Facial nerve hemangioma is a rare vascular lesion of the temporal bone, most frequently arising from the geniculate ganglion of the facial nerve. Imaging plays a pivotal role in its detection and characterization, and the combination of computed tomography (CT) and magnetic resonance imaging (MRI) may allow the diagnosis based on suggestive radiologic features. We report a case of a middle-aged female with a facial nerve hemangioma diagnosed through CT and MRI, emphasizing the main imaging findings and their correlation with previously published descriptions in the literature.

Thoracic outlet syndrome (TOS) results from the compression of neurovascular structures at the thoracic outlet. The clinical presentation of arterial compression ranges from chronic ischemic symptoms, such as upper limb pallor, coldness, and exercise-induced claudication, to acute vascular complications including arterial thrombosis, which may progress to limb-threatening ischemia. We report the case of a 33-year-old patient with no significant medical history who presented with acute ischemia of the left upper limb. Radiological investigations revealed TOS with a cervical rib as the underlying cause of acute limb ischemia. This case underscores the pivotal role of imaging in establishing the etiological diagnosis and identifying vascular complications, thereby enabling rapid therapeutic management.

We report an unusual case of a partially thrombosed aneurysm arising from the descending genicular artery, a supra-articular collateral branch of the popliteal artery, in an 80-year-old man, whose clinical and radiological features initially mimicked a soft-tissue sarcoma. The patient was referred for image-guided biopsy of a left popliteal mass that had been progressively enlarging over nine months and had become bothersome during walking. Magnetic resonance imaging (MRI) revealed a well-circumscribed, heterogeneous lesion with hypointense areas on T1- and PD-weighted images, initially interpreted as a fibrous component suggestive of a sarcoma. A pre-biopsy Doppler ultrasound subsequently demonstrated intralesional arterial flow, prompting computed tomography angiography (CTA), which confirmed a partially thrombosed aneurysm of the descending genicular artery, arising from the supra-articular segment of the left popliteal trunk. The main popliteal artery itself was of normal caliber. The most likely etiology was degenerative, given the patient's age, the diffuse atherosclerotic changes seen on imaging, and the absence of any traumatic, iatrogenic, or systemic predisposing factor. The patient subsequently underwent surgical exclusion of both the aneurysm and its feeding artery, with an uneventful postoperative course. This case illustrates the misleading appearance that aneurysms of popliteal artery branches may have on MRI, and emphasizes that any popliteal mass should be evaluated with Doppler ultrasound before any biopsy is considered, to avoid potentially life-threatening hemorrhage.

Introduction: Spinal epidural abscess (SEA) is an uncommon but serious infection involving the epidural space that may lead to irreversible neurological damage if not diagnosed and treated promptly. Early recognition is often difficult because clinical manifestations are variable and may occur without identifiable risk factors. Case presentation: We report the case of a 58-year-old man with a history of chronic alcohol and tobacco use who presented with sudden bilateral lower limb paralysis associated with urinary dysfunction. In the months preceding admission, he described progressive fatigue, intermittent dorsal pain, and lower limb paresthesia without any history of trauma or invasive procedures. Neurological examination revealed complete motor deficit of both lower extremities with a sensory level below the umbilicus. Imaging studies, including computed tomography and magnetic resonance imaging, demonstrated a posterior epidural collection extending from the sixth to the twelfth thoracic vertebral levels, causing marked spinal cord compression with extension into adjacent paraspinal tissues. The patient underwent urgent decompressive laminectomy with evacuation of purulent material. Microbiological analysis identified Staphylococcus aureus, and appropriate intravenous antibiotic therapy was initiated. Partial neurological recovery was observed postoperatively. Conclusion: This case highlights the importance of considering spinal epidural abscess in patients presenting with acute or progressive neurological deficits and emphasizes the role of early imaging and prompt combined surgical and antimicrobial management in improving outcomes.

