scholarly journals Gigantic vulvar masses: a case series of benign large vulvar tumors

Author(s):  
Lorie Ann H. Bringas ◽  
Jimmy A. Billod

Benign vulvar masses are uncommon condition of the lower genital tract. To date, there is no recognized classification for benign tumors. Most of the vulvar tumors show no symptoms, unless large enough to be noted on self-examination. Presented are 3 cases of large vulvar masses. The first case is a Bartholin’s gland cyst in 56 years old, G5P4 (4014) with a 5-year history of gradually enlarging mass characterized as fleshy, approximately 16x14x12 cm, soft, non-tender located in the medial portion of the left labia majora. Grossly, the specimen consists of a unilocular cyst filled with serous fluid and had a smooth glistening inner capsule wall. The second case is a cellular angiofibroma in 61 years old, G0, who developed a fleshy mass, approximately 13x18x15 cm, soft, non-tender, attached to the left labia majora via a pedicle, which developed for 10 years. The specimen is described as an irregular mass with well circumscribed nodules with soft to rubbery, flesh cut surface. The third case is lipoblastoma-like tumor of the vulva in 31 years old, G2P2 (2002), who had a fleshy hypopigmented mass, approximately 15x12x10 cm, pendulous, soft, smooth, non-tender in the right inferolateral labia majora, which grew for 8 years. The specimen is characterized as an irregular mass partially overlain by skin with cut sections showing cream fatty lobulated surfaces. Benign vulvar masses may present similarly to one another hence careful and detailed assessment should be done. Histologic evaluation is critical in establishing an accurate diagnosis due to the fact that multiple diagnoses may have similar gross characteristics. Management is based on type and size of mass and symptomatology of patient.

2014 ◽  
Vol 8 (5-6) ◽  
pp. 429 ◽  
Author(s):  
Jeffrey Peter McKay ◽  
Michael Organ ◽  
Christopher Gallant ◽  
Christopher French

We report 2 cases of inguinoscrotal hernias involving urologic organs. The first case involved an elderly gentleman with a history of micturition by squeezing his scrotum. He was diagnosed as having a right-sided indirect inguinal hernia involving the right ureter and bladder. Treatment was surgical. The second case involved an achondroplastic male who presented with acute kidney injury. He had bilateral hydronephrosis and ureteric obstruction secondary to an ureteroinguinal herniation bilaterally. The presentation, diagnosis, and treatment of inguinoscrotal hernias involving the bladder and ureters are discussed.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Sarantis Blioskas ◽  
Sotiris Sotiriou ◽  
Katerina Rizou ◽  
Triantafyllia Koletsa ◽  
Petros Karkos ◽  
...  

Plexiform neurofibromas are benign tumors that tend to occur in patients suffering from neurofibromatosis type 1 (NF-1). This report addresses a rare case where the tumor affected the parotid gland, deriving almost exclusively from the peripheral portion of the facial nerve. A 6-year-old male was referred to us complaining about a gradually enlarging swelling over the right parotid area. Imaging localized the lesion to the superficial lobe of the parotid gland, suggesting a neurofibroma. Cosmetic disfigurement and a functional deficit led us to perform complete surgical resection. Meticulous surgical dissection as well as auriculotemporal nerve origin made complete extirpation possible with almost zero morbidity and ensured alleviation of both aesthetic impairment and pain. This is the first case of an intraparotid PN in a pediatric NF-1 patient, which originated from branches of the auriculotemporal nerve and particularly from fibers of the autonomic nervous system. Radical surgical excision was decided according to established decision-making algorithms.


2021 ◽  
pp. 107110072110252
Author(s):  
Mohamad Aizat Rosli ◽  
Wan Faisham Wan Ismail ◽  
Wan Azman Wan Sulaiman ◽  
Nor Azman Mat Zin ◽  
Syurahbil Abdul Halim ◽  
...  

Background: Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors. Methods: We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case. Results: The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either. Conclusion: Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes. Level of Evidence: Level IV, case series.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. Cutting ◽  
C. Davies-Husband ◽  
C. Poitelea

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction. The patient underwent emergency needle decompression. A 51-year-old man presented to the Emergency Department with right-sided unilateral proptosis, reduced visual acuity, and binocular diplopia. This occurred after performing a Valsalva manoeuvre with no history of head trauma. He also mentioned that over the past year he had experienced multiple episodes of transient proptosis occurring after Valsalva manoeuvres. Visual acuity in the right eye was reduced to 6/21. A relative afferent pupillary defect was present and intraocular pressure (IOP) was 12 mmHg. The CT scan showed significant orbital emphysema in the medial aspect of the right orbit. Needle decompression was performed resulting in immediate resolution of his symptoms. This case demonstrates that, in cases of orbital emphysema, a lack of a history of trauma and a normal IOP cannot always be used to rule out serious pathology.


Author(s):  
Ahmet Kale ◽  
Gülfem Başol ◽  
Elif Cansu Gündoğdu ◽  
Emre Mat ◽  
Gazi Yıldız ◽  
...  

Introduction: Piriformis syndrome is an uncommon disease resulting from the piriformis muscle’s compression of the sciatic nerve. Pain and numbness in the buttocks and down the leg are the most common symptoms. This study analyzes the laparoscopic surgical treatment of piriformis syndrome. Methods: We report three cases of piriformis syndrome diagnosed in our hospital. The first case was a 40 years old woman with a 7-year history of intermittent low back pain and sciatica on her right side. Hyperesthesia and cutaneous allodynia were observed in the right sciatic nerve dermatome. The second case was a 30 years old woman with a 2-year history of sciatica on her left side. The third case was a 30 years old woman with a 2-year history of sciatica on her right side. All the patients underwent laparoscopic decompression surgery, which was performed to release the sciatic nerve or sacral nerve roots. Results: The patients were reexamined at the postoperative 3rd and 6th months. Their visual analog scale (VAS) scores were found to be decreased from 10/10, 9/10, and 7/10 to 0/10, 1/10, and 0/10, respectively. Conclusion: Due to the very few cases in the literature, pelvic piriformis syndrome is an exclusively clinical diagnosis. If the sciatica is refractory to conservative treatments, laparoscopic exploration and decompression surgery of the pelvic nerves and piriformis muscle could be an option.


