Search

Introduction: Merkel cell carcinoma (MCC) is an aggressive skin tumor of neuroendocrine origin that derives from Merkel cells and occurs predominantly on the head or neck of elderly individuals at an average age of 69 years old. Its main risk factors are immunosuppression and ultraviolet exposure. The diagnosis is established on the histological aspect and completed by immunohistochemistry. Case Report: We report the case of a 65-year-old female patient, with no particular antecedents, who had right axillary swelling. Thoracic computed tomography (CT) showed a large right axillary mass of irregular contours, lobulated, heterogeneously enhanced after CP injection with central hypodense zone of necrosis. The confrontation of the morphological aspect and the results of the immunohistochemistry carried out made it possible to retain the diagnosis of Merkel cell carcinoma. Conclusion: Merkel cell carcinoma is a very aggressive cancer of the elderly. In case of doubt, a biopsy for histological confirmation should be performed. The therapy is usually based on a radical surgery followed by adjuvant radiotherapy.

Atypical breast hyperplasia is a precancerous lesion with a high risk of invasive carcinoma. The atypical character of hyperplasia is confirmed by the absence of anti Ck5/6 immuno-marking in the immunohistochemical study. These lesions are difficult to identify on breast ultrasound. Magnetic reasoning imaging shows non-mass enhancement which can have focal or regional distribution. We report the case of a 53-year-old woman, with a history of infiltrating lobular carcinoma of the right breast treated, in which the senological findings were in favor of atypical ductal hyperplasia of the left breast.

Abdominal wall hernias are a common imaging finding. Their most common complications include bowel obstruction, incarceration, strangulation and trauma. We report an exceptional case of spigelian hernia in 55 years old women complicated by perforation and massive subcutaneous emphysema which was correctly diagnosed by CT scan. This case showed the interest of CT scan with multiplanar reconstructions in the confirmation of the diagnosis.

Introduction: Adenoid cystic carcinoma (ACC) of the lacrimal sac is a rare entity characterized by poor prognosis, because of the high rate of local recurrence and metastasis after treatment. Case Report: A 45-year-old male patient was seen at our institution for epiphora, pain, and swelling of the internal angle of the left eye evolving for three months. The clinical examination revealed a fixed mass above the medial canthus of the left eye with blood discharge from the lacrimal punctum at the pressure of the mass. Orbital magnetic resonance imaging (MRI) showed a left lacrimal sac mass. Incisional biopsy disclosed adenoid cystic carcinoma. Conclusion: This is a rare case of lacrimal sac malignant tumor. Adenoid cystic carcinoma can develop in the salivary or lacrimal glands; however, its occurrence in the lacrimal drainage apparatus is extremely rare. Imaging plays a key role in the diagnosis, thanks to computed tomography (CT) scan and magnetic resonance imaging (MRI) which allow a detailed analysis of the local and distant extension, as well as in post-treatment follow-up.

Introduction: The nasogastric tube (NGT) is frequently used in oncology in patients with tumors of the oral cavity. Often mild in the adults, this technique can lead to a gastric perforation which is a rare emergency surgery and of poor prognosis. Case Report: We report an interesting case of an old lady, tracheotomized for recurrent oral tumor, and got a NGT at his admission. After five days, computed tomography (CT) scan requested for extension assessment, discovered a gastric perforation by nasogastric intubation in the absence of clinical signs on physical examination. On CT scan, we have found evidence of gastric perforation, sign of the falciform ligament, ligamentum teres sign, and pneumoperitoneum. Finally, the patient has undergone a surgical repair. Conclusion: Computed tomography scan allows rapid diagnosis of gastric perforation though it is silent by showing pneumoperitoneum. Clinicians should systematically detect the favoring factors before insertion of NGT and think of any patient with tracheostomy with NGT and developing or not an acute abdomen in the continuations of the intubation.

Introduction: Ovarian vein thrombosis (OVT) is an uncommon but potentially serious clinical disorder, which mostly present in the postpartum period but can also occur with malignant and inflammatory conditions in the non-obstetrical patient. The diagnosis is mainly based on imaging techniques, in particular computed tomography (CT) and magnetic resonance, for their sensitivity and specificity. Case Report: We present a case of a 59-year-old female who was diagnosed with endometrial carcinoma. Her abdominal contrast-enhanced CT revealed an expanded right ovarian vein with soft tissue attenuation material in its lumen extending into the inferior vena cava, reaching the right atrium and ventricle. Conclusion: We describe this case of OVT, because, even though rare, it is a diagnosis to consider. Prompt recognition and treatment are crucial to avoid more severe outcomes.