Imaging findings of a metastatic myxopapillary ependymoma in the left inguinal region

Eccrine porocarcinoma (EPC) is an infrequent cutaneous neoplasm, and was described in 1963 by Pinkus and Mehregan. It is a rare type of skin tumor (0.005–0.01% of all skin tumors). Less than 300 cases have been described in the entire world medical literature. To our knowledge, no case of intergluteal cleft EPC has been reported in the literature in English and Spanish to date, so this would be the first reported case of such pathology. Metastatic EPC is less frequent, since only <10% of metastatic type have been reported and the rest as localized disease. The primary treatment of choice is surgical wide local excision of the tumor with histological confirmation of tumor-free margins. Prognosis is difficult to determine because of the rarity of EPC and the variations in natural history. There are no data to support the use of adjuvant chemotherapy or radiotherapy, and there are currently no agreed criteria to define patients at high risk of relapse. We present a 67-year-old man with intergluteal cleft eccrine tumor by biopsy. Metastasis to left inguinal region and lung was reported by contrasted abdominal and chest computed tomography. He started chemotherapy based on etoposide, vincristine, carboplatin. A review of pertinent literature is provided.

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Rare Case of Large Bowel Injury due to Direct Blunt Trauma to a Preexisting Femoral Hernia

Case Reports in Surgery ◽

10.1155/2017/5308027 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

C. Tinner ◽

M. Odermatt ◽

P. Villiger

Keyword(s):

Blunt Trauma ◽

Femoral Hernia ◽

Bowel Perforation ◽

Colorectal Anastomosis ◽

Oral Feeding ◽

Inguinal Region ◽

Emergency Laparotomy ◽

Time Interval ◽

Hernia Sac ◽

Left Inguinal Region

We report a case of an 85-year-old man with a known asymptomatic left femoral hernia who was admitted to the emergency ward a few hours after falling from a bicycle and suffering from blunt trauma of the handlebar to the left inguinal region. The clinical findings and a computed tomography (CT) scan detecting free air in the femoral hernia sac suggested bowel perforation. Emergency laparotomy 6 hours after the incident confirmed a tear of the sigmoid colon accompanied by free blood and faeces in the left inguinal region of the abdomen. A segmental sigmoid resection and a primary end-to-end colorectal anastomosis were performed. The postoperative course was complicated by delayed oral feeding, a local infection, and a partial left testicle necrosis that led to secondary resection. The patient was discharged after 32 days of in-hospital care. Three months post trauma, we recorded a restitutio ad integrum. The case exemplifies that blunt trauma to preexisting femoral hernias may cause potentially lethal bowel perforation and that the time interval between time of injury and surgical treatment may be a prognostic factor. CT scans seem most suitable for ruling out bowel perforation. The scarce literature for blunt trauma to hernias is reviewed.

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Inguinal pain during pregnancy, secondary to round ligament varicosities: case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184544 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4762

Author(s):

Gamaliel Vázquez Estudillo ◽

Junior J. Araiza Navarro ◽

Martin F. Tellez Romero ◽

Rogelio Mata Cruz ◽

Ivanhoe Larracilla Salazar ◽

...

Keyword(s):

Case Report ◽

Doppler Ultrasound ◽

Spontaneous Regression ◽

Emergency Service ◽

Regional Hospital ◽

Round Ligament ◽

Inguinal Region ◽

First Case ◽

Left Inguinal Region ◽

Rule Out

The exact incidence of round ligament varicosities (RLV) is uncertain, due to the fact that there are few cases reported in the literature, and in many cases, they can be confused with inguinal hernias. A 26-year-old female with 26.3 weeks of gestation by date of last menstruation, who went to the emergency service of the Naval Regional Hospital of Tampico with the presence of an increase in volume in the left inguinal region, accompanied by pain, which increased standing and decreasing with the dorsal decubitus, the physical examination confirmed an increase in volume at the left inguinal level. An ultrasound of the inguinal region was requested to rule out an inguinal hernia as the first diagnosis, Doppler ultrasound revealed RLV. The patient was treated conservatively and at two weeks after the resolution of the pregnancy, the RLV presented a spontaneous regression and her symptoms completely resolved. This is the first case of round ligament varicosities reported in present institution. It is important to be aware of this pathology, to perform extension studies (Doppler ultrasound) to avoid unnecessary surgery in pregnant women.

