Suicide of a diabetic by inducing hyperglycemic coma

Deaths due to hyperglycemic and hyperosmolar coma in diabetics are usually disease-related. In the exceptional case reported here there was evidence for an intentional ingestion of a sugar solution, the person was a diabetic and known to be depressive suggesting a suicidal intention. The autopsy findings were inconspicuous and only further laboratory findings led to the final diagnosis. Received: 7 January 1999 / Received in revised form: 10 March 1999     

Malignant degeneration of an osteochondroma with unusual intra-bursal invasion

Multiple hereditary osteochondromatosis is an uncommon autosomal dominant condition in which patients are predisposed to the development of chondrosarcoma. We report a case of a patient who developed a secondary low-grade chondrosarcoma in this setting. The tumor was associated with an unusual multinodular invasive growth pattern into a pre-existing bursa that was present overlying the osteochondroma. Received: 1 March 1999 Revision requested: 6 April 1999 Revision received: 7 May 1999 Accepted: 10 May 1999     

Cirsoid renal arteriovenous malformation treated by endovascular embolization with n-butyl 2-cyanoacrylate

The authors report a rare case of renal arteriovenous malformation (rAVM) which was diagnosed by arteriography years after onset of intermittent haematuria. The rAVM of the cirsoid type was superselectively catheterized and embolized in toto with n-butyl 2-cyanoacrylate. Diagnostic imaging modalities and the technique of embolization are discussed. Received: 16 July 1999; Revised: 17 September 1999; Accepted: 20 September 1999     

Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

A 9-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis affecting multiple sites. During an 8-year follow-up he developed premature closure of a distal radial epiphysis and degenerative changes in the adjacent radiocarpal joint. Received: 26 July 1999 Revision requested: 24 August 1999 Revision received: 27 September 1999 Accepted: 8 October 1999     

Intramural leiomyoma of the bladder

Mesodermal tumors of the urinary bladder are rare and the majority of them are malignant. We report a case of an intramural leiomyoma of the bladder presenting with symptoms of a mild lower urinary tract infection. The patient was managed with partial cystectomy and the outcome was excellent. Received: 31 May 1999; Revised: 21 September 1999; Accepted: 21 September 1999     

A fatal case of infantile scurvy

We report a case of infant death due to scurvy, which is very rare in Japan. We initially had little knowledge of the disease and suspected that the bleeding in the body was caused by domestic violence. The case did not fall under the category of the battered child syndrome but the death was caused by ignorance with respect to child care. In addition the parents usually locked the child alone in a room during the day and this is probably a case of neglect. Received: 16 June 1999 / Received in revised form: 31 August 1999     

Broad clavicles in trisomy 8 mosaicism: a new sign

Symmetrical clavicular widening was observed in a boy with mosaic trisomy for chromosome 8. This sign may be considered in conjunction with other clinical and radiographic features as an indication for chromosomal studies. Received: 31 December 1998 Revision requested: 31 January 1999 Revision received: 15 March 1999 Accepted: 18 March 1999     

Giant distal humeral geode

We describe the imaging features of a giant geode of the distal humerus in a patient with rheumatoid arthritis, which presented initially as a pathological fracture. The value of magnetic resonance imaging in establishing this diagnosis is emphasized. Received: 8 July 1999 Revision requested: 24 August 1999 Revision received: 25 October 1999 Accepted: 26 October 1999     

Aberrant cervical thymus in an infant: an unusual cause of stridor

We report an 8-month-old infant presenting with stridor caused by a nonpalpable neck mass discovered at imaging and surgery. The diagnosis of aberrant thymic tissue was confirmed at histopathology. The authors reviewed the literature and discuss the embryology, imaging findings and differential diagnosis of this rare disorder. Received: 1 July 1999; Revised: 3 September 1999; Accepted: 6 September 1999     

Spontaneous regression of a cyst of the cavum septi pellucidi

A 20-year-old woman with secondary amenorrhoea and an empty sella turcica was found to have a cyst of the cavum septi pellucidi (CSP) on MRI. The cyst had regressed spontaneously on follow-up MRI. Received: 21 June 1999/Accepted: 5 October 1999     

