Gossypiboma mimicking a distal pancreatic mass: Report of a case

Open Medicine ◽  
2010 ◽  
Vol 5 (1) ◽  
pp. 136-139 ◽  
Author(s):  
Savas Yakan ◽  
Safak Oztürk ◽  
Mustafa Harman ◽  
Oktay Tekesin ◽  
Ahmet Coker
Keyword(s):  
Histopathological Examination ◽  
Abdominal Mass ◽  
The Body ◽  
Mass Lesion ◽  
Soft Tissue Tumour ◽  
Peptic Ulcer Perforation ◽  
Palpable Mass ◽  
Tissue Tumour ◽  
Splenic Hilus ◽  
Greater Curvature

AbstractGossypiboma (retained surgical sponge) is a pseudotumor within the body that is composed of non-absorbable surgical material with a cotton matrix. Because the symptoms of gossypiboma usually are nonspecific and may appear years after surgery, the diagnosis of gossypiboma may be difficult because the condition may mimic a benign or malignant soft-tissue tumour in the abdomen and pelvis. A 61-year-old woman with a one-year history of left upper-quadrant pain and weight loss was referred to our center. She had undergone peptic ulcer perforation 23 year ago. Physical examination revealed dullness and palpable mass in the left upper abdomen. On examination by computed tomography (CT), a hypodense mass of 12 cm in diameter between the greater curvature of the stomach, pancreas, and splenic hilus was detected. Upon exploration, a mass lesion of 10 cm in diameter was detected between the greater curvature of the stomach and splenic hilus, which caused dense adhesions not in communication with the pancreas. It was excised and a splenectomy was performed. After a macroscopic examination, the mass lesion was diagnosed as gossypiboma. Although ultrasonography (US), CT, angiography, and magnetic resonance imaging (MRI) may be used to diagnose gossypiboma, definitive diagnosis is possibile only upon surgery or histopathological examination. As a result, when an abdominal mass is observed, surgeons should carefully investigate the patient’s past surgical history while taking the possibility of gossypiboma into consideration.

scholarly journals Intraneural synovial sarcoma of median nerve

2020 ◽  
pp. 275-279
Author(s):  
Sandeep Bhardwaj ◽  
Anil Kansal ◽  
Rohit Bansil ◽  
Rakesh Singh ◽  
Akangsha Sharma
Keyword(s):  
Median Nerve ◽  
Synovial Sarcoma ◽  
Histopathological Examination ◽  
Soft Tissue Tumour ◽  
Rare Tumour ◽  
Nerve Sheath Tumour ◽  
Nerve Sheath ◽  
Tissue Tumour ◽  
Dismal Prognosis ◽  
Synovial Sarcomas

Synovial sarcomas are highly aggressive soft tissue tumour with a poor and dismal prognosis. These tumours have a high propensity for distant metastasis and local recurrence.  Although originally believed to arise from synovium, these tumours have been found to occur anywhere in body [1],[2]. We report here, a case of median nerve sarcoma in a 15-year female. This is a rare tumour, which is diagnosed only after histopathological examination with only a few cases reported in the literature (Table 1). Although preoperatively tumour was thought to be a nerve sheath tumour, on histopathology analysis was found to be synovial sarcoma. Despite aggressive behaviour, wide local excision is recommended even in smaller lesions. So, the diagnosis should always be kept in differentials of nerve sheath tumour, as what may be a synovial sarcoma.

scholarly journals Surgical excision of complex lipoma from the foot: a case report 

2020 ◽  
Author(s):  
Akram Uddin ◽  
George Flanagan ◽  
Ian Reilly
Keyword(s):  
Soft Tissue ◽  
Diagnostic Imaging ◽  
Histopathological Examination ◽  
Histopathological Analysis ◽  
Soft Tissue Tumour ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Plantar Aspect ◽  
Tissue Tumour ◽  
Patient Reported