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AN AUTOPSY CASE OF MALIGNANT RHABDOID TUMOR ARISING FROM SOFT PARTS IN THE LEFT INGUINAL REGION

Pathology International ◽

10.1111/j.1440-1827.1988.tb02381.x ◽

1988 ◽

Vol 38 (8) ◽

pp. 1087-1096

Author(s):

Hitoshi Uchida ◽

Shigeo Yokoyama ◽

Iwao Nakayama ◽

Kenji Zeze

Keyword(s):

Rhabdoid Tumor ◽

Inguinal Region ◽

Malignant Rhabdoid Tumor ◽

Autopsy Case ◽

Left Inguinal Region

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Tuberculosis in the left inguinal region associated with cutaneous tuberculosis of left second toe: An unusual presentation of extrapulmonary tuberculosis

Annals of Nigerian Medicine ◽

10.4103/0331-3131.92952 ◽

2011 ◽

Vol 5 (2) ◽

pp. 59

Author(s):

JugalK Kar ◽

Manoranjan Kar ◽

Saswati Maiti

Keyword(s):

Extrapulmonary Tuberculosis ◽

Unusual Presentation ◽

Inguinal Region ◽

Cutaneous Tuberculosis ◽

Second Toe ◽

Left Inguinal Region

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A bull gore injury: a rare case report and review of the literature

10.36811/jcri.2019.110004 ◽

2019 ◽

pp. 27-36

Author(s):

Alegbeleye Bamidele Johnson

Keyword(s):

Rare Case ◽

Iliac Fossa ◽

Trauma Surgery ◽

Inguinal Region ◽

Review Of The Literature ◽

Left Iliac Fossa ◽

Abdominal Sonography ◽

Left Groin ◽

Essentially Normal ◽

Left Inguinal Region

Background: Bull gore injuries are not common in a city set up but are common in the rural areas. The range of injuries varies from abdominal, chest, scrotal injuries which are quite different from the usual injuries seen in the emergency and casualty like road traffic injuries and stab injuries. We report a rare case of bull gore injury seen in a 38-year-old farmer, managed in this peripheral mission hospital one involving a stray domestic bull, its management as well as review of the literature. It is aimed that the knowledge gained from analyses of these injuries may be beneficial to other clinicians in general and also applicable to the management of similar injuries sustained in rodeo or agricultural settings. Case Presentation: A 38-year-old male farmer of Kumbo origin, Northwestern Cameroon was seen at the emergency department after being hit by a stray domestic bull in his farm. He presented with a complaint of pain in the left iliac fossa, actively bleeding deep laceration in the left inguinal region and a left scrotal swelling. On presentation, his vital parameters (blood pressure: 120/80 mmHg, pulse rate: 82/minute, respiratory rate: 18/minute, temperature: 37.10 Celcius) were stable. On physical examination, the eviscerated left testes and cord was visible at the edge of a deep laceration in the left inguinal region and there was moderate swelling in the left iliac fossa. Rectal examination did not reveal additional finding. The bowel sounds were normal. We made a clinical diagnosis of penetrating abdominal injury with evisceration of left testes. The findings from the initial laboratory studies; Chest and plain abdomen radiographs were essentially normal. Focused abdominal sonography for trauma showed minimal free fluid in the left paracolic gutter and pelvis as well as diffuse hypoechoic mass (hematoma) of anterior abdominal wall essentially in the left iliac fossa. He was resuscitated on intravenous fluids, IV Ceftriaxone 1gm 12hourly, IV Metronidazole 500mg 8hourly, IV Paracetamol 1gm 8hourly. He also had anti-tetanus prophylaxis and was thereafter transferred to the OR. He had exploratory laparotomy, and left groin exploration; extensive left groin wound debridement with evacuation of hemoperitoneum, orchidopexy and wound closure over left pelvic as well as scrotal drains. The post-operative period was uneventful with optimal recovery. The patient was subsequently discharged on the seventh post-operative day and had since been seen in the surgical outpatient clinic at three weekly intervals for six months with satisfactory outcome. Conclusion: Trauma due to animals especially those caused by bull horn could be life threatening as well as leave disability due to the site involvement. Early intervention and trauma surgery can be both lifesaving and could also prevent disability at a later stage. Management of bull gore injury can be challenging to the surgeon who needs have high index of suspicion for the diagnosis of this condition and take a call on type of management. Also, surgical repair of the injury is also difficult because of the complex anatomy and the less accessibility. There is an increasing priority for preventive measures to curtail such mishaps. Keywords: Bull horn Injury; Abdominal Trauma; Bull-Fight; Goring; Evisceration

