Case report of giant retroperitoneal liposarcoma in a young woman

Retroperitoneal liposarcoma is a rare malignant mesenchymal tumor with an annual incidence of approximately 2.5 cases per 100,000 inhabitants. It does not present specific symptoms, so its early diagnosis is difficult and in most cases it is performed when it has a large size. A 45-year-old patient with a history of increased abdominal perimeter and local discomfort was admitted in our center. After performing an abdominopelvic CT, she was diagnosed of a large, bulky tumor of lipomatous origin that significantly displaced the intestinal loops and the rest of neighboring organs. In view of the clinical suspicion of a liposarcoma, the patient underwent a resection of the lesion located in the retroperitoneum. The histopathological study determined a well differentiated retroperitoneal liposarcoma. The well-differentiated liposarcoma located in the lower limbs and the retroperitoneal space. Its age of presentation is between the fourth and sixth decade of life without finding differences between men and women. Its treatment is surgical and involves the resection of the tumor mass with non-affected surgical margins. Retroperitoneal liposarcoma is a malignant tumor whose treatment is fundamentally surgical. These tumors tend to be resistant to radiotherapy and / or chemotherapy. Among the most important prognostic factors related to survival is surgery with non-affected margins.

Download Full-text

Retroperitoneal liposarcoma of the intestine: a rare cause of acute abdomen

International Surgery Journal ◽

10.18203/2349-2902.isj20211841 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1614

Author(s):

Vikash C. Tiwari ◽

Vaibhav Mudhale ◽

Kulkarni S. Sharang ◽

Jineshwar Nyamagoud ◽

Malluru Srividya

Keyword(s):

Sudden Onset ◽

Wide Resection ◽

Lumbar Region ◽

Retroperitoneal Mass ◽

Significant Past Medical History ◽

Current Case ◽

Retroperitoneal Liposarcoma ◽

Malignant Mesenchymal Tumor ◽

Well Differentiated ◽

Left Lumbar Region

Retroperitoneal liposarcoma is a rare malignant mesenchymal tumor with an incidence of 2.5 per million individuals. It is usually asymptomatic until its large enough to compress the surrounding organs, so its early diagnosis is difficult. In current case a 41 year old male patient with no significant past medical history presented to emergency department with sudden onset of abdominal pain in the left lumbar region. On examination, the abdomen was distended, guarding and rigidity present with tenderness to palpation in the left lumbar region, and no mass was palpated. Abdominal USG revealed a large heterogeneous mass in the left lumbar region. As the origin of the mass was uncertain, the patient was evaluated with CECT of the abdomen which revealed a retroperitoneal mass highly s/o liposarcoma. Given the suspicion of a liposarcoma, the patient underwent an abdominal exploration and there was a retroperitoneal mass of 12x8 cm adherent to the left colon. Wide resection of this mass was done along with left colectomy and the specimen was sent for examination. The histopathology study determined lipomatous tumor well differentiated retroperitoneal liposarcoma. Retroperitoneal liposarcoma is a malignant tumor whose treatment is fundamentally surgical. These tumors tend to be resistant to radiotherapy and/or chemotherapy. Among the most important prognostic factors related to survival is surgery with non-affected margins.

Download Full-text

Retroperitoneal Liposarcoma With Leiomyosarcomatous Differentiation

International Surgery ◽

10.9738/intsurg-d-13-00061.1 ◽

2014 ◽

Vol 99 (1) ◽

pp. 48-51 ◽

Cited By ~ 1

Author(s):

Masaki Suzuki ◽

Minoru Fukuchi ◽

Shinji Sakurai ◽

Hiroshi Naitoh ◽

Shinsuke Kiriyama ◽

...

