Incidental computed tomography diagnosis of a giant oesophageal leiomyosarcoma.

Leiomyosarcoma of the oesophagus is a very unusual tumour; only 53 cases have been reported in the English-language literature. A case is reported here of a patient with a giant leiomyosarcoma, without any symptoms of dysphagia. The diagnosis was made incidentally during CT examination of the chest for detection of possible pulmonary metastases from a coexisting carcinoma of the bladder.

Short tau inversion recovery magnetic resonance imaging in occult scaphoid injuries: effect on management.

Over a 21-month period, 16 patients with possible scaphoid fractures, where conventional radiographs were essentially normal on the day of injury and 10 days later, were examined by coronal short tau inversion recovery (STIR) and T1 weighted sequences on a 0.2 Tesla scanner. The magnetic resonance (MR) examinations were done in between electively booked patients and management was altered in 50% of patients.

Concomitant presentation and resolution of a post-traumatic pneumothorax and pneumopericardium.

The association of a right pneumothorax and a pneumopericardium due to non-penetrating trauma is exceedingly unusual. A patient with both complications presented 7 hours after a motorcycle accident. These were detected incidentally on a scout film for CT for lumbar fractures and both resolved entirely and simultaneously after chest tube insertion in the right pleural space.

Radiological imaging of a massive dermoid in the male pelvis.

A dermoid cyst, arising from the posterior aspects of the prostate and seminal vesicles, and extending into the pelvis to masquerade as a full bladder, must be exceedingly rare. Ultrasound, computed tomography and especially magnetic resonance imaging (MRI) proved to be invaluable in making the diagnosis, and MRI in particular was very useful in providing an anatomical road map for surgery.

Female sterilization by the vaginal route: a positive reassessment and comparison of 4 tubal occlusion methods.

Over the last 15 years female sterilization by the vaginal route has been abandoned in favour of the abdominal approach via a laparoscope or a suprapubic incision. This was justified when the vaginal route was used for a fimbriectomy or a Pomeroy type of sterilization. The use of tubal occlusion methods designed for the laparoscope has simplified the technique of vaginal sterilization and lowered the morbidity.

Raised endothelial cell stimulating angiogenesis factor in ankylosing spondylitis.

Endothelial cell stimulating angiogenesis factor (ESAF) is important in the neovascularisation that precedes new bone formation, and raised levels are found in association with healing fractures and osteoarthritis. We investigated its relevance to the new bone growth that is found at inflammatory sites in ankylosing spondylitis (AS). Forty-one patients with AS were studied clinically and radiographically and had their serum ESAF levels measured.

Monosymptomatic hypochondriasis treated with a tricyclic antidepressant.

A case of a patient with monosymptomatic hypochondriasis exhibiting koro-like symptoms is reported. The patient did not respond to pimozide, but improved with a tricyclic antidepressant and has remained symptom-free for 1.5 years.

Neuroleptic malignant syndrome: case report and review.

A patient with neuroleptic malignant syndrome is reported. The clinical features, complications and management are discussed and literature reviewed.