A rare cause of persistent hyperparathyroidism.

In a case of patient with persistent hypercalcemia after parathyroidectomy, different imaging techniques and particularly 18F-fluorocholine PET/CT are important to localize the adenoma even in a very unusual location.

Multiple Endocrine Neoplasia or Accidental Association?

Unlabelled: Pheochromocytoma, papillary thyroid carcinoma and hyperparathyroidism have rarely been reported together. Whether this association is coincidental or results from an unknown genetic predisposition is difficult to ascertain. We present the case of a patient who was diagnosed with pheochromocytoma, bilateral papillary thyroid carcinoma and parathyroid hyperplasia with primary hyperparathyroidism.

Can we safely reduce the administration of 131-iodine in patients with differentiated thyroid cancer? - experience of the Brugmann hospital in Brussels.

Background: 131-iodine (I) administration after surgery remains a standard practice in differentiated thyroid cancer (DTC). In 2014, the American Thyroid Association presented new guidelines for the staging and management of DTC, including no systematic I in patients at low-risk of recurrence and a reduced I activity in intermediate risk.The present study aims at evaluating the rate of response to treatment following this new therapeutic management compared to our previous treatment strategy in patients with DTC of different risks of recurrence.

Post-traumatic Bone Granuloma Caused by Retained Foreign Bodies.

Bone granulomas (BGs) due to foreign bodies are a rare condition, especially in children, with only few cases reported in literature. As foreign bodies are not always visible on imaging, BGs can mimic bone tumors. We hereby present a case of a six-year-old boy with histopathologically confirmed BG of his right hand fifth finger due to intraosseous foreign bodies, along with imaging work-up.

Best soil comanagement practices for two watersheds in Germany and Iran using game theory-based approaches.

Collaborative management is increasingly applied to indicate environmental and socio-economic negotiations in every corner of the world. The engagement of multiple stakeholders accompanying experience, science, and economy probing skills is expected to unravel such issues. However, the collaborative approaches to manage existing issues at watershed scale have not been adequately applied.

Osteoid osteoma of the pisiform bone: A rare cause of wrist pain.

Non-traumatic wrist pain remains a diagnostic challenge. An accurate diagnosis is crucial in order to choose the appropriate treatment. We report the case of a 23-year-old female with a four-month history of mainly nocturnal wrist pain.

Improved hydrological model parametrization for climate change impact assessment under data scarcity - The potential of field monitoring techniques and geostatistics.

According to current climate projections, Mediterranean countries are at high risk for an even pronounced susceptibility to changes in the hydrological budget and extremes. These changes are expected to have severe direct impacts on the management of water resources, agricultural productivity and drinking water supply. Current projections of future hydrological change, based on regional climate model results and subsequent hydrological modeling schemes, are very uncertain and poorly validated.

Simulation of future groundwater recharge using a climate model ensemble and SAR-image based soil parameter distributions - A case study in an intensively-used Mediterranean catchment.

We used observed climate data, an ensemble of four GCM-RCM combinations (global and regional climate models) and the water balance model mGROWA to estimate present and future groundwater recharge for the intensively-used Thau lagoon catchment in southern France. In addition to a highly resolved soil map, soil moisture distributions obtained from SAR-images (Synthetic Aperture Radar) were used to derive the spatial distribution of soil parameters covering the full simulation domain. Doing so helped us to assess the impact of different soil parameter sources on the modelled groundwater recharge levels.

Oesophageal lesions as first manifestation of necrotising sarcoid granulomatosis.

Necrotising sarcoid granulomatosis is a rare disease associating sarcoid-like granulomas, vasculitis and necrosis in the lungs and seldom in extrapulmonary locations. We report the case of a 23-year-old woman with an initial symptom consisting of epigastric pain. Oesophagoscopy demonstrated oesophagitis.

Sensitivity of mGROWA-simulated groundwater recharge to changes in soil and land use parameters in a Mediterranean environment and conclusions in view of ensemble-based climate impact simulations.

This study examines the impact of changing climatic conditions on groundwater recharge in the Riu Mannu catchment in southern Sardinia. Based on an ensemble of four downscaled and bias corrected combinations of Global and Regional Climate Models (GCM-RCMs), the deterministic distributed water balance model mGROWA was used to simulate long-term mean annual groundwater recharge in the catchment for four 30-year periods between 1981 and 2100. The four employed GCM-RCM combinations project an adverse climatic development for the study area: by the period 2071-2100, annual rainfall will decrease considerably, while grass reference evapotranspiration will rise.

Fatal multiple coronary involvements in a young woman with systemic lupus erythematosus.

We report a rare case of fulminant congestive heart failure with fatal outcome in a 21-year-old girl with systemic lupus erythematosus (SLE). A young woman was admitted in the intensive care unit for pericardial tamponade associated with disseminated coagulopathy and refractory shock secondary to multiple coronary aneurysms. Post-mortem examination revealed significant multiple coronary lesions with aneurysms of the interventricular and right coronary arteries, responsible of muscular necrosis, thrombosis of the coronary sinus, and significant pericardial infiltration with hemorrhagic fluid.