Keyword(s):

Computed Tomography ◽

Tumor Resection ◽

Abdominal Distention ◽

Low Density ◽

Solid Mass ◽

Retroperitoneal Liposarcoma ◽

Old Japanese ◽

Giant Tumor ◽

History Of ◽

Well Differentiated

Abstract We herein describe a 60-year-old Japanese man with a giant retroperitoneal liposarcoma undergoing leiomyosarcomatous differentiation. He was admitted to our hospital because of a 5-month history of dysphagia and abdominal distention. Abdominal computed tomography showed a giant tumor that occupied the entire retroperitoneal space. The majority of the mass was lipomatous and low density; both a heterogenous and solid mass were also present. A giant retroperitoneal liposarcoma was diagnosed, and tumor resection was performed. At surgery, the tumor was mostly isolated from the retroperitoneum and other organs. Histopathologically, the tumor comprised well-differentiated and dedifferentiated liposarcoma with heterologous differentiation of the leiomyosarcomatous components, which is a rare phenomenon in liposarcoma. The patient was alive 3 years after the first treatment, although he has had 3 local recurrences (approximately one recurrence yearly) and has been treated by repeated resection and radiotherapy.

Download Full-text

Retroperitoneal Liposarcoma with Multilocular Cysts

Case Reports in Gastroenterology ◽

10.1159/000504695 ◽

2019 ◽

Vol 13 (3) ◽

pp. 514-520 ◽

Cited By ~ 1

Author(s):

Chika Komine ◽

Minoru Fukuchi ◽

Shinji Sakurai ◽

Yuichi Tabe ◽

Akihiko Sano ◽

...

Keyword(s):

Signal Intensity ◽

External Iliac Artery ◽

Cystic Mass ◽

Resonance Imaging ◽

Solid Fat ◽

Weighted Image ◽

Intermediate Signal Intensity ◽

Retroperitoneal Liposarcoma ◽

History Of ◽

Well Differentiated

In this study, we describe a 60-year-old man with a giant retroperitoneal liposarcoma with multilocular cysts. He was admitted to our hospital because of a 5-month history of abdominal distention. Abdominal computed tomography revealed a giant lobulated cystic mass occupying the retroperitoneal space that contained partially solid fat components. Magnetic resonance imaging indicated that this complex mass exhibited a low signal intensity on a T1-weighted image, whereas it exhibited a high and focally intermediate signal intensity on a T2-weighted image. This patient was diagnosed with a mucinous type of retroperitoneal sarcoma, which was then resected. During surgery, the tumor was isolated from the retroperitoneum and other organs, but the detachment was required only because of fixation around the left external iliac artery. The histological diagnosis was a well-differentiated liposarcoma with multilocular cysts that contained old bloody, serous, and mucinous fluids, which are a rare phenomenon in liposarcoma. This case indicates that retroperitoneal liposarcoma should also be considered as a differential diagnosis of retroperitoneal cystic mass.

Download Full-text

Middle ear squamous cell carcinoma: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212905 ◽

2021 ◽

Vol 7 (8) ◽

pp. 1358

Author(s):

Nilesh H. Mahajan ◽

Asha M. ◽

Vinay Kumar Vijayendra ◽

Vijayendra Honnurappa

Keyword(s):

Squamous Cell Carcinoma ◽

Soft Tissue ◽

Cell Carcinoma ◽

Middle Ear ◽

Squamous Cell ◽

Histopathological Study ◽

Soft Tissue Lesion ◽

Tissue Lesion ◽

History Of ◽

Well Differentiated

<p class="abstract">Squamous cell carcinoma of middle ear is a rare entity. We present a case of 77 year old male, with squamous cell carcinoma of middle ear. Patient presented with blood tinged otorrhoea. Oto-endoscopy examination revealed a soft tissue lesion in middle ear which bled on touch. Histopathological study of this soft tissue lesion gave a diagnosis of well differentiated squamous cell carcinoma. Radical clearance of the tumour achieved after removal of the malleus and incus. Tumour was seen extending into the eustachian tube orifice and it was removed in toto. Uderlying bone was ablated using diode laser to confirm the radical clearance. Later patient was given radiotherapy 6 weeks after surgery to allow the healing of the operative site. The objective to report this case was to emphasize the importance of early diagnosis and prompt treatment for a better survival. Long standing history of ear discharge with soft tissue lesion bleeding on touch should always be evaluated by histopathological study to exclude malignancy.</p>

