Year 2022, Volume 6 - Issue 7

Background: Infrarenal aortic agenesis is an extremely rare condition that has been described in a few case reports in the literature. Imaging clues to distinguish infrarenal abdominal aorta agenesis from other abdominal aortic occlusions include: the absence of an aorta at the infrarenal level without peri-aortic soft tissue or thickening of the aortic wall that suggests vasculitis or mass, and collaterals, such as a Riolan arch, for the anomaly to be life reconcilable. Case Presentation: In this case report, a 60-year-old female patient with a diagnosis of infrarenal segmental aorta agenesis is described. Computed Tomography (CT) angiography was performed to evaluate the vascular involvement of the patient who is followed up with sarcoidosis. It was observed that the abdominal aorta terminated abruptly at the level of the renal arteries, and refilled via collaterals 2 cm distal to this level. Conclusion: Recognition of this very rare entity by the radiologist is important in guiding the clinician in terms of treatment follow-up protocol. It is aimed to make this entity easier to recognize by radiologists with this case report.

Background: Retrocecal hamartomas are rare cystic lesions due to the persistence of the tailgut. Sometimes the epithelial or mesenchymal components of the cyst wall undergo neoplastic transformation, and, within them, carcinomas and sarcomas can develop. Case Presentation: We present the case of a multicystic lesion, discovered in a patient with perineal pain, which the imaging investigations have localized in the retrocecal space. The histological evaluation performed on his excisional biopsy demonstrates a retrocecal hamartoma harboring a neuroendocrine neoplasm. Conclusion: Tailgut cysts (TGC) are quite rare, only sometimes symptomatic, and infrequently, they also undergo a malignant transformation; in particular, the literature reviews report a higher frequency of adenocarcinomas. The differential diagnosis between lesions with different prognoses and pathogenesis that can develop in the retrocecal space requires a histological examination, which in some cases, becomes essential if we consider the potential for metastatic and local recurrence of any malignant neoplasm that arose in this site.

Background: Herniation of the brain within the cranial vault is rare in newborns and carries a high mortality. Reported cases show herniation downward, through the foramen magnum. This case report uniquely describes upward herniation through the cerebellar tentorium. Case Presentation: A male infant born at 38 weeks gestation had a postnatal collapse at 17 hours. There were no spontaneous movements with hypotonia, reduced reflexes, nystagmus, and seizures. Cranial ultrasound showed diffuse changes in the posterior fossa, with acute cerebellar hematoma confirmed on MRI scan with significant mass effect, herniating the right cerebellar hemisphere in an upward direction. The baby was initially managed on a palliative care pathway but stabilized with clinical and MRI improvements. He survived to discharge and has mild neurological deficits at 14 months of age. Conclusion: Herniation can occur in an upward direction, evoking cerebellar signs like nystagmus in a neonate and it appears to be potentially survivable.

Background: Most cases of negative serology in proven human immunodeficiency virus (HIV) patients occur due to testing during the window period. However, true non-seroconversion is a phenomenon that should always be considered. Case Presentation: A 13-year-old female with a family history of multi-drug resistant tuberculosis (MDR-TB) presented with cough without fever for 1 month. She was vitally stable and the physical examination was unremarkable. Chest X-ray was suggestive of active TB, sputum positive for acid-fast bacilli, and GeneXpert positive for Mycobacterium tuberculosis. Her HIV RNA polymerase chain reaction (PCR) was positive at 28,866 IU/ml. She was registered as presumed MDR-TB and started on anti-tuberculosis treatment. Serum specimen sent inadvertently 6 weeks later was positive for HIV- p24 antigen while negative for anti-HIV ½ on Determine HIV Early Detect fourth generation lateral flow assay. A fresh specimen 2 weeks later showed similar results and was also negative by Alinity HIV Ag/antibody Combo (Abbott Diagnostics) and Bio-Rad Geenius HIV-1/2 Supplemental Assay. HIV antibodies were still negative at 20 weeks (5 months) after positive PCR. Conclusion: This is a case of a seronegative HIV/TB co-infected patient. Non-seroconversion should always be considered in patients with clinical suspicion and discordant results.

Introduction: The condition known as scrotal cystocele occurs when the urinary bladder slides through the inguinal canal and fills the scrotum. It is a rare condition that typically affects obese male patients between the ages of 50 and 70. Massive scrotal cystocele in men younger than 45 or in the pediatric population is uncommon. Most people with scrotal cystocele are asymptomatic or present with the typical two-phase micturition with intermittent swelling that goes down after voiding. Presentation of the case: We present the case of a 44-yearold obese man who visited the radiology department with unusual symptoms, such as urinary frequency, urgency, nocturia, and suprapubic pain, along with scrotal enlargement. He was diagnosed as having a large scrotal cystocele based on his clinical history and radiological findings. Discussion: Rarely, reported cases include massive scrotal cystocele and left-sided ureter herniation. Preoperative diagnosis of IBH is important to lessen postoperative complications. Conclusion: Ultrasound, computed tomography intra-venous urogram (IVU), fluoroscopic cystography, antegrade IVU, and singlephoton emission computerized tomography aid to diagnose the scrotal cystocele or mimicking inguinal metastasis on bone scan.