Human rabies is a fatal viral encephalitis that presents a profound diagnostic challenge in the absence of a known history of animal exposure. We report the case of a 9-year-old boy from Morocco who presented with fever, seizures, psychomotor agitation, hypersalivation and hydrophobia, despite no reported history of an animal bite or scratch. Brain magnetic resonance imaging (MRI) served as a critical diagnostic tool, strongly suggesting rabies encephalitis by revealing classic bilateral symmetric grey matter hyperintensities in the thalami and temporal lobes. Concurrently, MRI revealed an atypical and rare macrovascular finding: extensive cerebral venous sinus thrombosis of the right transverse and sigmoid sinuses, which likely accounted for additional asymmetric white matter changes. A nuchal skin biopsy analyzed via reverse transcription polymerase chain reaction confirmed the presence of rabies virus RNA. Despite aggressive neurocritical care and therapeutic anticoagulation, the patient’s condition deteriorated, and he passed away on day 9 of admission. This case underscores the dual role of MRI in acute encephalitis: guiding early etiological diagnosis of rabies and identifying concurrent, clinically significant macrovascular complications like cerebral venous sinus thrombosis.

Primary bone lymphoma (PBL) is a rare extra nodal manifestation of non-Hodgkin lymphoma, representing less than 5% of primary bone tumors. Diffuse large B-cell lymphoma (DLBCL) is the predominant histologic subtype, whereas indolent variants, including follicular lymphoma, are infrequently reported. We present three cases of PBL, each illustrating distinct clinical, radiological, and pathological features. The first patient, a 54-year-old woman, presented with progressive left knee pain and swelling. Imaging revealed an extensive osteolytic lesion in the distal femur with soft tissue extension. Histopathology confirmed DLBCL of the germinal center B-cell (GCB) subtype. The second case involved a 54-year-old man with chronic bilateral iliac pain. Pelvic CT demonstrated well-circumscribed osteosclerotic lesions in both iliac wings. Biopsy and immunohistochemistry confirmed primary bone follicular lymphoma, an indolent and rare PBL subtype. The third patient, a 39-year-old woman, presented with recurrent right-sided basi-thoracic pain. Imaging identified a solitary osteolytic lesion in the posterior aspect of the sixth rib. Histopathology confirmed DLBCL. These cases emphasize the heterogeneity of PBL presentations, highlight the critical role of early biopsy for accurate diagnosis, and illustrate the value of a multidisciplinary approach in patient management.

Rasmussen encephalitis (RE) is a rare, progressive inflammatory encephalopathy typically characterized by drug-resistant focal epilepsy, cognitive decline, and unihemispheric brain atrophy. Bilateral involvement remains an exceptional clinical entity with limited documentation in medical literature. We present the case of a 2.5-year-old female who exhibited two separate episodes of febrile status epilepticus impacting alternating hemispheres over a six-month period. Serial neuroimaging was pivotal in tracking the disease; the initial MRI revealed right-sided cytotoxic edema and cortical thickening, while a subsequent scan unveiled new contralateral left-sided cortico-subcortical signal alterations alongside progressive right hemispheric atrophy. Continuous bilateral epileptic activity was further corroborated by electroencephalography (EEG). This case highlights that, while RE is classically unilateral, clinicians must maintain a high index of suspicion for bilateral variants, where sequential multimodal neuroimaging proves indispensable for timely diagnosis, prognostic assessment, and therapeutic planning.

Background: Classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is the most common cause of 46,XX disorders of sex development (DSD), resulting in androgenic virilization of the female external genitalia. Magnetic resonance imaging (MRI) plays a central and increasingly indispensable role in the non-invasive characterization of internal genitourinary anatomy and in guiding multidisciplinary management. Case Presentation: We report a 6-month-old infant registered as male at birth, followed for classical CAH due to 21-hydroxylase deficiency with bilateral adrenal hyperplasia on imaging, subsequently found to have a 46,XX karyotype on genetic testing. Clinical examination revealed pseudo-masculine external genitalia with Prader stage IV–V virilization and bilaterally non-palpable gonads. Biochemical workup confirmed markedly elevated 17-hydroxyprogesterone (17-OHP) and adrenal androgens. Pelvic MRI demonstrated probable clitoromegaly, an identifiable urogenital sinus with a vaginal component, a small median uterus with visible endometrium, bilateral hypoplastic ovarian structures, absence of any male gonadal structure, and left adrenal gland enlargement — consistent with 46,XX DSD with advanced virilization. Conclusion: MRI is a valuable, non-irradiating modality for the comprehensive evaluation of internal genitourinary anatomy in 46,XX DSD secondary to CAH, providing essential information for sex assignment, surgical planning, and multidisciplinary management decisions.