Download Full-text

Screening for haemorrhagic disorders in paediatric patients by means of a questionnaire

Hämostaseologie ◽

10.1055/s-0037-1621503 ◽

2009 ◽

Vol 29 (S 01) ◽

pp. S87-S89 ◽

Cited By ~ 4

Author(s):

I. Music ◽

M. Novak ◽

B. Acham-Roschitz ◽

W. Muntean

Keyword(s):

Predictive Value ◽

Laboratory Diagnosis ◽

Von Willebrand Disease ◽

Control Group ◽

Older Children ◽

Mild Disease ◽

History Of ◽

Von Willebrand ◽

Specific Symptoms ◽

Infants And Young Children

SummaryAim: In children, screening for haemorrhagic disorders is further complicated by the fact that infants and young children with mild disease in many cases most likely will not have a significant history of easy bruising or bleeding making the efficacy of a questionnaire even more questionable. Patients, methods: We compared the questionnaires of a group of 88 children in whom a haemorrhagic disorder was ruled out by rigorous laboratory investigation to a group of 38 children with mild von Willebrand disease (VWD). Questionnaires about child, mother and father were obtained prior to the laboratory diagnosis on the occasion of routine preoperative screening. Results: 23/38 children with mild VWD showed at least one positive question in the questionnaire, while 21/88 without laboratory signs showed at least one positive question. There was a trend to more specific symptoms in older children. Three or more positive questions were found only in VWD patients, but only in a few of the control group. The question about menstrual bleeding in mothers did not differ significantly. Sensitivity of the questionnaire for a hemostatic disorder was 0.60, while specifity was 0.76. The negative predictive value was 0.82, but the positive predictive value was only 0.52. Conclusions: Our small study shows, that a questionnaire yields good results to exclude a haemostatic disorder, but is not a sensitive tool to identify such a disorder.

Download Full-text

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

Iranian Journal of Neurosurgery ◽

10.32598/irjns.5.3.9 ◽

2020 ◽

Vol 5 (3 And 4) ◽

pp. 155-160

Author(s):

Mohsen Aghapoor ◽

◽

Babak Alijani Alijani ◽

Mahsa Pakseresht-Mogharab ◽

◽

...

Keyword(s):

Antifungal Drugs ◽

The Body ◽

Lower Limbs ◽

Lumbar Pain ◽

Case Presentation ◽

Delay In Diagnosis ◽

Death Case ◽

Therapeutic Results ◽

History Of ◽

Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

Download Full-text

Sirenomelia: two case reports

Journal of Medical Case Reports ◽

10.1186/s13256-021-02699-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Asiyeh Shojaee ◽

Firooze Ronnasian ◽

Mahdiyeh Behnam ◽

Mansoor Salehi

Keyword(s):

Case Reports ◽

Three Dimensional ◽

First Trimester ◽

Mendelian Inheritance ◽

Lower Limbs ◽

Congenital Deformity ◽

White Family ◽

Her Family ◽

Caudal Regression ◽

History Of

AbstractBackgroundSirenomelia, also called mermaid syndrome, is a rare lethal multi-system congenital deformity with an incidence of one in 60,000–70,000 pregnancies. Sirenomelia is mainly characterized by the fusion of lower limbs and is widely associated with severe urogenital and gastrointestinal malformations. The presence of a single umbilical artery derived from the vitelline artery is the main anatomical feature distinguishing sirenomelia from caudal regression syndrome. First-trimester diagnosis of this disorder and induced abortion may be the safest medical option. In this report, two cases of sirenomelia that occurred in an white family will be discussed.Case presentationWe report two white cases of sirenomelia occurring in a 31-year-old multigravid pregnant woman. In the first pregnancy (18 weeks of gestation) abortion was performed, but in the third pregnancy (32 weeks) the stillborn baby was delivered by spontaneous vaginal birth. In the second and fourth pregnancies, however, she gave birth to normal babies. Three-dimensional ultrasound imaging showed fusion of the lower limbs. Neither she nor any member of her family had a history of diabetes. In terms of other risk factors, she had no history of exposure to teratogenic agents during her pregnancy. Also, her marriage was non-consanguineous.ConclusionThis report suggests the existence of a genetic background in this mother with a Mendelian inheritance pattern of 50% second-generation incidence in her offspring.

