Cowper's gland syringocele is an uncommon, underdiagnosed cystic dilatation of Cowper's gland ducts showing various radiological patterns. Herein we report a rare case of giant Cowper's gland syringocele in an adult male patient, with description of MRI findings and management outcome.

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Key words deep vein thrombosis, inferior vena cava malformation, thrombophilia.In a recent study, the prevalence of interruption or congenital stenosis of the inferior vena cava (IVC) was found to be 0.15%. 1 Embryological formation of IVC occurs between the fourth and eighth weeks of gestation; this period coincides with the development of most organs (spleen, liver, heart, and lungs). Thus, it is not surprising to have asplenia, polysplenia, situs inversus, congenital heart disease, lung and kidney malformation associated with IVC anomalies. 2 The IVC is formed of four segments (in a caudal direction: hepatic, suprarenal, renal and infrarenal). These segments are formed by complex embryological processes involving the formation, fusion and regression of three main paired primitive veins called cardinal veins. Failure of proper development of one or all of these events leads to several congenital anomalies; one of these is the congenital absence of IVC (AIVC). It may be the entire IVC or one of its segments. 2 It is also suggested that absence of the infrarenal segment of the IVC is not embryonic in origin, rather the result of intrauterine or perinatal thrombosis. 3,4 The prevalence of AIVC in deep venous thrombosis (DVT) is about 5%. 5,6 Approximately 90% of previously reported cases involved the absence of the suprarenal segment and 6% involved the renal or infrarenal segment. The combined absence of the suprarenal and infrarenal segments (infrahepatic) is so rare that only 10 cases were reported in the English-language literature prior to 2002. 3 We present a patient who developed right iliofemoral thrombosis at the age of 8.5 years and was found to have this rare infrahepatic AIVC on computed tomography (CT) of the abdomen and magnetic resonance venography. There was no recurrence 16 months after discontinuing the anticoagulant treatment.To the best of our knowledge, this patient is one of the youngest patients reported to develop unprovoked DVT in association with infrahepatic AIVC. Case reportThe patient is currently 10.5 years old. He was seen at the age of 8.5 years because of painful swelling involving the whole right lower limb over a few hours before admission. The skin looked bluish-red and slightly tender. The popliteal arteries and dorsalis pedis arteries felt well in both lower limbs. There was no history of preceding trauma, strenuous exercise, high fever, severe vomiting or diarrhea. There was no family history of venous thrombosis or suggestive of a hypercoagulable state.The patient is the product of in vitro fertilization because of primary infertility for 11 years. It was a twin pregnancy. Delivery was by cesarean section at 36 weeks of gestation because of maternal gestational diabetes. Our patient weighed 1.3 kg at birth, while his co-twin weighed 2.5 kg. Our patient was admitted to the neonatal ward for extreme low birthweight with Apgar scores of 6 and 9 at 1 and 5 min, respectively. Reviewing his chart, he did very well in the neonatal ward and did not develop sepsis, respiratory dist...

Neuropathies caused by jellyfish stings are extremely rare and poorly studied. A 20-year-old female patient was stung on the volar aspect of the right forearm by an unidentified species of jellyfish. Local cutaneous reaction was followed within few days by severe median mononeuropathy, involving the motor and sensory branches to the hand and forearm but sparing the palmar branch. The patient had neuropathic pain relieved by pregabaline. Electrodiagnostic studies confirmed a demyelinating lesion. Ultrasound and magnetic resonance imaging of the median nerve revealed uniform swelling with mild uptake of contrast along the forearm. Within 2 months, strength improved significantly, pain subsided, and numbness partially resolved. Literature review and discussion of the possible mechanisms and implications of this rare effect of marine animal envenomation is presented. Jellyfish sting may cause focal mononeuropathies most probably because of the local effects of the toxins.