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Clear cell adenocarcinoma of the urethra is an extremely rare malignancy with a poor outcome, mainly affecting females in old age. We present the case of a 42-year-old female patient who presented with progressively worsening lower urinary tract symptoms, leading to a cystoscopy-guided core needle biopsy diagnosis of clear cell adenocarcinoma of the urethra. We will mainly discuss the cross-sectional imaging and pathological aspects of the case., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

We hereby present a case of an 18-year-old patient who, following initial cerebrospinal fluid overshunting to relieve a congenital hydrocephalus for Dandy-Walker malformation, developed chronic calcified subdural hematoma or an armored brain as a late complication. Chronic calcified subdural hematoma or armored brain is generally rare, and it is even rarer after overshunting. In this report, we present a rare case of bilateral chronic subdural hematoma, also known as "armored brain", 18 years after a ventriculoperitoneal shunt was placed during infancy. We emphasize the appearance of the lesion on a noncontrast brain computed tomography., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Vascular ring anomalies, represented mainly by the double aortic arch (DAA), account for about 1% of congenital cardiovascular anomalies and are characterized by tracheoesophageal compression due to encircling vascular or ligamentous structures. These anomalies arise from the failure of the right fourth aortic arch to regress during embryonic development, leading to symptoms ranging from respiratory distress to dysphagia. Diagnostic imaging includes chest radiography, CT, MRI, and echocardiography, each with specific considerations, especially in pediatric patients. Management, often surgical, focuses on relieving compression symptoms and has a favorable prognosis. This case series emphasizes the manifestations of the double aortic arch, whether it be respiratory distress or dysphagia, and addresses both right and left dominant arches., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Background: Cervical cancer remains a significant challenge in developing countries, with many patients diagnosed at advanced stages. The clinical staging of cervical cancer is guided by the International Federation of Obstetrics and Gynecology (FIGO) guidelines, while computed tomography (CT) and magnetic resonance imaging (MRI) offer valuable supplemental information. This study aimed to evaluate the initial clinical and imaging stages of cervical cancer and to assess the agreement between these staging methods., Methods: A cross-sectional study was conducted involving 115 newly diagnosed cervical cancer patients at Tikur-Anbessa Specialized Hospital from September 1, 2022, to February 30, 2023. Clinical staging was performed for all patients, with CT staging for 107 and MRI staging for 34. Data were extracted from the hospital's central databases and analyzed using SPSS version 27. Descriptive and reliability analyses were conducted, with statistical significance set at a p-value of <0.05 and a 95% confidence interval., Results: At diagnosis, 61 patients (53%) presented with advanced clinical stages (III-IV). CT imaging indicated advanced stages in 85 patients (73.9%), while MRI was performed on 34 patients. Agreement between clinical and CT-based staging was poor (weighted Cohen's kappa = 0.171, p = 0.016), while agreement between clinical and MRI-based staging was moderate (weighted Cohen's kappa = 0.418, p = 0.007)., Conclusion: Newly diagnosed cervical cancer patients exhibit a high prevalence of advanced-stage disease. There is poor agreement between clinical and CT-based cervical cancer staging, contrasted with moderate agreement between clinical and MRI-based staging., (© 2024 Fami Zekeriya Yusuf, et al.)

Hydatid disease is a common parasitic illness. The paravertebral region is rarely involved. After presenting with chronic posterior upper neck swelling, a 28-year-old male patient underwent successful surgical treatment for a primary hydatid disease of the cervical paravertebral compartment after he presented with chronic posterior neck pain. Magnetic resonance imaging was very helpful in identifying a single, well-encapsulated lesion located in the suboccipital paravertebral region. The lesions contained classic daughter cysts that were isointense to the cerebrospinal fluid on all sequences. He had no abdominal or chest hydatid diseases. Primary hydatid disease is extremely rare in this area, and to our knowledge, only 1 previous case similar to ours exists., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Osteonecrosis is the death of bone cells due to insufficient blood supply; radiotherapy for various underlying malignancies is one of the uncommon causes. Microvascular damage or underlying tissue fibrosis, which leads to an ischemic environment and cell death, is a proposed mechanism. Factors influencing risk of radiation induced AVN include type of radiation whether external beam radiotherapy or brachytherapy, age of the patient, included body part and concomitant additional steroid or chemotherapy treatment. In this case report we brought a case of 40-year-old male patient with right proximal thigh leiomyosarcoma who underwent surgical resection and adjuvant radiotherapy, about a year later when Pelvic MR was done for evaluation of surgical bed and tumor progress right femoral head AVN was detected, the patient was asymptomatic. The exact cut-off radiation dose that causes AVN is unknown and varies across studies, necessitating a cautious study of joints included in the radiation field even in asymptomatic patients for early diagnosis and to prevent morbidity associated with delayed diagnosis., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