Abstract Background: Soft tissue malignant tumours of the foot and ankle are rare. Diagnostic imaging and interventional biopsy are vital to establish the nature and grading of a suspicious tumour prior to surgical intervention. The purpose of the study is to provide an account on how a symptomatic mass to the plantar aspect of the foot warranted a referral to a sarcoma centre, highlighting the importance of having urgent access to diagnostic imaging and a pathway to refer suspected cases to specialist centres. Method: A single patient with a symptomatic soft tissue tumour of the plantar foot was referred from our service to the regional sarcoma centre. It was considered to be benign and therefore open surgical resection was performed under local anaesthesia by our team, and the lesion sent for histopathological examination. Results: Histopathological analysis identified the excised mass as a lipoma to show no atypia or necrosis and mature adipose tissue with fibrous bands. At 2 years postoperatively there was no recurrence and the patient presented an asymptomatic foot. Favourable patient reported outcomes measures were observed. Conclusion: United Kingdom (UK) Guidelines suggest that all soft tissue masses of suspicious nature, greater than 50mm, deep seated irrespective of size, or fast growing should be referred to a sarcoma unit prior to surgical management. European guidance identifies a threshold of 15mm for a mass in the foot. Patients presenting with red flag symptoms irrespective of size of mass should be referred to a sarcoma centre. Advanced imaging and multidisciplinary input to enable appropriate surgical planning is recommended for these soft tissue tumours that present to the foot and ankle surgeon.Level of evidence: V case study.

Interdigitating dendritic cell sarcoma of the parotid gland

2005 ◽  
Vol 120 (3) ◽  
pp. 244-246 ◽  
Author(s):  
M Sharma ◽  
F Ahsan ◽  
K W Ah-See ◽  
M E McKean ◽  
R Kain ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Dendritic Cell ◽  
Parotid Gland ◽  
Histopathological Examination ◽  
Single Case ◽  
Needle Aspiration ◽  
Soft Tissue Tumour ◽  
Dendritic Cell Sarcoma ◽  
Single Case Report ◽  
Tissue Tumour

Interdigitating dendritic cell sarcomas (IDCSs) are extremely uncommon tumours that arise predominantly in lymphoid tissue. We report a case of an IDCS arising in the parotid gland of a 73-year-old man. Clinically, a primary salivary gland tumour was suspected but fine needle aspiration cytology suggested a soft tissue tumour. A diagnosis of IDCS was made on histopathological examination of the resection specimen, with subsequent confirmation by electron microscopy. Given the extreme rarity of this tumour at this site, it is unlikely to be a common diagnostic problem, but the importance of multiple diagnostic modalities is emphasized. The findings of cytology, histology, immunohistochemistry and electron microscopy have not previously been described together in a single case report of this tumour.

scholarly journals Perianal rhabdomyomatous mesenchymal hamartoma

2017 ◽  
Vol 99 (6) ◽  
pp. e193-e195 ◽  
Author(s):  
K Sampat ◽  
E Cheesman ◽  
S Siminas
Keyword(s):  
Histopathological Examination ◽  
Neck Region ◽  
Male Infant ◽  
Mesenchymal Hamartoma ◽  
Soft Tissue Tumour ◽  
Anal Lesion ◽  
Tissue Tumour ◽  
The Face ◽  
Histological Characteristics

A rhabdomyomatous mesenchymal hamartoma (RMH) is a rare benign soft tissue tumour found in the face and neck region of children. A three-month-old male infant was referred to our unit with a polypoid anal lesion that had been present from birth. Histopathological examination of the excised sample showed haphazard arrangement of mature striated skeletal muscle in among nerves and blood vessels, and immunohistochemistry confirmed the lesion to be a RMH. There was no evidence of recurrence during the follow-up period. This case emphasises two points: the unique histological characteristics associated with RMH and how this allows distinction from other differential diagnoses, and the consideration of RMH as a diagnosis in perianal lesions.

scholarly journals Surgical excision of complex lipoma from the foot: a case report 

2020 ◽  
Author(s):  
Akram Uddin ◽  
George Flanagan ◽  
Ian Reilly
Keyword(s):  
Soft Tissue ◽  
Diagnostic Imaging ◽  
Histopathological Examination ◽  
Histopathological Analysis ◽  
Soft Tissue Tumour ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Plantar Aspect ◽  
Tissue Tumour ◽  
Patient Reported

