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Lumbar radiculopathy associated radicular schwannoma: A case report and literature review [Case Report]

Hyseni, Fjolla; Harizi, Edlira; Blanco, Rubén; Bido, Robert; Pichardo, Jessie; Rahman, Masum; Tahir, Muhammad; Guy, Ali; Fathma, Sawsan; Shemsi, Kledisa; Bhatti, Atiq Ur Rehman; Nasir, Fareeha; Decka, Arlind; Ikram, Samar; Kola, Erisa; Musa, Juna
Lumbar radiculopathy is a clinical condition defined by symptoms of pain, weakness, numbness, or tingling due to lumbar nerve root compression in levels L1-L4. Typically, it is characterized by a narrowing near the nerve root possibly caused by stenosis, bone osteophytes, disc herniation, and similar conditions. Reports of lumbar radiculopathy brought about by the presence of a radicular schwannoma are exceedingly rare. In this paper, we discuss the case of a 67-year-old female patient, presenting with complaints of low back pain, numbness, and antalgic gait for the past eight months. Her physical examination revealed motor and sensor neurological deficits affecting the left lower limb. The electromyoneurography evaluation showed neurogenic atrophy of the left radicular area, while the MRI revealed the presence of a giant, radicular schwannoma at L4-L5 level. This case report aims to underscore the clinical course and management of lumbar radiculopathy caused by a rare L4-L5 radicular schwannoma. Our patient had no significant risk factors or previous spinal pathology.
PMID: 35198087
ISSN: 1930-0433
CID: 5164962

Acute spinal cord ischemia in a patient with Situs Inversus Totalis [Case Report]

Hyseni, Fjolla; Hla, Diana; Siddik, Abu Bakar; Ahmetgjekaj, Ilir; Vokshi, Valon; Ikram, Samar; Rahman, Abdur; Shoushtarizadeh, Alireza; Saliaj, Kristi; Guy, Ali; Tahir, Muhammad; Bajwa, Ibrahim A; Mohammed, Essa A; Musa, Juna
Situs inversus totalis (SIT) is a rare developmental abnormality where the organs throughout both the thoracic cavity and abdomen are a mirror image of normal anatomy, often occurring concomitantly with other genetic and developmental defects. Acute spinal cord ischemia is diagnosed based on the clinical presentation along with consistent imaging, but since clinical manifestations of acute spinal cord ischemia- rapidly progressive motor, sensory, and autonomic dysfunction-overlap with a wide spectrum of myelopathies, a thorough diagnostic workup with consideration of inflammatory, infectious, compressive and nutritional etiologies is required to establish the diagnosis. In this report, we present the case of an 18-year-old female patient who was admitted with acute onset of severe lower back pain, progressive weakness, paralysis, loss of sensation in both lower limbs and voiding difficulties. The diagnosis of acute spinal cord ischemia in a patient with situs inversus totalis was made. Our case highlights the spectrum of the pathological entities that can be associated with situs inversus totalis. Due to the lack of the classic signs and symptoms of sinus inversus, a diagnosis of situs inversus totalis with concomitant pathological conditions may require a more in-depth evaluation by complex imaging modalities to ensure a comprehensive assessment of the condition and its associated complications.
PMID: 35003454
ISSN: 1930-0433
CID: 5118312

The importance of computed tomography (CT) scans in the early diagnosis of Gorham-Stout Disease - A case report [Case Report]

Hyseni, Fjolla; Vokshi, Valon; Kola, Erisa; Fathma, Sawsan; Guy, Ali; Bushati, Fiona; Ahmetgjekaj, Ilir; Hla, Diana; Saliaj, Kristi; Ikram, Samar; Mohamed, Essa A; Bajwa, Ibrahim A; Nasir, Fareeha; Musa, Juna
Gorham Stout disease (GSD) or vanishing bone disease is an infrequent entity in clinical practice characterized by gross and progressive bone loss along with excessive growth of vascular and lymphatic tissue. Very little is known about the pathogenesis of GSD, which makes the diagnosis challenging. Due to the rarity of the disease, no treatment guidelines have been created yet. We report a case of GSD in a 53-year-old male patient. He presented with bone pain and initial imaging showed widespread osteolytic lesions in the cervical and mid thoracic spine, ribs, sternum, clavicles, scapula and humerus. Two percutaneous bone biopsies were performed, followed by an open spine biopsy of the L2 spinous processes for histological examination. Unfortunately, no diagnosis was established. Although, he was treated symptomatically, he kept enduring pain and presented again after seven months. His laboratory values were out of the normal range which prompted thorough investigations. New imaging and bone biopsy revealed multiple osteolytic lesions and vascular lesions with cavernous morphology. GSD was diagnosed after ruling out a neoplastic process and confirming the cavernous morphology with immunohistochemical stain. He was treated symptomatically with immunomodulators, bisphosphonates and supplements. Regular follow-up with a specialist was recommended. We hope this case will raise awareness of GSD in common clinical practice and shed some insight on its clinical presentation and the role CT and other imaging modalities play in the diagnosis of GSD.
PMID: 34950281
ISSN: 1930-0433
CID: 5099622

