Published: 2012 Jul
Issue: 6(7) :: Pages: 9-16

   

Abstract: We report a case of radiation necrosis in an unusual location, the pons, in a patient who had received chemoradiation for nasopharyngeal carcinoma (NPC) over one year prior to presentation. This patient presented with subacute onset of ataxic hemiparesis and slurred speech. Initial magnetic resonance imaging (MRI) studies showed two 1-2cm peripherally contrast-enhancing lesions in the pons with extensive surrounding edema. Proton magnetic resonance spectroscopy (MRS) played a key role in narrowing the differential diagnosis to radiation necrosis. The patient underwent biweekly bevacizumab therapy and has remained clinically stable with radiologic improvement of his lesion. In addition to this case, we present an overview of the use of advanced neuroimaging in distinguishing radiation necrosis of the central nervous system (CNS) from other entities as well as the role of bevacizumab in treatment.

Published: 2012 Jul
Issue: 6(7) :: Pages: 1-8

   

Abstract: Although the overall prevalence of tuberculosis has decreased in the United States, with the increasing prevalence of tuberculosis globally, higher rates of tuberculosis in some states and localities have been reported, with some component probably related to immigrant populations. We report a case of primary pulmonary tuberculosis in a malnourished adolescent.

Published: 2012 Jul
Issue: 6(7) :: Pages: 23-28

   

Abstract: Ureteral polyps are rare causes of ureteropelvic junction (UPJ) obstruction, particularly in children. We report a nine year-old boy with UPJ obstruction initially suggestive of an obstructive urinary stone. CT showed intraureteral calcification at the UPJ and hydronephrosis. A retrograde pyelogram showed narrowing at the UPJ and partial obstruction that was found to be a ureteral polyp. This case illustrates a rare cause of UPJ obstruction that should be considered when the imaging findings and presentation are atypical for more common etiologies of ureteral obstruction.

Published: 2012 Jul
Issue: 6(7) :: Pages: 29-35

   

Abstract: Localized cystic disease of the kidney is a benign nonsurgical entity and presents with multiple cystic lesions in just one portion of the kidney or involves the entire one kidney. We report a case of localized cystic disease of the kidney in a 16 year-old-male. This patient underwent an ultrasound examination and incidentally found to have multiple cysts in the right kidney whereas the left kidney was normal. Diagnosis was confirmed by typical MRI findings, absence of any family history, normal results of urine analysis and renal function tests.

Published: 2012 Jul
Issue: 6(7) :: Pages: 17-22

   

Abstract: Esophageal lipomas are rare tumors, making up 0.4% of all digestive tract benign neoplasms. Most of these lesions are clinically silent as a result of their small size, however, the majority of lesions over 4 cm have been reported to cause dysphagia, regurgitation and/or epigastralgia. We report a case of a 53 year-old African American female who presented with dysphagia. Computed tomography of the chest and esophagram confirmed esophageal lipoma as the cause of the patient`s symptoms. Accurately diagnosing an esophageal lipoma is crucial in order to rule out potential malignant lesions, relieve patient symptoms and plan the appropriate treatment.