Abstract Background: Soft tissue malignant tumours of the foot and ankle are rare. Diagnostic imaging and interventional biopsy are vital to establish the nature and grading of a suspicious tumour prior to surgical intervention. The purpose of the study is to provide an account on how a symptomatic mass to the plantar aspect of the foot warranted a referral to a sarcoma centre, highlighting the importance of having urgent access to diagnostic imaging and a pathway to refer suspected cases to specialist centres. Method: A single patient with a symptomatic soft tissue tumour of the plantar foot was referred from our service to the regional sarcoma centre. It was considered to be benign and therefore open surgical resection was performed under local anaesthesia by our team, and the lesion sent for histopathological examination. Results: Histopathological analysis identified the excised mass as a lipoma to show no atypia or necrosis and mature adipose tissue with fibrous bands. At 2 years postoperatively there was no recurrence and the patient presented an asymptomatic foot. Favourable patient reported outcomes measures were observed. Conclusion: United Kingdom (UK) Guidelines suggest that all soft tissue masses of suspicious nature, greater than 50mm, deep seated irrespective of size, or fast growing should be referred to a sarcoma unit prior to surgical management. European guidance identifies a threshold of 15mm for a mass in the foot. Patients presenting with red flag symptoms irrespective of size of mass should be referred to a sarcoma centre. Advanced imaging and multidisciplinary input to enable appropriate surgical planning is recommended for these soft tissue tumours that present to the foot and ankle surgeon. Level of evidence: V case study.

scholarly journals Surgical excision of complex lipoma from the foot: a case report 

2020 ◽  
Author(s):  
Akram Uddin ◽  
George Flanagan ◽  
Ian Reilly
Keyword(s):  
Soft Tissue ◽  
Diagnostic Imaging ◽  
Histopathological Examination ◽  
Histopathological Analysis ◽  
Soft Tissue Tumour ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Plantar Aspect ◽  
Tissue Tumour ◽  
Patient Reported

Abstract Background: Soft tissue malignant tumours of the foot and ankle are rare. Diagnostic imaging and interventional biopsy are vital to establish the nature and grading of a suspicious tumour prior to surgical intervention. The purpose of the study is to provide an account on how a symptomatic mass to the plantar aspect of the foot warranted a referral to a sarcoma centre, highlighting the importance of having urgent access to diagnostic imaging and a pathway to refer suspected cases to specialist centres. Method: A single patient with a symptomatic soft tissue tumour of the plantar foot was referred from our service to the regional sarcoma centre. It was considered to be benign and therefore open surgical resection was performed under local anaesthesia by our team, and the lesion sent for histopathological examination. Results: Histopathological analysis identified the excised mass as a lipoma to show no atypia or necrosis and mature adipose tissue with fibrous bands. At 2 years postoperatively there was no recurrence and the patient presented an asymptomatic foot. Favourable patient reported outcomes measures were observed. Conclusion: United Kingdom (UK) Guidelines suggest that all soft tissue masses of suspicious nature, greater than 50mm, deep seated irrespective of size, or fast growing should be referred to a sarcoma unit prior to surgical management. European guidance identifies a threshold of 15mm for a mass in the foot. Patients presenting with red flag symptoms irrespective of size of mass should be referred to a sarcoma centre. Advanced imaging and multidisciplinary input to enable appropriate surgical planning is recommended for these soft tissue tumours that present to the foot and ankle surgeon. Level of evidence: V case study.

scholarly journals Intraneural synovial sarcoma of median nerve

2020 ◽  
pp. 110-115
Author(s):  
Sandeep Bhardwaj ◽  
Anil Kansal ◽  
Rohit Bansal ◽  
Rakesh Sharma ◽  
Akangsha Sharma
Keyword(s):  
Median Nerve ◽  
Synovial Sarcoma ◽  
Histopathological Examination ◽  
Soft Tissue Tumour ◽  
Rare Tumour ◽  
Nerve Sheath Tumour ◽  
Nerve Sheath ◽  
Tissue Tumour ◽  
Dismal Prognosis ◽  
Synovial Sarcomas

Synovial sarcomas are highly aggressive soft tissue tumour with a poor and dismal prognosis. These tumours have a high propensity for distant metastasis and local recurrence.  Although originally believed to arise from synovium, these tumours have been found to occur anywhere in body1,2. We report here, a case of median nerve sarcoma in a 15-year female. This is a rare tumour, which is diagnosed only after histopathological examination with only a few cases reported in the literature (Table 1). Although preoperatively tumour was thought to be a nerve sheath tumour, on histopathology analysis was found to be synovial sarcoma. Despite aggressive behaviour, wide local excision is recommended even in smaller lesions. So, the diagnosis should always be kept in differentials of nerve sheath tumour, as what may be a synovial sarcoma.

