Nicolette Cassim’s research while affiliated with Eric Williams Medical Sciences Complex and other places

This case highlights the importance of thoroughly investigating incidental findings, particularly in patients with unexplained symptoms. Solitary plasmacytoma, though rare and accounting for 4–5% of plasma cell dyscrasias, can occur outside the spine and may present without systemic symptoms. Early diagnosis through imaging and biopsy is crucial for appropriate management, as these lesions can be effectively treated if identified early.

Amyand hernias are unusual inguinal hernias that contain the vermiform appendix. Rarely, an Amyand hernia can be complicated by acute appendicitis and present a diagnostic dilemma. Herein, we present the case of a complicated Amyand hernia that was initially diagnosed as an incarcerated inguinal hernia. However, imaging later clinched the diagnosis of an Amyand hernia complicated by acute appendicitis.

A ureterocele is a congenital abnormality in which there is abnormal dilatation of the distalmost portion of the ureter, as it enters the urinary bladder. Patients present with frequent urinary tract infections, urinary retention, cyclical abdominal pains, failure to thrive, and hematuria. Ureteroceles are often diagnosed on antenatal ultrasound and sometimes postnatally on ultrasounds done in the setting of a urinary tract infection. This case describes a 51-year-old female who presented with recurrent urinary tract infections. Subsequent imaging with ultrasound, intravenous urogram, and computed tomography demonstrated features typical for bilateral ureteroceles.

Median arcuate ligament syndrome (MALS) is a rare and controversial vascular compression syndrome. In this condition, the median arcuate ligament compresses the celiac artery, resulting in symptoms such as postprandial abdominal pain, vomiting, and weight loss. Its diagnosis is based on clinical findings in conjunction with supporting radiological features such as elevated flow velocities on Doppler ultrasound and focal indentation of the proximal celiac artery with the typical 'hooked' or 'J'-shaped appearance on conventional angiography or computed tomography angiography (CTA). Herein is the case of a 44-year-old female who presented with early satiety, postprandial abdominal pain, vomiting, and weight loss. A computed tomography mesenteric angiogram (CTMA) showed thickening of the median arcuate ligament with a hooked appearance of the celiac artery and thrombosis of the mid to distal superior mesenteric artery with associated ischemia of a short segment of the jejunum. Subsequent Doppler ultrasound demonstrated elevated peak systolic velocities within the celiac artery over the compressed segment, which varied with respiration (end-inspiration: 234.3 cm/s and end-expiration: 373.5 cm/s).

Intraoral foreign bodies (IOFBs) can be seen incidentally on computed tomography (CT) imaging and may mimic pathology. It is therefore important to identify the imaging features of a comestible intraoral foreign body and differentiate them from true pathology to avoid unwarranted patient distress and further imaging or procedures that are unnecessary and costly. This case describes a 31-year-old male who presented to the emergency room following a fall from an eight- foot height, with loss of consciousness for five minutes and right periorbital edema. Subsequent CT imaging of the facial bones revealed multiple facial and orbital fractures as well as a circumscribed, ovoid, hyperdensity with internal air pockets within the inferior left buccal space, which was diagnosed as an intraoral foreign body. Here, we aim to highlight the imaging features of this particular case of comestible intraoral foreign body.

Pituitary adenomas are common primary neoplasms of the pituitary gland, accounting for 10% of all intracranial neoplasms and 30%-50% of all pituitary region masses. They can be broadly classified by size, into pituitary microadenomas (< 10 mm) and pituitary macroadenomas (> 10 mm). Most pituitary microadenomas are asymptomatic and usually found incidentally on imaging performed for other indications. Incidentalomas are usually non-secreting, and are of no clinical consequence. On the other hand, secreting pituitary microadenomas (lactotroph, somatotroph, corticotroph, thyrotroph, and rarely gonadotroph adenomas) present with signs of hormone excess.