Primary testicular lymphoma (PTL) a relatively rare disease of non-Hodgkin's lymphomas occurring with a lesser incidence of 1-2% has a propensity to occur at later ages above 50 years. PTL spreads to extra nodal sites due to deficiency of extra cellular adhesion molecules. We present detection of multiple sites of extra nodal involvement of PTL by F-18 positron emission tomography/computed tomography study aiding early detection of the dissemination thus aiding in staging and management.

Echinococcisis is an emerging zoonotic parasitic disease worldwide and is a signifi cant health burden among developing nations. Cystic hydatidosis is more commonly found in lungs and liver but rarely cerebral involvement can occur. Multiple hydatid cysts of brain are uncommon and may be either primary or secondary. Hydatid cyst shoud be considered as a differential diagnosis for cystic lesions of the brain. Here we are reporting a 8 year old boy with multiple cerebral hydatid cysts recurring within three months after surgical rupture of a primary large cerebral hydatid cyst.

Ifosfamide-induced encephalopathy (IIE) is a rare adverse event and is usually transient and reversible. However, it may cause permanent neurological dysfunction and even death if not addressed early. The use of aprepitant and presence of acute kidney injury may precipitate IIE. In this report, a 55-year-old female presented with a 3-month history of abdominal mass and bleeding per vagina and was diagnosed as locally advanced high-grade uterine leiomyosarcoma. She underwent surgery followed by adjuvant radiotherapy and combination chemotherapy with doxorubicin plus ifosfamide regimen. During her third cycle chemotherapy, despite dose adjustment of ifosfamide according to patient's creatinine clearance, the patient became aphasic, disoriented, and landed in a stuporous state. After complete evaluation and ruling out other causes, she was diagnosed with IIE for which she was treated with methylene blue and thiamine. This patient showed dramatic response within 8 h of methylene blue administration and complete recovery within 24 h. Our report focuses on the risk factors for the development of IIE and the persistent risk despite ifosfamide dose adjustment according to creatinine clearance.