Erdheim-Chester disease with intramuscular lipogranuloma

We report on a rare manifestation of Erdheim-Chester disease with intramuscular lipogranuloma. The patient was a 66-year-old man who noted a soft tissue mass in the right quadriceps femoris muscle. Radiographs revealed symmetrical osteosclerosis in the diametaphysis of both femora and tibiae. An open biopsy revealed a proliferation of lipid-laden histiocytes in the femoral bone marrow and the quadriceps femoris muscle. To our knowledge, this is the second case of Erdheim-Chester disease involving muscle. Received: 4 October 1999 Revision requested: 18 November 1999 Revision received: 1 December 1999 Accepted: 2 December 1999     

Errors in ABO typing of blood stains using PCR

Genotypes of the ABO blood group system were investigated using a multiplex PCR and subsequent restriction enzyme digestion on experimental blood stains. Differences were found when typing blood between the PCR and serological methods and one blood sample, typed as B with the agglutination test was classified as AB using the method described here. The subsequent sequencing procedure revealed the genotype to be BB. Methodological causes for errors in typing which should be taken into consideration are discussed. Received: 28 June 1999 / Received in revised form: 23 September 1999     

Ectopic localisation of adrenal cortex

We present a case of concurrence of ectopic adrenal cortex with a renal cell carcinoma. The diagnosis of the accessory adrenal tissue was made by CT-guided biopsy. With this case report, we draw attention to a specific differential diagnostic problem, policy and to the MR characteristics of ectopic adrenal cortex. Received: 10 August 1999; Revised: 21 October 1999; Accepted: 27 October 1999     

Atypical adult non-calcified pilomatricoma

We present a rare case of a non-calcified pilomatricoma in a 67-year-old man. This tumor was extremely large in size, and its location, in the lower extremity, was very unusual. The clinical, radiographic, and histopathological features are described in detail. The role of magnetic resonance imaging (MRI) in the diagnosis of this entity is discussed. Definite internal reticulations and septations were observed. A possible explanation for this observation is that the high signal intensity reticulations may represent edematous stroma surrounding basaloid cells. Received: 8 July 1999 Revision requested: 28 July 1999 Revision received: 10 September 1999 Accepted: 13 September 1999     

Vesicouterine fistula: MRI diagnosis

A case of vesicouterine fistula in a young woman following caesarean section is presented. The diagnosis was established successfully using heavily T2-weighted MRI which clearly demonstrated fluid within the fistula, obviating the need for conventional radiographic contrast examination. Received: 21 October 1998; Revised: 27 January 1999; Accepted: 1 March 1999     

Intra-articular regional migratory osteoporosis of the knee

We report a case of lntra-articular regional migratory osteoporosis of the knee in a 53-year-old man. The case demonstrates an unusual pattern of migration of the marrow edema within the knee joint. This phenomenon has received scant attention in the radiological literature. Received: 9 July 1999 Revision requested: 24 August 1999 Revision received: 6 October 1999 Accepted: 8 October 1999     

Adenosarcoma arising in hepatic endometriosis

We report a case of adenosarcoma arising in hepatic endometriosis. Both CT and MR scans demontrated a huge heterogeneous mass containing septated, thick-walled cystic lesions. After enlarged right hepatectomy, the patient was asymptomatic with no abnormalities at liver and abdominal CT scan at 2-year follow-up. Received: 5 August 1999; Revised: 17 December 1999; Accepted: 20 December 1999     

Metadiaphyseal chondroblastoma of the thumb

Chondroblastoma is typically located in the epiphysis. Predominant metadiaphyseal location is very rare, as is involvement of the digits. We describe a case of chondroblastoma involving the metadiaphysis of the thumb. The patient was a 13-year-old boy who presented with pain and swelling of his left thumb. Radiographs showed an expanded lytic lesion involving the whole metaphysis and diaphysis of the proximal phalanx, which subsequently progressed to involve the epiphysis. Curettage and bone grafting were done. Received: 9 July 1999 Revision requested: 12 August 1999 Revision received: 1 November 1999 Accepted: 4 November 1999     

Solitary fibrous tumour of the spinal cord

We report an intramedullary primary solitary fibrous tumour of the cervical spinal cord in a 33-year-old man. The tumour predominantly consisted of monomorphic spindle cells with a storiform pattern. MRI demonstrated an inhomogeneously enhancing cervical intramedullary tumour. The patient was well without recurrence 18 months after surgery. Received: 19 July 1999/Accepted: 6 November 1999     

Myxoma of the humerus: an exceptional site of origin

Myxoma of bone, outside of the jaws, is exceptional. We present such a tumor in the humerus and discuss the criteria for the diagnosis of myxoma. Received: 10 August 1999 Revision requested: 10 September 1999 Revision received: 14 September 1999 Accepted: 14 September 1999