The obturator nerve is an extremely rare location for schwannomas to originate, and such diagnosis is typically not considered among the imaging diagnostic possibilities for a cystic-solid pelvic mass. A 63-year-old female with a known pelvic mass presented with increasing pelvic pain. The mass, which had been followed by serial imaging over five years, was described showing mixed solid and cystic components, likely arising from the left ovary. Although the key diagnosis to be excluded was a primary ovarian malignancy, the patient chose to pursue active surveillance. Over the five years of close observation, the lesion increased slowly, while her CA-125 level showed no significant elevation. Increase in size of the mass and worsening pain and concern for a gynecologic malignancy on MRI led her to ultimately consent to a hysterectomy with bilateral salpingooophorectomy. During the surgery, the mass was noted to be contiguous with the left obturator nerve. Pathologic evaluation revealed a schwannoma (WHO grade I). The patient's postsurgical course was uneventful, without residual weakness in the left adductor muscles.

A 76-year-old female with coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus type II, and 40 pack-year smoking history presented with a four-day history of cough, productive of green-yellow sputum. Chest X-ray revealed opacification of the left upper lung field, and computed tomography (CT) of the chest showed a large cavitary lesion invading the T2-T3 vertebral bodies, extending into the epidural space, giving rise to mild cord compression. Biopsy of the lesion revealed a poorly differentiated neoplasm composed of distinct epithelial and mesenchymal components, consistent with carcinosarcoma. A metastatic workup was negative. Primary lung carcinosarcoma is a rare tumour that can demonstrate an especially aggressive clinical course; diagnosis is often nuanced by limited sampling at initial presentation, especially in a setting of advanced disease and debility that precludes consideration for upfront resection or more extensive, invasive sampling.

A 48-year-old man with a history of intravenous drug use and chronic, untreated hepatitis C presented to the emergency room with acute bilateral lower extremity swelling, erythema and maculopapular rash. Serum C4 levels were low, but dermatology felt the rash was due to venous stasis dermatitis. The patient was discharged with compression stockings, but returned to the hospital 5 days later with no improvement in his symptoms. A more extensive laboratory workup revealed hepatitis C viral load of 4 million, elevated serum cryoglobulins, and skin biopsy showing leucocytoclastic vasculitis. He was treated with oral prednisone, with complete resolution of his symptoms after 2 weeks. He was scheduled for follow-up in gastroenterology clinic for treatment of his hepatitis C for definitive cure of his mixed cryoglobulinaemia, but failed to get insurance authorisation to begin treatment with Harvoni. He presented to the hospital 4 months later with diffuse alveolar haemorrhage.

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An obese but otherwise healthy 22-year-old female presented to the hospital with an episode of acute psychosis. On exam the patient was febrile and had labile systolic blood pressure. Urine drug screen and infectious workup were negative. A CSF Anti-N-methyl-D-aspartate (Anti-NMDA) receptor antibody was positive. Brain magnetic resonance imaging (MRI) showed hyperintensity in the left hippocampus on diffusion weighted imaging (DWI). The patient was started on prednisone, intravenous immunoglobulins, and rituximab. Hospital course was complicated by seizures and autonomic instability, requiring prolonged stay in the ICU. Cognitive, motor, and autonomic function gradually improved with therapy. Magnetic resonance imaging of the pelvis revealed a 3 cm × 3 cm left ovarian teratoma that was removed with oophorectomy. The patient was discharged to rehab hospital for continued treatment and physical therapy.