A case with primary hyperaldosteronism associated with chronic kidney disease [Case Report]

Cadri, Vilma; Rista, Elvana; Toti, Florian; Celep, Bahadir; Shehu, Sokol; Dyrmishi, Blertina; Hyseni, Fjolla; Ahsan, Eram; Hla, Diana; Guy, Ali; Ikram, Samar; Rahman, Abdur; Tahir, Muhammad; Musa, Juna
Primary hyperaldosteronism (PA) is one of the most common causes of secondary hypertension. PA may be associated with a decline in renal function. About 20% of cases with resistant HTN eventually cause PA, so all these patients should be evaluated for PA. Herein, we present a case with drug-resistant hypertension and chronic kidney disease (CKD), the cause of which was PA. Despite his low-salt diet modifications and treatment with several classes of antihypertensive medication, he had poorly controlled blood pressure (BP). Measurements of aldosterone and renin raised the concern of PA. Imaging confirmed bilateral adrenal hyperplasia. Due to the persistently high BP, despite the modification of the antihypertensive treatment, the patient underwent unilateral adrenalectomy, as the only feasible possibility of lowering aldosterone levels. After surgery, the patient had an improvement in both BP values and renal function. PA is difficult to diagnose in patients with CKD and Arterial Hypertension because hypertension is often associated with CKD, but PA accounts for a significant percentage of drug-resistant hypertension, so these patients should be screened for secondary arterial hypertension.
PMID: 34987684
ISSN: 1930-0433
CID: 5105942

Corrigendum to 'Anterior interosseous nerve lesion and distal myoclonus revealing a Parsonage Turner Syndrome associated with Hashimoto's thyroiditis' [Radiology Case Reports 16 (2021) 3176-3181]

Musa, Juna; Rahman, Masum; Siddik, Abu Bakar; Saliaj, Kristi; Ikram, Samar; Kola, Ina; Shoushtarizadeh, Alireza; Hyseni, Fjolla; Guy, Ali; Mamica, Inva; Rahman, Abdur; Ahsan, Eram; Cobo, Anisa; Blanco, Ruben
[This corrects the article DOI: 10.1016/j.radcr.2021.07.067.].
PMID: 35140833
ISSN: 1930-0433
CID: 5152972

Corrigendum to 'Ectopic thyroid tissue in the anterior mediastinum along with a normally located gland' (Radiology case reports 16 [2021] 3191-3195)

Kola, Erisa; Gjata, Arben; Kola, Ina; Guy, Ali; Khadra, Ronny; Musa, Juna; Biba, Valbona; Filaj, Vladimir; Horjeti, Edlira; Nakuci, Daniela; Cobo, Anisa; Saliaj, Kristi; Alimehmeti, Mehdi; Hyseni, Fjolla; Siddik, Abu Bakar; Ikram, Samar
[This corrects the article DOI: 10.1016/j.radcr.2021.07.064.].
PMID: 35140835
ISSN: 1930-0433
CID: 5176092

The importance of imaging in tuberous sclerosis complex (tsc) in children: Two cases [Case Report]

Dedushi, Kreshnike; Hyseni, Fjolla; Musa, Juna; Saliaj, Kristi; Vokshi, Valon; Guy, Ali; Bhatti, Atiq; Tahir, Muhammad; Shatri, Jeton; Dervishi, Bardha; Shabani, Krenare; Shatri, Mentor
Tuberous sclerosis complex (TSC) is an inherited, multisystemic, hamartomatous neurocutaneous disorder, with an autosomal dominant inheritance pattern. It affects multiple organs, however the most susceptible ones include the brain, skin, kidneys, lungs, the retina, and the heart. TSC is characterized by considerable clinical heterogeneity. The majority of patients present with a constellation of clinical signs and symptoms, most prominently central nervous system manifestations including epilepsy, cognitive impairment and autism spectrum disorders, cutaneous, cardiac, renal and ophthalmic manifestations. Epilepsy affects 70% - 90% of patients, representing the primary neurological feature and 1 of the foremost clinical findings of the disorder. Cardiac rhabdomyomas are the most frequent cardiac manifestations, appearing as isolated or multiple lesions. Herein, we present 2 patients diagnosed with tuberous sclerosis. A 3-month-old male patient with cardiac rhabdomyomas and hypopigmented macules and a 19-month-old male patient with partial epilepsy and mild psychomotor retardation. As brain lesions represent some of the most prevalent clinical features and early onset seizures are associated with more severe cognitive, function delay, through this article we hope to emphasize the potential role MRI can play in the diagnostic workup of TSC, to ensure a more timely diagnosis, thus modifying the natural course of the disorder and its prognosis.
PMID: 34925673
ISSN: 1930-0433
CID: 5108692