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Perineal Hernia in a Bitch

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.100110 ◽

2020 ◽

Vol 48 ◽

Author(s):

Ângela Valentina De La Porta Machado ◽

Gabriela Lugoch ◽

Ana Paula Ibarra dos Santos ◽

Maria Eduarda Pons Gonçalves ◽

Marília Teresa De Oliveira ◽

...

Keyword(s):

Physical Examination ◽

Surgical Procedure ◽

Perineal Hernia ◽

Inguinal Region ◽

Ultrasound Scan ◽

Hernia Sac ◽

Pelvic Diaphragm ◽

Perineal Region ◽

The Right ◽

Left Inguinal Region

Background: Perineal hernia is characterized by the displacement of abdominal organs to the perineal region after rupture or weakening of the pelvic diaphragm muscles. This condition is common among middle-aged and elderly unneutered male dogs. Considering the severity of the condition and its rarity among bitches, this paper reports on a case of perineal hernia caused by hydrometra in a 12-year-old pinscher bitch.Case: The patient was a 12-year-old Pinscher bitch, weighing 3 kg, suffering from anuria and constipation in the 36 h prior to treatment, without reported trauma. She was unspayed, and her last estrus had occurred approximately thirty days previously. The physical examination revealed an increase in volume in the right perineal region, increased volume in the left inguinal region, increased body temperature (39.8ºC), pale mucous membranes, tachycardia, tachypnea, abdominal pain and increased popliteal lymph nodes. The diagnosis was determined based on her medical history, clinical signs and an ultrasound scan, which revealed dilated uterine horns displaced unilaterally in the left inguinal region, with evidence of hydrometra, full urinary bladder inside the hernia sac in the right dorsolateral perineal region and right kidney pyelectasis. After evaluating the animal’s physical condition, surgery was recommended, involving ovariohysterectomy associated with inguinal and perineal herniorrhaphy.Discussion: Perineal hernia, a common condition in male dogs, is characterized by the displacement of organs towards the perineal region. However, in this case, this condition occurred in female dog. Unlike males, the main causes of perineal hernia in females are trauma, chronic coughing related to heart disease, bronchitis, and tracheal collapse. Increased intra-abdominal pressure associated with a weak pelvic diaphragm predisposes for herniation of abdominal contents, such as occurred through hydrometra. In this case, other factors that could pertain to the etiology of perineal hernia were excluded, given the absence of trauma or secondary diseases. The diagnosis was made based on a physical examination and ultrasound scan. Pre-surgical biochemical blood tests were also performed. The chosen treatment was ovariohysterectomy followed by inguinal and perineal herniorrhaphy. The traditional surgical procedure to reduce the perineal hernia was employed, using approximation sutures due to the easy apposition of wound edges. The structures and soft tissues involved showed no changes in color or texture, thus obviating the need for more elaborate techniques, which are employed in the case of relapse or muscle atrophy. The patient showed clinical evolution after surgical correction, with decreased perineal volume and recovery of urinary function (normuria). The patient was discharged after 72 h, and six months after the surgical procedure, she presented no clinical alteration, according to information provided in a telephone call by her owner. It is believed that the increase in volume caused by the presence of hydrometra was the determining factor for the development of inguinal and perineal hernias. It is suggested that alterations causing uterine enlargement be investigated in order to include perineal hernia in female dogs as a differential diagnostic tool.

