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Rectosigmoid Adenocarcinoma Mimicking a Tubo-Ovarian Abscess: CT and Apple Core Sign

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  How pelvic abscess, entero-ovarian fistula, rectosigmoid stenosis, and Apple Core morphology can reveal an occult colorectal malignancy. Edited by ScholarGen MediAI Team Executive Clinical Summary A woman in her early 40s presented with approximately one month of progressively worsening abdominal pain, nausea, vomiting, and fever. Two months earlier, she had been treated for pelvic inflammatory disease associated with a tubo-ovarian abscess. Contrast-enhanced CT initially appeared to support a gynecologic diagnosis. A multiloculated gas-fluid collection with peripheral rim enhancement was present in association with the right ovary, compatible with a tubo-ovarian abscess. However, the adjacent rectosigmoid colon was abnormal: bowel-wall thickening was present, and gas appeared to pass through a suspected defect in the bowel wall toward the pelvic collection. The critical diagnostic question was therefore not simply whether an abscess was present, but why the abscess had developed...
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Spontaneous Ureteral Rupture and Urinoma: A Delayed CT Diagnosis That Radiologists Must Not Miss

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  How Delayed CT Imaging Reveals Hidden Urinary Leakage and Prevents Missed Emergency Diagnoses Edited by ScholarGen MediAI Team Executive Clinical Summary A patient presented with persistent left-sided abdominal pain. Initial CT imaging demonstrated delayed nephrogram, proximal ureteral dilatation, and retroperitoneal fluid collection without a visible obstructing stone. The diagnosis remained uncertain until delayed excretory-phase CT revealed contrast extravasation into the retroperitoneal space—confirming spontaneous ureteral rupture with urinoma formation . This case reinforces a fundamental radiologic principle: Urinary leakage cannot be diagnosed without delayed-phase imaging. Clinical Hook The CT scan appears inconclusive. No stone is identified. Yet the kidney enhances asymmetrically. The ureter is subtly dilated. There is unexplained fluid in the retroperitoneum. At that moment, the diagnosis depends not on what is seen— but on what the radiologist chooses t...
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Multinodular and Vacuolating Neuronal Tumor (MVNT): A Distinctive Brain MRI Pattern in a Young Woman with Auditory Hallucinations

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  MRI characteristics, differential diagnosis, clinical correlation, management, and the emerging role of AI in Multinodular and Vacuolating Neuronal Tumor Edited by ScholarGrn MediAI Team Introduction A young woman with recurrent auditory hallucinations, disorganized thinking, and disorganized behavior may initially be evaluated primarily from a psychiatric perspective. However, when structural brain imaging is performed, an apparently normal CT examination does not completely exclude a subtle cerebral lesion. This case illustrates an important neuroradiologic entity: Multinodular and Vacuolating Neuronal Tumor (MVNT) . MVNT is an uncommon neuronal tumor characterized by multiple small nodules clustered within the superficial subcortical white matter. On MRI, these nodules may create a distinctive bubbly or bubble-like appearance , particularly on T2-weighted and FLAIR images. The lesions are typically nonaggressive in appearance, with little or no mass effect, surrounding edema, ...
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