Seminal vesicles are accessory glands of the male genitourinary system and contribute substantially to ejaculate volume, playing a key role in sperm motility and fertility. Congenital abnormalities—most commonly agenesis, fusion, and cystic malformations—are uncommon but well described on imaging, whereas ectopic seminal vesicles are exceedingly rare. We report a 79-year-old man with a history of squamous cell carcinoma of the larynx in whom a right pararectal mass was detected on staging CT and initially suspected to represent lymphadenopathy. CT-guided biopsy and histopathological analysis demonstrated seminal vesicle–type tissue, consistent with an ectopic seminal vesicle. To our knowledge, this represents only the second reported case of an ectopic seminal vesicle, the first case having described an inguinal location.

Jejunal diverticulosis (JD) is a rare condition of the small intestine characterized by acquired pseudodiverticula arising along the mesenteric border. Although most cases remain asymptomatic, complications may occur in a minority of patients and include diverticulitis, perforation, intestinal obstruction, malabsorption, and, more rarely, GI hemorrhage. Bleeding originating from jejunal diverticula is an uncommon but potentially life-threatening cause of obscure GI bleeding (OGIB). We report the case of a 59-year-old woman who presented to the ED with melena associated with symptomatic anemia. Initial gastroduodenal endoscopy failed to identify a source of bleeding. Subsequently, contrast-enhanced CT angiography of the abdomen was performed and demonstrated multiple jejunal diverticula. One diverticulum contained spontaneous hyperdense material on non-contrast images, compatible with intraluminal blood, and was associated with a dilated submucosal vascular structure, suggesting the site of recent hemorrhage. JD is a rare but important cause of OGIB. When endoscopic investigations are inconclusive, CT angiography plays a crucial role in identifying the bleeding source and guiding management. Awareness of this entity and its imaging features is essential for radiologists and clinicians involved in the evaluation of GI hemorrhage.

Medullary cavernomas are rare vascular malformations of the central nervous system composed of dilated, fragile vessels prone to spontaneous hemorrhage. Although spinal localization is less common than cerebral involvement, bleeding may result in severe neurological deficits and significant morbidity. We report the case of an 85-year-old patient with no major relevant history who presented to the emergency department with acute, intense cervical spinal pain associated with rapidly progressive tetraparesis. Neurological examination revealed marked weakness of all four limbs. Initial laboratory tests were unremarkable. Spinal magnetic resonance imaging demonstrated a cervical intramedullary cavernoma associated with surrounding hematomyelia and local mass effect, confirming the diagnosis of hemorrhagic medullary cavernoma. The patient was referred for multidisciplinary neurosurgical assessment. This case highlights the importance of considering hemorrhagic medullary cavernoma in elderly patients presenting with acute spinal pain and rapid neurological deterioration, and underscores the value of prompt MRI and individualized multidisciplinary evaluation for early diagnosis and management.