Download Full-text

Global Hypertrophic Calcification of Shoulder Joint Capsule

Clinical Medicine Insights Case Reports ◽

10.1177/11795476211025351 ◽

2021 ◽

Vol 14 ◽

pp. 117954762110253

Author(s):

Abdulkarim Yousef Aldehaim ◽

Abdurhman Saud Alarfaj

Keyword(s):

Rheumatoid Arthritis ◽

Shoulder Joint ◽

Joint Capsule ◽

Surgical Approaches ◽

Contributing Factors ◽

Severe Arthritis ◽

History Of ◽

Excellent Control ◽

Specific Symptoms ◽

Calcific Deposits

Background: Calcification around the shoulder joint usually occur inside or around the tendons of the rotator cuff. We herein report on a case of global hypertrophic calcification of shoulder joint capsule in a patient with Rheumatoid arthritis. Case Report: An 86 years-old male with a long-standing history of seropositive Rheumatoid arthritis. The treatment for his Rheumatoid arthritis included Methotrexate and Hydroxychloroquine initially, but due lack of control, adalimumab was added with excellent control of his arthritis. He has progressively experienced an increasing pain and stiffness in his shoulders, in addition to an increasing limitation of shoulder movement. Magnetic Resonance Imaging revealed severe arthritis with remoulding deformity with extensive capsular calcification, intra-articular loose-bodies. Discussion: This phenomenon of calcification of shoulder capsule has not been reported before. The pathophysiology of calcific tendinopathy of the shoulder remains controversial. The calcific deposits consist of poorly-crystallized hydroxyapatite. Conclusion: Global hypertrophic calcification of shoulder joint capsule is unique and unreported in the literature. We can postulate that the long-standing inflammation of the synovial lining of the capsules had a major part. Moreover, Diabetes Mellitus, smoking, and repetitive manoeuvres are recognized contributing factors as well for similar conditions. Genetic predisposition seems to play a role as well. We think all those have played part in the development of this unprecedented presentation. Management should be tailored to target specific symptoms for pain, rigidity, and decreasing calcification size. Several options are available, including Kinesiotherapy, electrotherapy modalities, iontophoresis, electroshock wave therapy, and finally surgical approaches for progressive and refractory cases.

Download Full-text

Atypical cutaneous and musculoskeletal manifestation of SARS-CoV-2: ‘COVID-19 toes’ and spasticity in a 48-year-old woman

BMJ Case Reports ◽

10.1136/bcr-2020-241410 ◽

2021 ◽

Vol 14 (3) ◽

pp. e241410

Author(s):

Avery Kopacz ◽

Cameron Ludwig ◽

Michelle Tarbox

Keyword(s):

Nervous System ◽

Adult Patient ◽

Early Identification ◽

Lower Limbs ◽

Rare Occurrence ◽

Cutaneous Manifestations ◽

Crucial Component ◽

History Of ◽

Screening Questions ◽

Insight Into

Establishing accurate symptomatology associated with novel diseases such as COVID-19 is a crucial component of early identification and screening. This case report identifies an adult patient with a history of clotting dysfunction presenting with rare cutaneous manifestations of COVID-19, known as ‘COVID-19 toes’', previously described predominantly in children. Additionally, this patient presented with possible COVID-associated muscle spasticity of the lower limbs, as well as a prolonged and atypical timeline of COVID-19 infection. The rare occurrence of ‘COVID-19 toes’' in this adult patient suggests that her medical history could have predisposed her to this symptom. This supports the coagulopathic hypothesis of this manifestation of COVID-19 and provides possible screening questions for patients with a similar history who might be exposed to the virus. Additionally, nervous system complaints associated with this disease are rare and understudied, so this novel symptom may also provide insight into this aspect of SARS-CoV-2.

Download Full-text