Browsing by Author "Raits , Uldis"

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    Ewing Sarcoma of the Lumbar Spine With Lung Metastases in A 20-Year-Old Adult : A Rare Case Report
    (2024-03-12) Balodis, Arturs; Eglīte , Everita; Zarembo, Zane; Raits , Uldis; Dolgopolova, Jūlija; Kalniņa, Marika; Lapse, Daire; Department of Radiology
    Background: Ewing sarcoma (ES), a rare bone tumor primarily affecting adolescents and young adults, exhibits aggressive behavior, typically originating from bones or nearby soft tissues. Histopathology reveals a small round cell tumour, posing a challenge in distinguishing from small cell carcinoma, sarcomas, or lymphoma. This report outlines a 20-year-old man’s case of lumbar spine ES with lung metastases. 1.2. Case Report: A 20-year-old male complained of back pain radiating to both legs, particularly the right. No signs of paralysis were evident. Magnetic Resonance Imaging revealed a lumbar mass with extradural spread in the spinal canal, compressing the dural sac and extending through the intervertebral foramen, auto necrosis areas were identified which led to working diagnosis of Schwannoma. The surgical extraction of the lumbar mass was performed. Immunohistochemical analysis of operative material revealed small round tumour cells with CD99 positivity. Subsequently, a t (11; 22) (q24.3; q12.2) translocation was identified, confirming the histopathological diagnosis of Ewing sarcoma. Two months post-surgery, lung metastases and hypermetabolism in L2 vertebra, spinal cord, and TH11-TH12 tissue were detected. The next step in the patient’s treatment plan involves chemotherapy. 1.3. Conclusion: Ewing’s sarcoma, a fast-growing malignancy, requires a multidisciplinary approach due to its clinical and radiographic features. This report underscores the challenge of distinguishing primary bone Ewing sarcoma from bone metastasis of other small round cell malignancies. The tumour’s unusual location may complicate diagnosis, potentially leading to confusion with schwannoma. Early, precise diagnosis is crucial for prompt treatment
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    Neurosyphilis Mimicking Herpes Simplex Encephalitis on Magnetic Resonance Imaging : A Case Report
    (2022-06-28) Balodis, Arturs; Grabovska, Dagnija; Valante, Ramona; Novasa, Arina; Raits , Uldis; Department of Radiology
    Objective: Rare disease Background: Neurosyphilis is a central nervous system infection caused by Treponema pallidum, that can develop at any time after the initial infection. The clinical signs of neurosyphilis are very variable, as well as its radiological features, and it is a diagnostic challenge. Knowledge of clinical symptoms and correct laboratory diagnostics, combined with routine radiological examination and additional diagnostic tools, such as high-resolution, threedimensional FLAIR sequence, T2-weighted, and T1-weighted contrast-enhanced magnetic resonance imaging (MRI) are key to making an accurate diagnosis of neurosyphilis. Case Report: We present the clinical case of a patient who presented a 1-year history of vague clinical symptoms and was misdiagnosed with herpes simplex virus (HSV) encephalitis. Initial head MRI revealed extensive cerebral white matter lesions with cortical contrast enhancement, mainly of anterior and medial parts of the left temporal lobe, as typically seen in HSV encephalitis. Empirical therapy with acyclovir was started until a diagnosis of syphilis was confirmed with laboratory findings. Later, the therapy was changed to penicillin G. The patient’s condition improved after receiving targeted treatment. A control MRI scan was performed, and previously detected changes in the brain had decreased significantly. Conclusions: MRI is the imaging of choice to support the diagnosis of neurosyphilis. Our findings suggest that neuroimaging can play an important role in indicating suspicion of syphilitic encephalitis. Enhancement of the anterior and medial parts of the temporal lobe is an atypical imaging finding, and it can simulate an infection with HSV. Early treatment is critical to a positive outcome.