Intussusception is a common cause of bowel obstruction in the pediatric population. Malignant lesions account for up to 30 % of all cases of intussusception in the small intestine. We herein report an interesting case of ileo-colic intussusception caused by diffuse large B-cell lymphoma, in a child. The patient underwent laparoscopic right hemicolectomy. Pathologic evaluation revealed a diffuse large B-cell lymphoma.In cases of intussusception, especially in the older age group of children, a high index of suspicion for malignant lymphoma of the bowel should be observed.

A 14-year-old boy presented with low-grade fever, widespread myalgia and difficulty in walking and standing 2 days after the undocumented trip which brought him from western Africa to Italy. His serum creatine phosphokinase was markedly elevated. He was diagnosed with rhabdomyolysis and was volume-restored with normal saline and bicarbonate-containing fluid. Anamnesis revealed illegal, not well-specified, forced consumption in his fatherland, and very bad conditions of the trip (prolonged immobility, dehydration, hypothermia). Workup included a respiratory microbiological panel which was positive for Other microbiological agents were excluded. After 3 weeks, he recovered complete motility. Undocumented immigrants may present several risk factors for rhabdomyolysis that give to this group of individuals a higher risk of developing this disorder.

Joubert syndrome (JS) is a rare autosomal recessive disorder. All patients affected by this syndrome presented a characteristic picture of cranial fossa malformations, called “molar tooth sign.” This sign is defined by the presence in axial section at the level of a deck/midbrain, of hypo/dysplasia of the cerebellar vermis, abnormally deep interpeduncular fossa and horizontalized thickened and elongated superior cerebellar peduncles. Although “molar tooth sign” is peculiar of JS, other radiological findings have been also reported in these patients. Here, the authors briefly assumed the principal magnetic resonance imaging findings of JS.

Rapid maxillary expansion (RME) is an orthodontic procedure that separates the two maxillary bones at the mid palatine suture level. RME is commonly used in the pediatric age group to reduce and/or eliminate a transverse maxillary deficiency. At our institution we followed up an 11-year-old adolescent who was diagnosed with a class III malocclusion and was treated by RME with the combined use of expansion appliances (i.e., Hyrax) in addition to maxillary protraction devices (i.e., Delaire facemask). Three months after the start of treatment, he complained of headache and double vision, and was admitted to our hospital. A funduscopic examination revealed papilledema. Magnetic resonance imaging of the brain showed intraocular protrusion of the optic nerve head and enlarged perioptic subarachnoid space. Cerebrospinal fluid opening pressure during lumbar puncture was elevated (+370?mm H2O), confirming the diagnosis of the pseudotumor cerebri syndrome (PTCS). Removal of the maxillary expander and facemask led to the complete resolution of clinical symptoms in 1 week. The association of RME and PTCS-related manifestations was first reported by Timms in 1986, but, to the best of our knowledge, further cases have been not described in the medical literature. This overlooks PTCS as a potential RME-associated complication. We suggest that clinicians should carefully consider PTCS in all pediatric patients that complain of headache and/or visual disturbances during a treatment by RME. We also speculate on the possible changes of the cerebral venous circulation during RME, potentially leading to an impaired venous drainage that may cause increased intracranial pressure and PTCS.

Pseudotumor cerebri syndrome (PTCS) is defined by increased pressure of cerebrospinal fluid (CSF), with normal CSF contents and without any intracranial disease found on brain imaging. PTCS is a disease with a predilection for childbearing obese women, but it may also occur in children and in man. The most common symptoms include headache, double vision, transient visual obscuration, and pulsatile tinnitus. The reason for which patients with increased CSF pressure experience tinnitus is not clear, and only a few studies have focused on the etiology of this peculiar clinical feature in the context of PTCS presentation. Besides tinnitus, additional otologic manifestations in children with PTCS include aural fullness, low-frequency hearing loss, and vertigo; these symptoms altogether can easily mimic M?ni?re disease. We hereby present two girls, who presented tinnitus as the first clinical symptom of PTCS, prior to developing headache and visual anomalies, and speculate on a shared pathophysiologic basis for both PTCS and M?ni?re disease.