This case report describes 2 patients with spinal cord schistosomiasis diagnosed based on a magnetic resonance imaging finding of a unique arborized type of postcontrast enhancement. Both patients presented with back pain and lower limb weakness, and prompt treatment with an anti-schistomal agent and steroid resulted in significant neurological and radiological improvement. The report emphasizes the role of imaging in the early diagnosis of spinal cord schistosomiasis, as well as the importance of early treatment for the best clinical outcomes., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Biliary ascariasis, resulting from the infestation of the biliary system by the roundworm Ascaris lumbricoides, is a rare but important cause of biliary blockage in children. In this case report, we present the clinical and radiological findings of a child who presented with symptoms and signs of ascending cholangitis, which followed biliary ascariasis. Double tube sign, typical for biliary ascariasis, was visualized on real time abdominal ultrasound examination., (© 2024 The Authors.)

Spondylocostal dysostosis (Jarcho Levin syndrome) is a rare costovertebral malformation syndrome that will result in restrictive pulmonary physiology. It manifests its major components at birth. Split cord malformation, together with spondylocostal dysostosis, is even rarer. We hereby report our experience with diagnosing 1 infant with spondylocostal dysostosis and type II split cord malformation using computed tomography and magnetic resonance imaging. We also present a concise summary of previously published case reports and case series involving patients with concurrent spondylocostal dysostosis and split cord malformations., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Castleman's disease is a rare benign lymphangioproliferative disorder. The hyaline vascular subtype has a better outcome and is curable after surgical resection. Typically, Castleman disease manifests in the thorax, with rare reports of a renal hilum location. We present a 42-year-old male patient who had an incidentally detected right hilar hyaline vascular type of Castleman's disease, which we managed with surgical excision. Cross-sectional imaging modalities help in suggesting the diagnosis based on enhancement patterns and, more importantly, define the extent of the tumor pre-operatively. Although the renal hilum is a rare location for Castleman disease, it needs to be considered when imaging features suggest it., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

We report the case of a 9-month-old female infant who presented with a history of enlarging chest wall mass secondary to a lipoblastoma with intrathoracic extension. The baby was successfully treated with a surgical resection. Chest wall lipoblastomas with intrathoracic extension are quite uncommon, with few reports available to date., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Synchronous pancreatic neuroendocrine tumors and renal cell cancer are extremely rare. Von-Hipple-Landau syndrome is a major association. A 43-year-old male patient with left upper quadrant pain and significant weight loss was diagnosed with a synchronous pancreatic tail neuroendocrine tumor with solitary splenic metastasis and a clear-cell renal cell carcinoma of the left kidney. Sonography and a computed tomography scan of the abdomen showed a complex exophytic left renal mass and a necrotic lesion limited to the spleen. Although not apparent on preoperative imaging, distal pancreatic mass was also discovered intraoperatively. Subsequently, left radical nephrectomy, splenectomy, and distal pancreatectomy were performed, and the synchronous primaries and splenic metastasis were confirmed histopathologically. This case is unique in that it demonstrates multiple extremely rare events occurring simultaneously, namely pancreatic and kidney primaries, as well as solitary splenic metastasis., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Pancreatic pseudocysts are benign lesions that typically originate within the pancreatic parenchyma, or peripancreatic tissue. They commonly occur following recurrent episodes of pancreatitis or trauma. In this article, we present a case of a giant pancreatic pseudocyst with unusual trans-spatial extensions and spontaneous size decrement in a 40-year-old male patient with a history of alcohol abuse. He presented with chronic epigastric pain, and a physical examination showed only mild abdominal tenderness. Initial computed tomography showed a giant (18.4cm in its largest axis) pancreatic pseudocyst with left subdiaphragmatic and gastrohepatic extensions and concurrent splenic cysts. On follow-up ultrasound, the pseudocyst showed a significant spontaneous size decrement to less than half of its initial size. The giant size and trans-spatial characteristics of the pseudocyst, along with a relatively benign symptomatology and subsequent spontaneous shrinkage, constitute unique aspects of this case., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Abera et al.)

