Pelvic granulocytic sarcoma

 Granulocytic sarcoma is an uncommon extraskeletal tumor most frequently associated with leukemia. We present a case of bone location with unusual pattern in a patient with no evidence of myeloproliferative disorder at presentation or follow-up.     

Computed tomography of complications caused by manufacturing defects in synthetic grafts

Two unusual cases of delayed synthetic graft complications resulting from manufacturing defects of knitted Dacron are presented. Computed tomography appears to be a suitable noninvasive alternative examination to angiography in this condition.     

Renal transplant dysfunction due to severe aorto-iliac atherosclerosis in the presence of patent renal transplant artery

We report a case of progressive deterioration in renal function and decreased renal graft perfusion induced by extensive aorto-iliac atherosclerotic lesions proximal to a patent renal graft artery. Significant improvement in kidney graft function followed left axillo-femoral bypass graft surgery, which to the best of our knowledge, has never been performed previously for permanent maintenance of renal transplant perfusion.     

Post-traumatic recto-spinal fistula

Acquired recto-spinal fistula has been described elsewhere as a rare complication of colorectal malignancy and Crohn's enterocolitis. We treated a young man who developed a recto-spinal fistula as a result of a high fall injury. The patient presented with meningeal signs, sepsis and perianal laceration. Computerized axial tomography revealed air in the supersellar cistern. Gastrografin enema showed that contrast material was leaking from the rectum into the spinal canal. Surgical management included a diverting sigmoid colostomy, sacral bone curettage and wide presacral drainage. To the best of our knowledge, rectospinal fistula of traumatic origin has not been previously reported in the English literature. Received: 7 December 1998; Revised: 10 May 1999; Accepted: 10 May 1999     

Congenital unilateral hydrocephalus--CT findings

Congenital unilateral hydrocephalus is extremely uncommon with 18 cases previously reported in the English literature. Two additional newborns with unilateral hydrocephalus are presented. The second baby also presented a mega cisterna magna. This unusual association between Dandy-Walker variant and unilateral hydrocephalus has not been previously reported. Following ventriculo-peritoneal shunt, the babies had a normal cognitive neurodevelopment. The role of cranial computed tomography (CT) in diagnosis and follow-up is emphasized.     

C.T. demonstration of metastatic anaerobic orbital abscess.

Orbital abscess of rhinosinogenic origin may develop, either by contiguous spread of the infection or by a thrombophlebitic process. While destruction of the bony walls of the paranasal sinus occurs in propagation of the infection by tissue continuity, haematogenous spread may take place through intact bone. Computed tomography demonstrates the status of the bony partitions shared by the orbit and paranasal sinuses, and the source of the orbital sepsis, thereby influencing the therapeutic approach.     

In utero diagnosis of a vein of Galen aneurysm by ultrasound

Summary A large midline supratentorial cystic lesion with associated cardiomegaly was seen in utero by ultrasound during the 34th week of pregnancy. The provisional diagnosis of a vein of Galen aneurysm was confirmed with CT and angiography after birth.     

Unilateral cerebellar hypoplasia

A case of unilateral cerebellar hypoplasia is presented. This was an incidental finding in a patient with no evidence of neuromuscular or metabolic disease and no past history of trauma, anoxia, or perinatal difficulties. Computed tomographic scans showed posterior fossa asymmetry with underlying unilateral cerebellar hemisphere hypoplasia. In addition, there was overlying skull table thickening and excess petrous pneumatization on the affected side.     

Intrathoracic rib demonstrated by helical CT with three-dimensional reconstruction

Intrathoracic rib is a rare congenital anomaly. An unusual location with atypical pleural tenting is reported. Helical CT with three-dimensional reconstruction seems the best modality for demonstrating the origin and location of these abnormal ribs. The importance of the diagnosis of intrathoracic rib is to rule out pulmonary lesions and prevent unnecessary investigations. Received: 21 November 1997; Revision received: 6 February 1998; Accepted: 26 March 1998     

Benign hamartoma of the lung presenting as massive hemoptysis

A case is presented of benign pulmonary hamartoma causing episodes of hemoptysis. This is an extremely unusual manner of presentation for such lesions.