A 50-year-old man with a history of chronic pancreatitis due to alcoholism presented with dyspnea, at which time he was diagnosed with pleural effusions, treated, and discharged. Two months later, he was readmitted with hemoptysis and abdominal pain. CT and MRI of the chest demonstrated a mediastinal cystic mass that communicated with the retroperitoneum. Ultrasound-guided aspiration of the cystic mass revealed high levels of amylase, confirming that the mass was a rare pancreatic pseudocyst extending into the mediastinum.

Remote Cerebellar Hemorrhage is a rare entity that manifests spontaneously after supratentorial craniotomy and spinal surgeries. We present a 53-year-old male who was admitted due to subdural hematoma along the left frontoparietotemporal convexity. After treatment of the subdural hematoma with craniotomy and evacuation, he developed remote cerebellar hemorrhage 1 week later. Brain computed tomography demonstrated the zebra sign. Follow-up imaging showed complete recovery without any neurologic symptoms or signs.

A 61-year-old woman presented to the emergency department, with a 4-day history of isolated oropharyngeal dysphagia associated with anorexia and weight loss over the previous 4 weeks. She had no other focal neurological symptoms and no deficits on examination. She had been in a 4-year remission of breast cancer postmastectomy and chemoradiation. Neuroimaging showed enhancement of cranial nerves VII, VIII, cisternal segment of cranial V, dorsal and ventral surfaces of the cervical and thoracic cord as well as enhancement of the cauda equina. Cerebrospinal fluid analysis revealed carcinomatous cells. The patient was diagnosed as having leptomeningeal carcinomatosis secondary to lobular breast cancer and was started on radiation therapy, antihormonal treatments and intrathecal methotrexate.

A 58-year-old male presented to the emergency department with right scrotal pain and swelling. The patient's past medical history of epididymitis was unraveled. A multiplanar grayscale sonogram with Doppler scan of the scrotum and intra-testicular arterial pulse waveform was performed which demonstrated features of tubular ectasia of the rete testis. There was increased flow at the epididymal head which prompted the possibility of an inflammatory process consequently antibiotic therapy was administered. Tubular ectasia of the rete testis is a benign condition usually found incidentally, it has a prevalence of 1.64% in the population. This condition can be associated with a history of trauma, surgery, and inflammatory or infectious conditions. In case there is a suspicion of malignant etiology, magnetic resonance imaging (MRI) is used for better tissue differentiation. Keywords: Scrotal pain; Doppler scan; Epididymal head; Testes Case ReportA 58-year-old male presented to the emergency department with right scrotal pain and swelling. The pain was severe, gradually progressive, radiated to the groin, and worsened with touch and movement. There was associated bilateral scrotal swelling and dysuria without fever, rash, or penile discharge. Our patient reported recurrent similar but less severe symptoms, as well as a history of epididymitis two years before presentation. A multiplanar grayscale ultrasound with color Doppler of the scrotum and intra-testicular arterial pulse wave was performed, which demonstrated normal homogenous echotexture bilaterally with no evidence of intra-testicular masses. Both testes demonstrated grossly symmetric color Doppler flow with normal intra-testicular arterial waveforms. A small anechoic left epididymal head cyst without evidence of a hydrocele was visualized (Figures 1 and 2). There were right and left tubular anechoic lesions located at the mediastinum testis, more prominent on the right, consistent with tubular ectasia of the rete testes. The right epididymal head demonstrated asymmetric increased color Doppler flow compared to the left, consistent with an inflammatory or infectious process.