Sclerosing encapsulating peritonitis is a very rare cause of intestinal obstruction. It usually follows peritoneal dialysis. The idiopathic form is also called abdominal cocoon and is more common in tropical and subtropical regions. We hereby present the clinical histories and imaging findings of 2 confirmed cases of sclerosing encapsulating peritonitis who presented with chronic symptoms of bowel obstruction., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Actinomycosis is an unusual, chronic granulomatous infection caused by Actinomycetes spp. The organism also causes mycetoma, a neglected tropical disease in endemic regions. We present a very uncommon case of extensive actinomycosis of the soft tissues in the neck with perivertebral extension that showed the dot-in-circle sign on magnetic resonance imaging. A 29-year-old male patient presented with progressively enlarging hard posterior neck swelling of 4 years duration. Subsequently, magnetic resonance imaging showed the dot-in-circle sign in an avidly enhancing infiltrative lesion with extensive involvement of the neck and perivertebral soft tissue. The pathologic examination was in line with actinomycosis. The patient responded to high doses of combination parenteral and oral antibiotics., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Background: Intraocular pressure is the only modifiable risk factor for the development and progression of glaucoma. Raised intraocular pressure could cause progressive visual field loss and blindness if left uncontrolled. Adherence to ocular hypotensive medications is vital to prevent optic nerve damage and its consequences. This study was conducted to systematically summarize the magnitude of glaucoma medication adherence and factors influencing adherence to glaucoma medications among adult glaucoma patients in Ethiopia., Methods: Database searches to identify research articles were conducted on PubMed, EMBASE, Cochrane, AJOL, SCOPUS, and Google Scholar without restriction on the date of publication. Data extraction was done using a data extraction Excel sheet. Analysis was performed using STATA version 16. Heterogeneity was assessed using I2 statistics. Pooled prevalence and pooled odds ratio with a 95% confidence interval using a random effect model were computed., Result: We included six studies with a total of 2101 participants for meta-analysis. The magnitude of adherence to glaucoma medication was found to be 49.46% (95% CI [41.27-57.66]). Urban residents (OR = 1.89, 95% CI; 1.29-2.49) and those with normal visual acuity (OR = 2.82, 95% CI; 0.85-4.80) had higher odds of adherence to glaucoma medications. Patients who pay for the medications themselves (OR = 0.22, 95% CI; 0.09-0.34) were found to have 78% lower odds of adherence than their counterparts., Conclusion: The magnitude of glaucoma medication adherence is lower than expected. Place of residence, visual acuity, and payment means had statistically significant associations with glaucoma medication adherence. Tailored health education on medication adherence and subsidization of glaucoma medication is recommended., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Abore et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Tuberculosis is one of the most common pediatric problems, especially in the developing world. In spite of that, intraocular tuberculosis is a rare disease that can easily be confused with other noninfectious processes, even in regions where tuberculosis is rampant. Diagnosis is difficult, yet it is very important to provide effective antituberculosis treatment and avoid potentially sight-losing interventions. We present a case of a 2-year-old child with a positive contact history of tuberculosis who presented with progressively worsening seizures and constitutional symptoms for 6 months. Brain computed tomography revealed right frontotemporal region conglomerated ring-enhancing lesions with central necrosis consistent with tuberculosis. On the same scan, a calcified right retinal lesion with a contrast-enhancing soft tissue component was identified. A chest radiograph and abdominal sonography showed evidence of disseminated tuberculosis. Subsequently, antituberculosis treatment was initiated, and the right retinal lesion improved, thus leading to the imaging diagnosis of right intraocular tuberculosis. Early and accurate diagnosis of retinal tuberculosis is of paramount importance in avoiding potentially catastrophic interventions. Neuroimaging is a useful, noninvasive method to consider this difficult diagnosis and also for follow-up., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Congenital lobar overinflation is a rare but well-recognized congenital cause of neonatal and infantile respiratory distress. At times, the condition can mimic other congenital or acquired diseases and have atypical distribution and imaging patterns. Lobectomy of the involved lobe(s) is curative. We present our experience with 3 surgically confirmed cases of congenital lobar overinflation. Referral papers, patient's charts, including operation notes, and radiographic records were reviewed. All of them were initially misdiagnosed or underdiagnosed based on the initial radiographic examination alone. All 3 were referred to our center with respiratory distress, and the first 2 were treated with antibiotics prior to the settlement of their diagnosis. Chest computed tomography was key in diagnosing all 3 cases. The first patient was a 10-day-old neonate diagnosed with bilateral congenital lobar overinflation. The second patient was a 2-month-old infant diagnosed with right middle lobe disease. In these 2 cases, the initial assessment of the vascularity was atypically excessive in the affected lobe(s). Eventually, correlation with typical concurrent imaging features and the clinical condition of the patients led to the correct diagnosis. The third case was a 4-month-old infant with left upper lobe congenital lobar overinflation. All cases underwent successful surgical treatment. Congenital lobar overinflation is a rare anomaly, and multiple-lobe involvement is even rarer. Vascularity within the affected lobes is a subjective assessment that can be overestimated, leading to confusion, and a feature that needs correlation with other common imaging features and the clinical course of patients., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

An abnormal communication between the extra and intracranial venous structures in the head is called sinus pericranii. The condition usually involves the frontal superior sagittal sinus. Occurrence in the lateral scalp is an uncommon pattern. Its commonest manifestation is scalp swelling, which can be cosmetically unappealing. Radiologic findings play an important role in correctly diagnosing the condition and planning treatment. In this case report, we present the computed tomography findings of a 10-year-old male patient who presented with right scalp swelling. Postcontrast head and neck computerized tomography diagnosed a lateral sinus pericranii with an unusual location in the right scalp that also involves the ipsilateral internal jugular vein. Subsequently, a conservative treatment approach with close clinical follow-up was adopted., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)