We describe a large functioning non metastasizing ACC in 8 years old boy who presented with a history of precocious puberty noticed by his parents since 3 months .Ultrasound of the abdomen showed a large well defined right suprarenal mass with calcification and necrosis . MRI showed the mass to be hypojntense to liver on T1 and hyperintense to liver on T2, and dynamic CT scan revealed a large hetrogenous enhancing right suprarenal mass with calcification and necrosis , clear chest .Histopathology done after surgical removal reveal adrenocortical carcinoma,so we recommend to do an abdominal ultrasound to any child with precocious puberty because it is easy,cheap and non invasive , if any suprarenal mass found it should be further characterized by MRI and dynamic conontrast enhanced CT to determine its respectability
Multiple Sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Up to 10 % of MS patients have onset in paediatric age group. Although the clinical profile of MS appears similar to that seen in adults, several features may differ and specific issues arise in children. Here, we reported a 12-year old girl who presented with 3-year history of episodes of seizures and facial nerve palsy and finally fatigue and cognitive impairment were noted and interfered with her academic performance. Because of the presumed atypical clinical presentations, the diagnosis was missed then dismissed despite neuroimaging features and CSF immunological findings that were highly suggestive of MS. Later, evolution of the
... Show MoreBackground: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date. Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magneti
... Show MoreBackground: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date.Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magne
... Show MoreAim: is to report a case of trans-oral pin, penetrating base of skull and upper cervical region, which is rarely reported in the literatures and to compare it with other studies reporting similar case.
Patients Methods: the details, the presentation, both clinical and radiological finding, and surgical approach of such a case are presented.
Results: the diagnosis was verified with plain x-rays and C.T. scan with bone study. Surgery was conducted under G.A., the patient was recovered well without neurological deficit.
Conclusion: meticulous and close pre-operative care with safe operator and careful fellow up is mandatory. Surgery only offers the best chance of care.
Background: Joubert syndrome (JS) is a very rare autosomal recessive disorder characterized by agenesis of cerebellar vermis, abnormal eye movements, respiratory irregularities, and delayed generalized motor development. Retinal dystrophy and cystic kidneys may also be associated with this clinical syndrome. The importance of recognizing JS is related to the outcome and its potential complications. This syndrome is difficult to diagnose clinically because of its variable phenotype. Its neuroimaging hallmarks include the characteristic molar tooth sign and bat wing-shaped fourth ventricle
Abstract The avulsion of the flexor digitorum profundus, also known as the jersey finger, is a well-known injury that can be treated surgically. It has been classified into four types, among them type IV which involves tendon avulsion from an associated bony fragment with subsequent retraction to the palm or proximal interphalangeal joint is very rare. We present a case of type IV injury in a 45-year-old man with a pulling-on injury. The repair followed a pull-out technique (reinserting the tendon into the avulsed fragment); the entire reduction was tied over a button on the dorsal aspect of the nail and was augmented with a volar plate. The case was reported due to its rarity. We found that early surgical management of this problem greatly
... Show MoreBackground: Management of immature permanent teeth with necrotic pulp is considered challenging to the clinician. Regeneration of pulp tissue is a relatively new approach for management of these teeth that allow continuation of root maturation rather than formation of just a calcific barrier as in apexification. Method: 9 years-old girl with traumatized upper left central incisor. The clinical and radiographical examinations revealed uncomplicated crown fracture, tenderness to percussion, absence of response to cold vitality test. Diagnostic X-ray revealed open apex with periapical radiolucency. Revascularization was suggested to treat the tooth, starting with irrigation of canal with 5% NaOCl + 3% H2O2, followed by 2 weeks of triple antibi
... Show MoreFibromuscular dysplasia (FMD) is a noninflammatory and nonatherosclerotic arteriopathy that is characterized by irregular cellular proliferation and deformed construction of the arterial wall that causes segmentation, constriction, or aneurysm in the intermediate-sized arteries. The incidence of FMD is 0.42–3.4%, and the unilateral occurrence is even rarer. Herein, we report a rare case of a localized extracranial carotid unilateral FMD associated with recurrent transient ischemic attacks (TIAs) treated by extracranial-intracranial bypass for indirect revascularization. The specific localization of the disease rendered our case unique.
Background: Factor V Leiden mutation is the most common cause of hereditary thrombophilia . this mutation was found to be highly prevalent in the Eastern Mediterranean region , with recently reported prevalence of 3% in random Iraqi blood donors.
Aim of study: to document the case reports of factor V leiden in association with venous thrombosis in Iraqi patients.
Sub. & Methods: Six patients with Doppler confirmed Deep Venous thrombosis attending the Medical City Hospital were evaluated haemostatically and by PCR for the presence of factor Vleiden mutation. The patients had ages ranging between 22-60 years , and included 5 females and one male.
Results: Four were found to be heterozygous, while two were homozygous for this m
Leigh's syndrome, or sub acute necrotizing encephalomyelopathy, is a rare inherited neurometabolic disease of infancy and early childhood with variable course and prognosis. Rarely, it occurs in juveniles and adults. The diagnosis is difficult and still remains to challenge the clinicians on the basis of history; hence the role of imaging is very essential. It is the neuroimaging, chiefly the Magnetic Resonance Imaging showing characteristic symmetrical necrotic lesions in the basal ganglia and/or brain stem that leads to the diagnosis. Late-onset varieties are rare and only few cases were reported all over the world. Here, I report a case of late onset (juvenile) Leigh syndrome presenting with an acute polyneuropathy. Neuroimaging confi
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