a subgroup of septo-optic dysplasia that has schizencephaly.  Besides seizures this patient was essentially asx.

Cortical involvement, nodule of enhancement. Exams from 2008 and 2011each read as nonspecific lesion, tumor vs. perivascular space. Notice the change on post-contrast imaging (2008 – no enhancement, 2011 – no enhancement and 2012 – nodular enhancement).

Reportedly a schwannoma. Should consider extra-adrenal pheo of organ of Zuckerkandel. Slides 5-10 – Comparison Case Slides 9-10 – Extraadrenal Pheochromocytoma