Objectives: The aim of this study was to develop AI-based predictive models to assess the risk of osteoporosis in postmenopausal women using panoramic radiographs (OPTs). Methods: A total of 301 panoramic radiographs (OPTs) from postmenopausal women were collected and labeled based on DXA-assessed bone mineral density. Of these, 245 OPTs from the Hospital of San Giovanni Rotondo were used for model training and internal testing, while 56 OPTs from the University of Parma served as an external validation set. A mandibular region of interest (ROI) was defined on each image. Predictive models were developed using classical radiomics, deep radiomics, and convolutional neural networks (CNNs), evaluated based on AUC, accuracy, sensitivity, and specificity. Results: Among the tested approaches, classical radiomics showed limited predictive ability (AUC = 0.514), whereas deep radiomics using DenseNet-121 features combined with logistic regression achieved the best performance in this group (AUC = 0.722). For end-to-end CNNs, ResNet-50 using a hybrid feature extraction strategy achieved the highest AUC in external validation (AUC = 0.786), with a sensitivity of 90.5%. While internal testing yielded high performance metrics, external validation revealed reduced generalizability, highlighting the challenges of translating AI models into clinical practice. Conclusions: AI-based models show potential for opportunistic osteoporosis screening from OPT images. Although the results are promising, particularly those obtained with deep radiomics and transfer learning strategies, further refinement and validation in larger and more diverse populations are essential before clinical application. These models could support the early, non-invasive identification of at-risk patients, complementing current diagnostic pathways.

Pseudomyxoma peritonei (PMP) is a rare clinical condition, most commonly arising from appendiceal or ovarian mucinous neoplasms. This case report describes an exceptionally rare origin of PMP from a mucinous adenocarcinoma of the transverse colon, highlighting unique diagnostic and therapeutic challenges. Multimodality imaging played a crucial role in the diagnostic process, with computed tomography (CT) providing initial identification of low-attenuation peritoneal lesions with characteristic scalloping of visceral surfaces. Magnetic resonance imaging (MRI), less frequently reported in the literature for PMP, offered superior lesion characterization through high-resolution T2-weighted sequences, revealing hyperintense mucinous deposits. The combination of CT and MRI findings facilitated accurate diagnosis and staging, guiding surgical planning. Management involved cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC), which remains the standard approach for PMP, improving survival in selected patients. This case underscores the critical role of comprehensive radiological assessment, particularly the added value of MRI, in enhancing diagnostic accuracy and optimizing patient outcomes in rare presentations of PMP.

Peutz-Jeghers syndrome (PJS) is a rare genetic disorder characterized by multiple gastrointestinal hamartomatous polyps and distinctive mucocutaneous pigmentations. Intussusception is a significant complication associated with Peutz-Jeghers syndrome and it can lead to potential bowel obstruction and ischemia. We present a case report in which PJS was first suspected by a radiologist after performing abdomen Computed Tomography (CT) at the emergency department. We will discuss the clinical presentation, radiological findings and surgical management in a case of acute small bowel intussusception.

Background: Schwannomas are benign, slow-growing tumors arising from Schwann nerve sheath cells and affecting the peripheral and cranial nerves. Twenty to 40% of all schwannomas involve the head and neck region. Facial nerve schwannomas are rare and tend to occur in the infratemporal part of the nerve. Intraparotid facial nerve schwannomas involving the deep lobe of the parotid are uncommon. Case presentation: A 72-year-old woman was admitted to our maxillofacial surgery clinic with a mass in the left retromandibular region. The patient underwent an MRI examination that showed a sizeable well-circumscribed lesion affecting the deep lobe and the inferior part of the left parotid gland and a CT scan without contrast injection to evaluate the stylomastoid foramen and the facial nerve canal. The patient underwent a parotidectomy without sparing the facial nerve. Histopathological examination showed a biphasic neoplasm with spindle cell areas arranged in fascicles with striking palisades resulting from stacked nuclei alternating with anucleate zones. Conclusions: Intraparotid facial nerve schwannoma (IFNS) is a rare entity. Although radiological diagnosis represents a challenge, the presence of some radiological signs, morphological characteristics, and the typical intensity signal in MRI could be beneficial for preoperative diagnosis and treatment. This case report will discuss the radiological-pathological findings and surgical management of a large intraparotid facial nerve schwannoma.

Background: To evaluate p-Cry in 10 years as a feasible and radical approach in patients with small renal masses (<5 cm), we evaluated technical success, side effects, and survival rates. Materials and Methods: We retrospectively evaluated 421 patients with small renal masses (<5 cm) with a median age of 70 years (47–92 C.I.) between June 2014 and July 2024 at our department. We also evaluated side effects, surgical radicality, and therapeutic outcomes of renal functions. Survivals were also evaluated in terms of disease-free, metastasis-free, and cancer-related survival rates. Results: Median follow-up was 90 months (1–120 months C.I.), and median size of the tumor was 3.85 cm (1–4 C.I.). Two cryoprobes were used in median, and two 10-min freeze–thaw cycles were performed. The technical efficacy rate was 100%, whereas only one of 121 lesions required retreatment. No impact on the renal function was registered after p-Cry. Cancer-free survival and metastases-free survival was reached. Conclusions: Compared to surgery, p-Cry is a feasible treatment option in patients with small renal masses, as it does not affect renal function and gives patients good survival rates.

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare inflammatory disorder that affects the brainstem and cerebellum. Patients often show symptoms like ataxia, diplopia, and dysarthria. Diagnosis can be complex due to the need to exclude other conditions. We present a case of a 35-year-old previously healthy female admitted to our hospital with dizziness, progressively worsening gait, and mild dysarthria. Advanced MRI techniques revealed characteristic lesions in the pons and cerebellum with characteristic “peppering” appearance, supporting a diagnosis of CLIPPERS. The patient improved significantly with corticosteroid treatment, emphasizing the importance of early recognition and treatment. Follow-up MRIs demonstrated a reduction in lesions, reinforcing the effectiveness of corticosteroids. The etiology of CLIPPERS remains unclear, but it is believed to involve immune-mediated mechanisms. Regular monitoring and long-term treatment strategies are essential to manage this condition effectively. This case underscores the critical need for increased awareness of CLIPPERS among clinicians and radiologists. It also highlights the importance of integrating clinical, radiological, and neuropathological findings for accurate diagnosis. Given its rarity and diagnostic complexity, this case report provides valuable pathogenetic insights into a poorly understood condition.