An unusual case of ischemic stroke due to calcified cerebral embolus occurring in a pregnant patient during the peripartum period is reported. The source of the embolus was suspected to be a pelvic phlebolith in origin which paradoxically embolized via a patent foramen ovale to the supraclinoid right internal carotid artery. To our knowledge, this is the first reported case of calcified cerebral embolus attributed to paradoxical embolism of a pelvic phlebolith, and we theorize that introduction of the phlebolith into the venous system may have occurred as a consequence of vascular remodeling due to pregnancy-related hemodynamic changes. Clinicians should be aware of this potential source of calcified cerebral emboli in patients with a patent foramen ovale during pregnancy. Our patient ultimately achieved an excellent outcome with surgical endarterectomy and embolectomy following an unsuccessful attempt at mechanical thrombectomy.

Sherwin Azad

John Anson

Tamara Majic

Raisa Lev

Varoujan Kostanian

Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy

Infantile fibrosarcoma (IF) is a rare malignant fibroblastic tumor that affects infants and young children, occurring most commonly in the extremities. Here, we present a 14-year-old patient with an abdominal mass incidentally detected after a blunt injury to the abdomen. The initial trauma protocol CT revealed a high attenuation mesenteric lesion in the left central abdomen suggestive of mesenteric hematoma. However, the possibility of a solid neoplastic mass lesion could not be excluded. Further evaluation with dynamic contrast-enhanced serial MRI showed a progressive enhancing mass and excluded a hyperacute hematoma with active bleeding. The mass was resected, and histopathological examination and molecular analysis of tumor cells were consistent with a high-grade fibrosarcoma with KMT2D : BCOR fusion.

Kamand Khalaj

Nikoo Fattahi

Allen C. Omo-Ogboi

Jaiyeola O. Thomas-Ogunniyi

Olanrewaju A. Ogunleye

Ashish Khanal

Larry A. Kramer

Incidental Detection of a Rare Pediatric High-Grade Fibrosarcoma in a Post-traumatic Setting: The Conundrum of Intra-Abdominal Hematoma versus Neoplasia

Background. Diffuse idiopathic skeletal hyperostosis (DISH) is a rare noninflammatory disorder impacting spinal longitudinal ligament and enthesis. The majority of DISH cases are asymptomatic or have few manifestations. Manifestations include neck pain and stiffness, stridor, breathing disturbances, and dysphagia. Case Presentation. A mid-aged man with progressive dysphagia to solid food was admitted to Loghman Hakim Hospital. In cervical X-ray, a huge ossification in the anterior longitudinal ligament was evident. Eventually, he was diagnosed with DISH. Because of coronary artery disease, conservative treatment was considered for him. Conclusion. DISH is a rare disorder usually asymptomatic. In this case report, we present a DISH case with progressive dysphagia to solid foods.

Farzin Davoodi

Narges Bazgir

Reza Naseri

Diffuse Idiopathic Skeletal Hyperostosis Causing Progressive Dysphagia: A Case Report and Review

Subcapsular renal hematomas may appear spontaneously in patients in chronic hemodialysis, though other causes as neoplasms, vasculitis, and infections should be excluded. Patients may present with abdominal pain and hemorrhagic shock; hence, early diagnosis is vital. Nephrectomy or renal artery embolization are suitable treatment options.

Jorge Luis Bermudez-Gonzalez

Bethsabel Rodríguez-Encinas

Ángel Miguel Beverido-Florido

Jesús Alejandro Gabutti-Thomas

Spontaneous Subcapsular Renal Hematoma as Cause of Hypovolemic Shock in a Chronic Hemodialysis Patient

Primary chest wall hydatid cyst is a very rare disease in endemic areas. This case report describes a 22-year-old male patient with a 3-year history of chronic left chest pain. He had a history of close animal contact in childhood. Chest computed tomography (CT) scan showed a left upper posterior paravertebral cystic mass with peripheral and intrinsic calcifications. Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) scan showed no significant FDG uptake. Magnetic resonance imaging (MRI) showed a left paravertebral cystic mass with daughter cysts and a peripheral low T2 wall, compatible with hydatid disease. Medical treatment was started, and a follow-up MRI showed rupture of hydatid cysts. The patient underwent surgical resection, and a hydatid disease diagnosis was confirmed by histopathologic examination. During the postoperative hospital course, the patient developed pneumothorax which was successfully treated with a surgical procedure. The patient was discharged with medical treatment (albendazole). In conclusion, this case highlights the importance of considering hydatid disease in the differential diagnosis of chest wall cystic masses, especially in endemic regions, and the value of multimodality imaging in diagnosis and treatment planning.

Waleed Althobaity

Ayman Aldeheshi

Mnahi Bin Saeedan

Primary Chest Wall Hydatid Disease: A Case Report with Multimodality Imaging Findings

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Case Reports in Radiology publishes case reports and case series in all areas of radiology.

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Case Reports in Radiology - Table of contents 2023

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Case Reports in Radiology publishes case reports and case series in all areas of radiology.

Case Reports in Radiology