2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093606
Author(s):  
Li-Fang Shen ◽  
Ya-Lian Chen ◽  
Shui-Hong Zhou

Tumors of the parapharyngeal space (PPS) are rare, most originate from salivary and neurogenic tissues, and most are benign. However, there are some rarer masses in the PPS, with just a few published reports in the literature worldwide, and we may not consider them in the differential diagnosis of PPS neoplasms. We report three cases of rare masses in the PPS: Warthin’s tumor, branchial cleft cyst, and carcinoma ex pleomorphic adenoma. The three patients were admitted to our department with complaints of painless swelling in the lower side of the right face or a long history of snoring; diagnoses were confirmed histopathologically. An endoscopy-assisted transoral approach was used that allowed wide visibility for safe resection and resulted in a short hospitalization time and good functional and cosmetic outcomes. All patients have been followed to the current time, and there have been no recurrences. The transoral endoscopy-assisted approach appears to be safe, effective, and less invasive for excision of masses in the PPS.


2015 ◽  
Vol 156 (28) ◽  
pp. 1140-1143
Author(s):  
István Hartyánszky ◽  
Márta Katona ◽  
Krisztina Kádár ◽  
Asztrid Apor ◽  
Sándor Varga ◽  
...  

Aortico-left ventricular tunnel is a rare congenital cardiac defect, which bypasses the aortic valve via the paravalvar connection from the aorta to the left ventricle. The authors report the history of a 14-year-old boy with aortico-left ventricular tunnel in whom the aortic orifice arose from the right aortic sinus and was closed by a pericardial patch. The diagnosis was confirmed by combined two-dimensional and real time three-dimensional echocardiogram and magnetic resonance imaging. This is the first case, in which these complex diagnostic imaging methods have been used in the pre- and postoperative management of this defect. Optimally the new transthoratic three-dimensional echocardiography would be needed to define the anatomy and functional consequences of the aortico-left ventricular tunnel and in the postoperative follow-up. Orv. Hetil., 2015, 156(28), 1140–1143.


2020 ◽  
Vol 8 (1) ◽  
pp. e001031
Author(s):  
Nicola Fletcher ◽  
Camilla Brena ◽  
Amanda Carson ◽  
Mark Wessels ◽  
Tobias Floyd

Mesotheliomas are rare tumours in domestic animals. These tumours have a range of clinical presentations, and a range of gross and microscopic features can be present. We report mesotheliomas in two sheep submitted to Animal and Plant Health Agency’s diagnostic pathology service with diverse clinical presentations. The first case was a 2-year-old ewe with a history of sudden death that had a nodular mass in the wall of the right auricle and marked pericardial effusion and ascites. The second case was a 3-year-old ewe with a history of recumbency which had a papillary mass in the peritoneal cavity and marked ascites. A diagnosis of mesothelioma in both cases was confirmed by immunohistochemistry for cytokeratin and vimentin. These cases highlight the diverse presenting signs that can be present with mesothelioma, and this tumour should be considered as a differential diagnosis in sheep with peritoneal, pericardial or pleural effusion at gross postmortem.


2001 ◽  
Vol 94 (2) ◽  
pp. 322-326 ◽  
Author(s):  
Kazumichi Yamada ◽  
Masaki Miura ◽  
Haruhiko Miyayama ◽  
Naohiko Furuyoshi ◽  
Jun Matsumoto ◽  
...  

✓ The authors report the first case of a solitary xanthogranuloma of the cavernous sinus without systemic manifestation. A 43-year-old woman experienced decreased visual acuity on the right side in association with papilledema and a visual field defect. She was alert and no other neurological sign was observed. She had no family history of hyperlipoproteinemia and no cutaneous and/or systemic xanthomatous lesions. Skull x-ray films showed an enlarged right superior orbital fissure. Computerized tomography revealed a low-density oval mass 2 × 3 cm in diameter in the right cavernous region that was compressing the right optic nerve in the lateral to medial direction. This mass exhibited isointensity on T1-weighted and mixed-pattern hyperintensity on T2-weighted magnetic resonance images with diffuse contrast enhancement. Cerebral angiography demonstrated fine staining in the margin, originating from the right middle meningeal artery. These neuroimaging findings closely mimicked those associated with trigeminal neuroma. The lesion was partially removed via a right-sided zygomatic approach, and her symptoms improved. Clinical characteristics and histopathological features of this rare case are discussed.


2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
S. Guerriero ◽  
G. Infante ◽  
E. Giancipoli ◽  
S. Cocchi ◽  
M. G. Fiore ◽  
...  

Hepatocellular carcinoma rarely metastasizes to the orbit. We report a 45-year-old male, HBV+, HIV+, with a past history of a liver transplant for ELSD (end-stage liver disease) with hepatocellular carcinoma and recurrent HCC, who presented with proptosis and diplopia of the left eye. CT scans of the head revealed a large, irregular mass in the left orbit causing superior and lateral destruction of the orbital bone. Biopsy specimens of the orbital tumor showed features of metastatic foci of hepatocellular carcinoma. Only 16 other cases of HCC metastasis to the orbit have been described in literature, and this is the first case in a previously transplanted HIV+, HBV+ patient.


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