When Air is a Red Herring: Benign Appearances of Air in Unusual Locations

In the emergency radiology setting, ectopic air can frequently be a cause for alarm, such as with pneumothorax, pneumomediastinum, and portal venous gas. Ectopic air can often serve as a harbinger of serious injury, which can prompt the radiologist to notify clinicians so patients can receive appropriate care. However, there are many benign conditions which may present radiographically with air in unusual locations. It is critical to be able to recognize these benign entities, as inaccurate identification could lead to unnecessary procedures or imaging. We present numerous benign conditions which can produce air in unusual locations that we have encountered in our practice. For each condition, we will describe its etiology and will also provide key imaging findings that help to distinguish it from pathology.

A rare case of low-grade fibromyxoid sarcoma of the thigh: Diagnostic and therapeutic challenges in a resource-limited setting.

Low-grade fibromyxoid sarcoma (LGFMS) is a rare slow-growing malignant tumour with a deceptively benign histologic appearance. It typically involves young or middle-aged adults. These tumours usually occur in the proximal extremities and trunk. Sporadically they may be found in unusual locations leading to diagnostic dilemma. We report a 5year old boy that presented with painless right parotid swelling of 6 weeks duration. There was a 12-week presentation-to-diagnosis delay, due to the initial misdiagnosis as Burkitt's lymphoma that was entertained because of the region involved, rate of progression and endemicity of Burkitt's in our setting. Compromise of the aerodigestive tract was a major challenge, in addition to early recurrence and metastasis. We advocate for high index of suspicion, prompt tissue diagnosis and multidisciplinary intervention for better outcome.