A fatal case of cutaneous adverse drug-induced toxic epidermal necrolysis associated with severe rhabdomyolysis.

Toxic epidermal necrolysis represents an immunologic reaction to a foreign antigen and is most often caused by drugs. Atorvastatin, a blood cholesterol-lowering agent, is a recognized cause of rhabdomyolysis; while naproxen, a widely used nonsteroidal anti-inflammatory drug, is a known cause of photo-induced skin lesions. We report the first fatal case of drug-induced toxic epidermal necrolysis associated with severe muscle necrosis due to the use of a nonsteroidal anti-inflammatory drug and a statin with very high levels of creatine phosphokinase leading to acute kidney injury, disseminated intravascular coagulation, and complete skin necrosis leading to death.

Coexistence of renal malakoplakia and myelodysplastic syndrome.

Malakoplakia is a protean systemic chronic granulomatous disease that usually targets the genito-urinary system and most particularly the bladder. Only in rare occasions do the kidneys get involved. Myelodysplastic syndrome is a heterogeneous clonal haematopoietic disorder characterised by either a hyper- or hypocellular bone marrow dysmyelopoiesis and peripheral blood pancytopenia.

Late onset of Aspergillus aortitis presenting as femoral artery embolism following coronary artery bypass graft surgery.

Aspergillus sp. are ubiquitous mould infections and in most patients, the source is presumed to be air-borne infections during surgical procedures. Prevention of these infections requires special attention of ventilation systems in operating rooms.

A delayed fatal metastatic Hürthle cell carcinoma.

Hürthle (oxyphilic or oncocytic) cell carcinoma is a variant of follicular cell carcinoma of thyroid. Although this entity of thyroid cancer is well known, its occurrence in young patients has scarcely been reported. We report a case of a 26 year-old male patient, at the time of diagnosis, of Turkish origin, who developed a tracheal, pulmonary and mediastinal metastatic Hürthle cell carcinoma with bilateral cervical and mediastinal lymphadenopathies.

Adult polyglucosan body disease masquerading as "ALS with dementia of the Alzheimer type": an exceptional phenotype in a rare pathology.

We describe an exceptional clinical picture, namely, cognitive impairment of the Alzheimer disease type in a man who later developed manifestations typical of amyotrophic lateral sclerosis and who was subsequently found to have adult polyglucosan body disease (APGBD) upon postmortem neuropathologic explorations. The combined occurrence of amyotrophic lateral sclerosis and cognitive impairment of the Alzheimer disease type in APGBD has not been reported before. This case also underlines the diverse clinical presentation of this rare clinicopathologic entity (namely APGBD) and highlights the importance of recognizing the unusual association of clinical features in making the diagnosis.

Spontaneous rupture of the spleen in relation to a non-Hodgkin lymphoma.

A 35-year-old man was admitted for surgery with complaints of left upper abdominal quadrant pain, tachycardia and hypotension with no history of trauma. A splenomegaly had just been diagnosed one week before, during, the work up for asthenia. An immediate CT scan revealed an intraperitoneal haemorrhage with splenic rupture.

Benign retroperitoneal schwannoma presenting as colitis: a case report.

We report a case of a patient presenting with clinical, radiological and endoscopic features of colitis due to a compressive left para-aortic mass. Total open surgical excision was performed, which resulted in complete resolution of colitis. Histopathology and immunohistochemistry revealed benign retroperitoneal schwannoma.

[Metastatic sternal mass].

Sternal masses are rare and their differential diagnosis is relatively unknown by most of us. The management of such masses mobilize often a lot of expensive radiological means. We expose the case of a patient, where a lung carcinoma is diagnosed by a surgical biopsy of a sternal mass.

Intra-abdominal lymphatic malformation.

Intra-abdominal lymphangioma is a rare congenital lymphatic vascular malformation. It is found, most commonly, in adult patients who present with abdominal pain, and whom medical imaging (ultrasound, endoscopy and tomography) reveals a cystic intra-abdominal mass. Such masses may be on the mesentery, in contact with abdominal viscera or may be part of the visceral wall.

Perianal Paget's disease: case report and review of the literature.

Cutaneous Paget's disease (PD) is a rare entity, predominantly involving the breasts. Anal involvement is rather exceptional, and can be associated with underlying malignancies, among which prostate and rectal adenocarcinoma. We report the case of a 71-year-old man suffering from a long history of anal itching, associated with an erythematosquamous lesion of the right buttock extending up to the anus.

Metastasis of a renal cell carcinoma to the nose and paranasal sinuses.

We present a case of a metastasis of a renal cell carcinoma to the nose and paranasal sinuses. A 66 year old male patient developed a mass in his left nasal cavity and paranasal sinuses, five years after he underwent a left sided nefrectomy for a renal cell carcinoma. The histopathologic examination of the nasal mass showed metastasis of a renal cell carcinoma.