scholarly journals Primary Hydatid Disease in Femoral Muscles

2005 ◽  
Vol 33 (6) ◽  
pp. 703-706 ◽  
Author(s):  
CJ Kazakos ◽  
VG Galanis ◽  
D-AJ Verettas ◽  
A Polychronidis ◽  
C Simopoulos
Keyword(s):  
Hydatid Cyst ◽  
Unusual Case ◽  
Left Thigh ◽  
The Body ◽  
Soft Tissue Tumour ◽  
Resonance Imaging ◽  
Anterior Aspect ◽  
Tissue Tumour ◽  
Ultrasound Computed Tomography ◽  
Primary Hydatid Cyst

Usually, intramuscular hydatid cysts are secondary, resulting from the spread of cysts from other areas either spontaneously or after operations for hydatidosis in other regions. We present an unusual case of a primary hydatid cyst found in the left thigh of a 35-year-old woman, presenting as an enlarging soft-tissue tumour. Ultrasound, computed tomography and magnetic resonance imaging examinations revealed a multilocular intramuscular cyst in the anterior aspect of her left thigh, and no disease at any other location. We removed the entire cyst surgically, and macroscopic and microscopic histopathological examinations confirmed the diagnosis of muscular hydatidosis. Three years after the operation there had been no recurrence. In regions where hydatidosis is endemic, a tumour in any part of the body should be considered a hydatid cyst until proven otherwise.

scholarly journals Granular Cell Tumours: A Rare Entity in the Musculoskeletal System

Sarcoma ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Barry Rose ◽  
George S. Tamvakopoulos ◽  
Eric Yeung ◽  
Robin Pollock ◽  
John Skinner ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
Immunohistochemical Analysis ◽  
Granular Cell ◽  
The Body ◽  
Soft Tissue Tumour ◽  
Granular Cell Tumour ◽  
Tissue Tumour ◽  
Neural Origin ◽  
Granular Cell Tumours

Granular Cell Tumours are rare mesenchymal soft tissue tumours that arise throughout the body and are believed to be of neural origin. They often present as asymptomatic, slow-growing, benign, solitary lesions but may be multifocal. 1-2% of cases are malignant and can metastasise. Described series in the literature are sparse. We identified eleven cases in ten patients treated surgically and followed-up for a period of over 6 years in our regional bone and soft tissue tumour centre. Five tumours were located in the lower limb, four in the upper limb, and two in the trunk. Mean patient age was 31.2 years (range 8–55 years). Excision was complete in one case, marginal in five cases and intralesional in five cases. No patients required postoperative adjuvant treatment. Mean follow-up was 19.3 months (range 1–37 months). One case was multifocal, but there were no cases of local recurrence or malignancy. Histopathological and immunohistochemical analysis revealed the classical granular cell tumour features in all cases. We believe this case series to be the largest of its type in patients presenting to an orthopaedic soft tissue tumour unit. We present our findings and correlate them with findings of other series in the literature.

scholarly journals Scaphoid instability caused by a giant cell tumour of the tendon sheath: A case report

2017 ◽  
Vol 46 (3) ◽  
pp. 1263-1270
Author(s):  
Yanjun Wang ◽  
Xiaoxiao Zhu ◽  
Genwang Pei ◽  
Xianshang Zeng ◽  
Deng Chen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Giant Cell ◽  
External Fixator ◽  
Giant Cell Tumour ◽  
Histopathological Examination ◽  
Tendon Sheath ◽  
Cell Tumour ◽  
Carpal Instability ◽  
Soft Tissue Tumour ◽  
Tissue Tumour

Giant-cell tumour of the tendon sheath (GCTTS) is a soft tissue tumour that may invade bone, causing an intrinsic osseous lesion or instability on radiographs. A case with scaphoid instability caused by a histologically-confirmed neighbouring GCTTS has rarely been described in the literature. No definite and radical method is available for the treatment of GCTTS. This report describes an unusual case of a 22-year-old woman who previously experienced a GCTTS in her right elbow, which was removed 10 years earlier. Currently, she presented with an enlarged painless right wrist mass with focal swelling. The mass has been present for 5 years. During the previous 6 months, she felt something pop and experienced pain with limited motion in her right wrist. Magnetic resonance imaging demonstrated a well-circumscribed soft tissue mass. Under general anaesthesia, complete surgical resection of the mass was undertaken. Histopathological examination revealed that the mass was a GCTTS. Less invasive leverage reduction with external fixator support and iliac crest bone autologous graft for treatment of carpal instability were performed. Radical resection combined with external fixator support and bone grafting can provide a new option for the treatment of carpal instability.

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