MRI diagnosis of Takayasu arteritis in a young woman [Case Report]

Dedushi, Kreshnike; Hyseni, Fjolla; Musa, Juna; Rahman, Masum; Saliaj, Kristi; Vokshi, Valon; Shatri, Jeton; Siddik, Abu Bakar; Ahsan, Eram; Ikram, Samar; Abdullahu, Blina; Kabashi, Serbeze; Guy, Ali; Ugurel, Mehmet Sahin
Takayasu arteritis is a rare type of chronic, granulomatous vasculitis, characterized by inflammation of blood vessels of large caliber, such as the aorta, and its branches. Clinical presentation varies, depending on the severity of symptoms. Onset may be gradual, however at times, presentation may be acute, and life threatening. Herein, we present the case of a 29-year-old female, 3 months post-op, following a right carotid artery stenting procedure. The patient presented with nonspecific symptoms of malaise, arthralgia, and blurry vision. Clinical presentation and imaging findings were consistent with Takayasu's Arteritis.
PMID: 34703518
ISSN: 1930-0433
CID: 5042422

A rare case of anophthalmia without any family history and antenatal risk factors [Case Report]

Dedushi, Kreshnike; Hyseni, Fjolla; Musa, Juna; Saliaj, Kristi; Vokshi, Valon; Guy, Ali; Bhatti, Atiq; Rahman, Abdur; Tahir, Muhammad; Rakovica, Loran; Rahman, Masum; Shatri, Jeton
Anophthalmia is a rare genetic disorder. It is defined as the absence of one or both eyes in a patient. It can be unilateral or bilateral. Based on the absence of anatomical structures, it is divided into primary, secondary, and degenerative anophthalmia. It occurs in an infant with a diabetic mother or any exposure to teratogens. Most of the patients have a positive family history of anophthalmia or related genetic disorder. Its diagnosis is crucial as there is a similar condition called micro ophthalmia. Sometimes it is difficult to differentiate between severe microphthalmia and anophthalmia. We present a case of a 5-day-old infant diagnosed with bilateral anophthalmia. In the majority of the cases of bilateral anophthalmia the patients usually have a positive family history of antenatal exposure to teratogenic substances. But in our case, no family history or antenatal teratogenic exposure was noted.
PMID: 34630815
ISSN: 1930-0433
CID: 5137172

Ectopic thyroid tissue in the anterior mediastinum along with a normally located gland [Case Report]

Kola, Erisa; Gjata, Arben; Kola, Ina; Guy, Ali; Musa, Juna; Biba, Valbona; Filaj, Vladimir; Horjeti, Edlira; Nakuci, Daniela; Cobo, Anisa; Saliaj, Kristi; Alimehmeti, Mehdi; Kadhra, Ronny
Ectopic thyroid tissue is a rare developmental abnormality arising from an aberration in the normal migration of the thyroid gland, from the floor of the primitive foregut to its final position. It is usually asymptomatic, often being diagnosed as an incidental finding. However, it can present with symptoms of compression such as chest pain, cough, stridor, dysphagia, dyspnea and superior vena cava syndrome. Herein, we present the case of a 42-year-old male patient, presenting with dyspnea, chest pain and fatigue. Laboratory tests showed low serum levels of thyroid-stimulating hormone (TSH) and a thoracic computed tomography revealed a heterogeneous mass in the anterior mediastinum. The patient underwent a full surgical resection. The postoperative histopathological examination of the mass demonstrated the presence of benign ectopic thyroid tissue with no evidence of malignancy. This case report emphasizes the importance of taking Ectopic thyroid tissue into account when considering the differential diagnosis of a mediastinal mass, as other common diagnoses including lymphomas, dermoid cysts and thymic tumors, require an entirely distinct treatment approach.
PMID: 34484517
ISSN: 1930-0433
CID: 5152892