Introduction and Importance: Morgagni Hernia is a congenital diaphragmatic hernia, typically diagnosed in neonates or infants, but in rare cases, it can present in adults. This condition results from a developmental defect in the diaphragm during embryogenesis, leading to an opening that allows abdominal contents, to herniate into the thoracic cavity. In adults, the presentation is often subtle and may be overlooked until significant symptoms or complications arise. In this case, we report a 50-year-old female with symptomatic Morgagni hernia, highlighting the importance of early recognition and management. Case Presentation: A 50-year-old female patient with a history of adult-onset asthma presented with recurrent chest symptoms, including persistent cough and shortness of breath. These symptoms had been ongoing for several months, prompting further investigation. A contrast-enhanced CT (CECT) of the chest revealed omental fat herniated into the right hemithorax, confirming the diagnosis of a Morgagni hernia. Clinical Discussion: Morgagni hernias are typically diagnosed incidentally on routine chest radiographs when patients are asymptomatic. However, when symptoms do occur, they may mimic various respiratory or gastrointestinal conditions, such as chest pain, cough, or dyspnea, which can be attributed to other more common causes. In the case of adults, the hernia often remains undiagnosed for years or even decades due to the nonspecific nature of the symptoms. This case represents an adult patient with Morgagni hernia who presented with chest symptoms, a relatively rare but significant clinical presentation. The imaging modality of choice for diagnosing Morgagni hernia is CECT, which allows for precise identification of the herniated contents in the thoracic cavity. Surgical repair of the hernia is advised, even in asymptomatic cases, due to the potential for serious complications such as strangulation or incarceration of the herniated bowel. In summary, Morgagni hernia in adults, though rare, should be considered in the differential diagnosis of patients with recurrent chest symptoms, especially when conventional causes of such symptoms have been excluded. Early diagnosis and timely surgical intervention are crucial to prevent complications.

Mucormycosis is a severe, angioinvasive fungal infection associated with elevated mortality rates, particularly in immunocompromised patients. Rhinoorbital mucormycosis (ROM) is one of its most prevalent and fatal forms, typically manifesting with nonspecific sinonasal symptoms before rapidly advancing to orbital and intracranial complications. Prompt identification of subtle imaging signs is essential for early intervention. We present a case of rhinoorbital mucormycosis in a 10-year-old child with Fanconi anemia-associated bone marrow aplasia, emphasizing critical CT findings including obliteration of peri-antral fat, deep facial and masticator space involvement, extension through the sphenopalatine fissure and inferior orbital fissure, and progressive orbital proptosis. This case highlights the pivotal role of CT imaging in early extrasinus disease detection and the unique challenges of management in a severely thrombocytopenic pediatric patient in whom surgical debridement a cornerstone of treatment was formally contraindicated.

Acute necrotizing encephalopathy of childhood (ANEC) is a rare, severe disorder in previously healthy infants and children, associated with high morbidity and mortality. Early recognition is essential for timely management. We report two pediatric cases. A three-month-old female infant presented with hypotonia, feeding refusal, and lethargy; MRI revealed bilateral, symmetrical thalamic lesions with edema. A four-year-old female developed status epilepticus following a febrile illness; imaging showed diffuse, asymmetrical cortical and subcortical lesions, including hemorrhagic changes in the thalami and brainstem. Both patients received aggressive supportive care, immunomodulation with corticosteroids, and empiric antimicrobial therapy. The second patient also required intensive management for status epilepticus. ANEC presents with nonspecific symptoms such as fever, seizures, and altered consciousness. MRI is crucial for diagnosis, demonstrating characteristic lesions that may vary in distribution and severity. Early neuroimaging, prompt supportive care, and awareness of lesion variability are essential for accurate diagnosis and optimizing outcomes in children with ANEC.

Autoimmune pancreatitis is an increasingly recognized variant of chronic pancreatitis, classified into 2 subtypes by the international consensus diagnostic criteria: type 1, associated with IgG4 (Immunoglobulin G4)-related disease, and type 2, a pancreas-specific disorder often linked to inflammatory bowel disease. The diagnosis is based on histology, imaging of pancreatic parenchyma/ducts, serology (serum IgG4 levels), other organ involvement or extrapancreatic manifestations, and response to the steroid treatment. Cross-sectional imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), is crucial for diagnosing both autoimmune pancreatitis subtypes, which exhibit a wide range of imaging patterns, the most commonly described being diffuse pancreatic enlargement with a fibrous pericapsular rim. Multifocal presentations of autoimmune pancreatitis are less common and often more challenging to diagnose because of an important overlap with pancreatic malignancies. Autoimmune pancreatitis is commonly described as a cause of exocrine pancreatic insufficiency; it can also be associated with severe compressive complications, such as biliary dilation and portal hypertension. We report a rare case of a multifocal pattern of type 2 autoimmune pancreatitis, revealed by pancreatic insufficiency, imaged with both CT and MRI, which initially raised suspicion of malignant pancreatic masses, and which was complicated by segmental portal hypertension.

