A previously healthy 61-year-old Caucasian woman presented to the emergency department after collapsing at home with associated abdominal pain radiating to her back. An urgent CT angiogram was requested to rule out a ruptured aortic aneurysm. This showed a large 21 cm fat-containing lesion arising from the mid-pole of the left kidney, with an adjacent 4 cm perirenal haematoma. An initial diagnosis of a ruptured angiomyolipoma was made. Her haemoglobin was 105 g/L, with a creatinine of 104 mmol/L and an eGFR of 47 mL/min. Her clotting profile was normal. Following resuscitation, she was taken to the operating room and underwent an emergency open left radical nephrectomy via a left flank incision. Her recovery was uneventful and she was discharged home after 6 days. The histopathology confirmed a well-differentiated liposarcoma.

Introduction:Actinomycosis is a saprophytic infection caused by actinomycetes. Actinomycetes is a gram positive, anaerobic, non acid-fast, filamentous bacterium. Although actinomyce is considered as a part of the normal flora, it is rarely seen in middle ear and mastoid cavity.Aim:is to report a rare case of Actinomycosis infection of the middle ear and mastoid cavity.Case report:We presented A 24 years old male arrived to our outpatient department complaining of right-sided otalgia and hearing loss for 8 years, no history of otorreah, vertigo or dizziness. He had a history of right-sided chronic suppurative otitis media with a history of two operations at the same side. This report suggests that actinomycosis , although it is rare, it could occurs in middle ear. It should be considered as one of the differential for chronic suppurative otitis media patients with no improvement on medical treatment.Conclusion:Combined medical and surgical treatment is the recommended management for Actinomycosis infection of the middle ear and mastoid cavity.

The etiology of profound hearing loss in children is complex. Congenital inner ear malformation is an important cause of SNHL in children. It consists of labrynthine aplasia, cochlear aplasia, common cavity deformity, cystic cochleovestibular anomaly, cochlear hypoplasia and Modini's deformity. We report one patient who was born deaf and was being evaluated in our service for possible cochlear implantation. CT scan evaluation shows cochlear aplasia on one side and hypoplasia.