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A Case of Brown Lipoma.

Tumori Journal ◽

10.1177/030089166705300613 ◽

1967 ◽

Vol 53 (6) ◽

pp. 636-640

Author(s):

Lorenzo Zingo ◽

Gabriele Tancini ◽

Franco Talamazzi

Keyword(s):

Inguinal Region ◽

Fatty Tissue ◽

Left Inguinal Region

A case of brown lipoma of left inguinal region in a woman is described. The authors analyse histomorphology, philogenesis and nomenclature of this tumor of brown fatty tissue.

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Experiences with Hermann’s tortoise (Testudo hermanni) microchipping in Slovenia — Short communication

Acta Veterinaria Hungarica ◽

10.1556/004.2016.005 ◽

2016 ◽

Vol 64 (1) ◽

pp. 47-53

Author(s):

Alenka Dovč ◽

Mateja Stvarnik ◽

Urška Mavri ◽

Gordana Gregurić-Gračner ◽

Iztok Tomažić

Keyword(s):

Short Communication ◽

Environmental Temperature ◽

Inguinal Region ◽

Breeding Stock ◽

Testudo Hermanni ◽

Animal Size ◽

Left Inguinal Region

This study describes experiences obtained with microchipping of Hermann’s tortoises in Slovenia. Over a period of three years, a total of 5,128 Hermann’s tortoises from parental breeding stock were microchipped. Microchips were implanted subcutaneously in the left inguinal region. During the application of microchips, males were bleeding in 2.6% and females in 1.4% of the cases. Bleeding frequency was related to sex, animal size and environmental temperature at the time of microchipping. The presence of microchips was followed up over a period of several years. At the control check conducted a few years later, all previously microchipped tortoises were included. Out of the entire parental breeding stock, 235 (4.6%) had lost their microchips, thus 63 males (5.7%) and 172 females (4.3%) were unmarked. The possible reasons for microchip loss are migration or inactivity of the implanted microchips.

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Case Report: An extremely rare occurrence of recurrent inguinal low-grade fibromyxoid sarcoma involving the scrotum

F1000Research ◽

10.12688/f1000research.24287.2 ◽

2020 ◽

Vol 9 ◽

pp. 789

Author(s):

Samy Chitayat ◽

Rodrigo Barros ◽

José Genilson Ribeiro ◽

Heleno Augusto Moreira Silva ◽

Flávio Rondinelli Sá ◽

...

Keyword(s):

Tumor Resection ◽

Muscle Flap ◽

Inguinal Region ◽

Purulent Discharge ◽

Histopathological Diagnosis ◽

Low Grade ◽

Patient Reported ◽

Fibromyxoid Sarcoma ◽

Left Inguinal Region

Low-grade fibromyxoid sarcoma (LGFMS) is a rare sarcoma subtype. The most common tumor locations are the deep soft tissue of extremities or trunks. We report a rare case of recurrent LGFMS in the inguinal region involving the scrotum and both testicles. A 38-year-old male patient reported a history of multiple nodular lesions in the left inguinal region accompanied by local inflammation. The patient was submitted for local resection of the lesion at our institution, with histopathological diagnosis of LGFMS. He missed his follow-up, returning with a large bulge in the left inguinal region involving the scrotum with signs of tissue necrosis and local purulent discharge. Surgical exploration was performed and the patient underwent tumor resection in the left inguinal region and the entire scrotum, with bilateral orchiectomy, with the margins enlarged to the right inguinal region and proximal surface of the penis. Local reconstruction was performed with a left fascia lata tensor muscle flap and ipsilateral thigh coverage using partial skin graft. On microscopic examination, the tumor showed spindle cells arranged in bundles, with abundant collagen and myxoid stroma with interspersed prominent vessels. The immunohistochemical study carried out showed immunoreactivity with Ki67 (<5%), immunonegativity with desmin and S100, confirming the diagnosis of LGFMS. Postoperative recovery was good and no recurrence was seen after two years. The patient is in good health, realizing multidisciplinary outpatient follow-up and performing continuous testosterone replacement. Surgical resection with negative margins for localized disease remains the standard treatment for LGFMS.

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