Ischemic strokes resulting from internal carotid artery (ICA) dissection are typically associated with trauma, connective tissue disorders, or spontaneous causes. However, rare mechanical factors-including well-documented compression by the styloid process and, more exceptionally, by the hyoid bone-have been identified as potential triggers of such injuries. The close proximity or elongation of the hyoid bone relative to the ICA may exert pressure on or cause injury to the arterial wall, leading to hemodynamic or embolic ischemia in the anterior cerebral circulation, or to a transient ischemic attack (TIA). Carotid dissection may also occur as a result of repeated or sudden microtrauma. We report the case of a 46-year-old woman with no significant medical history, admitted 2 hours after the onset of ischemic stroke symptoms, which included left-sided heaviness and facial paralysis. The remainder of the clinical examination was unremarkable. Radiological investigations revealed an acute right sylvian ischemic infarction with abrupt occlusion of the ipsilateral middle cerebral artery on CT angiography. Imaging of the supra-aortic trunks demonstrated a dissection of the right ICA in direct contact with the posterior horn of the hyoid bone.

Xanthogranulomatous pyelonephritis (XGP) is a rare, severe form of chronic renal infection associated with long-standing urinary tract obstruction, most commonly due to staghorn calculi. Although considered a benign inflammatory condition, it may rarely be associated with or evolve into squamous cell carcinoma (SCC) of the renal pelvis, an aggressive malignancy with poor prognosis. We report the case of a 55-year-old male with a history of urolithiasis who initially presented with left flank pain. Computed tomography (CT) demonstrated findings consistent with XGP in a non-functioning left kidney. Despite nephrostomy drainage and indication for nephrectomy, the patient was lost to follow-up. One year later, he returned with fever, purulent nephrostomy discharge, anorexia, and weight loss, with marked inflammatory syndrome. Follow-up CT revealed an infiltrative renal mass with heterogeneous enhancement and necrosis, extending beyond the kidney, associated with ureteral involvement, lymphadenopathy, and multiple hepatic lesions. Biopsy of a liver lesion confirmed metastatic squamous cell carcinoma. The patient was managed with urinary diversion and systemic chemotherapy. This case highlights the potential for malignant transformation of untreated XGP into aggressive renal SCC. The presence of infiltrative masses, heterogeneous enhancement, and extrarenal extension on imaging should raise suspicion for malignancy. Early surgical management and close follow-up are essential to prevent disease progression and improve outcomes.

Rectosigmoid endometriosis is an uncommon cause of bowel obstruction and may closely mimic colorectal malignancy, particularly when imaging findings are nonspecific. We report the case of a 39-year-old woman who presented with acute bowel obstruction caused by a stenosing rectosigmoid lesion highly suspicious for cancer. Repeated endoscopic biopsies were inconclusive. Surgical management was performed and was complicated by hemorrhagic shock. Final histopathological examination revealed deep infiltrating endometriosis with rectosigmoid involvement. Postoperative imaging demonstrated extensive pelvic involvement of endometriosis, and subsequent attempts at bowel continuity restoration were unsuccessful due to dense adhesions. This case highlights the diagnostic challenges of bowel endometriosis mimicking colorectal cancer and underscores the importance of multidisciplinary evaluation and advanced imaging in women of reproductive age presenting with tumor-like colorectal lesions.

Haemobilia, a rare but life-threatening condition, requires prompt diagnosis and intervention due to its high mortality risk. Transcatheter arterial embolization has become the gold-standard treatment, offering both diagnostic confirmation and immediate therapeutic efficacy while minimizing invasiveness. We present a case of haemobilia successfully managed with this approach, underscoring its clinical value.