Intranodal Capillary-Cavernous Hemangioma- An Uncommon Histopathological Lesion

A 35 year female presented with gradually increasing swelling in inguinal region of 8 years which was painful during menses. On systemic examination no significant disease was noted. On local examination right inguinal region showed soft tissue nodular mass measuring 3x1.5x1cm.On ultrasonography showed soft tissue nodule suggestive of vascular lesion. Minimal pericapsulitis was noted .No abscess or necrosis was noted. Lesion was surgically excised and sent for histopathology. Grossly received single oval lymph node measuring 2.5x2x1 cm. Cut section was dark grey brown with areas of hemorrhages. On histopathology diagnosed as Capillary Cavernous Hemangioma of right inguinal lymph node. We are presenting this case for its extreme rarity, its clinical, radiological, histopathological presentation. Recognizing these vascular lesion entities in lymph node is essential to for diagnosis and to guide therapy. Key words: Intranodal tumor, Inguinal lymphadenopathy, Nodal hemangioma.

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The Pedicled Flap of Adductor Longus, a New Technique for Inguinal Reconstruction

Frontiers in Surgery ◽

10.3389/fsurg.2021.639893 ◽

2021 ◽

Vol 8 ◽

Author(s):

Hong Zhang ◽

Zhenfeng Li ◽

Jianmin Li ◽

Lei Zhu ◽

Yakubu Ibrahim

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Inguinal Lymph Node ◽

Pedicled Flap ◽

Local Resection ◽

Inguinal Region ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Adductor Longus

Introduction: Reconstruction surgeries of the inguinal area pose a challenge for oncological and orthopedic surgeons, especially after radical local resection (RLR), radical inguinal lymph node dissection (RILND), or both. Although numerous surgical procedures have been reported, there is no report about a pedicle adductor longus flap method. The aim of this work is to show our experience about inguinal reconstruction with pedicled adductor longus flap and associated outcomes.Patients and Methods: A retrospective study of 16 patients with localized inguinal region interventions and reconstructed by adductor longus flap from March 2016 to July 2020. Patients' average age was 60.0 years (range = 38–79 years) and had postoperative follow-up of 10 months (ranging 2–19 months). All patients had unilateral inguinal region involvement—seven cases on the left and nine cases on the right. The patients' clinical course, operative course, and postoperative follow-up data were evaluated.Results: All 16 patients recovered well post-operatively and did not require any re-intervention. Four patients experienced negligible discomfort around the groin area. Five patients experienced a minor strength deficit in thigh adduction compared with that of preoperative strength in the same or contralateral leg. The aforementioned complications resolved during the postoperative course and had no functional impact on their activity of daily living. All adductor longus flaps survived, completely filled the inguinal dead space, and wounds healed uneventfully within 3 weeks except for three patients who suffered delayed wound healing for more than 4 weeks. Other common complications such as infection, seroma, or wound dehiscence were not encountered in this series.Conclusion: The adductor longus flap is a reliable alternative method for inguinal region reconstruction following radical local resection (RLR), radical inguinal lymph node dissection (RILND), or both.

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Malignant peripheral nerve sheath tumor with lymph node metastasis: an uncommon presentation

International Surgery Journal ◽

10.18203/2349-2902.isj20170880 ◽

2017 ◽

Vol 4 (3) ◽

pp. 1138

Author(s):

Suruchi Shreshtha

Keyword(s):

Lymph Node ◽

Soft Tissue ◽

Lymph Node Metastasis ◽

Inguinal Lymph Node ◽

Soft Tissue Sarcomas ◽

Nerve Sheath Tumor ◽

Inguinal Lymph Node Metastasis ◽

Soft Tissue Neoplasm ◽

Node Metastasis ◽

Uncommon Presentation

MPNST is a rare soft tissue neoplasm that accounts for less than 10 % of all soft tissue sarcomas. These tumors often affect males between 20 to 50 years, often with NF1, These with predilection for buttocks, thigh, brachial plexus, upper arm and paraspinal region. MPNST spread perineurally or hematogenously to lungs. Lymph node metastasis is seen in less than 5% cases of all sarcomas. This is a case of 46 year old male with NF-1 with MPNST posterior abdominal wall. The patient had metastatic pleural effusion in the absence of lung metastasis, along with widespread axillary, retroperitoneal and inguinal lymph node metastasis. Thus, although lymph node metastasis from MPNST is rare, this case expands our knowledge of the clinical behavior of MPNST.

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Infected femorocele: case report of an extremely rare surgical condition in a middle-aged lady suffering from a painful inguinal swelling

Surgical Case Reports ◽

10.1186/s40792-019-0716-4 ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Sabyasachi Bakshi

Keyword(s):

Lymph Node ◽

Femoral Hernia ◽

Urine Analysis ◽

Inguinal Lymph Node ◽

Histopathological Examination ◽

Stable Condition ◽

Sensitivity Test ◽

Inguinal Region ◽

Hernia Sac ◽

The Right

Abstract Background The hydrocele of the femoral hernia sac, an extremely rare occurrence, is termed femorocele. Very few authentically reported cases of femorocele are available in the literature. The present case, diagnosed as a case of infected femorocele, was managed successfully by excision of the femorocele sac and repair of the femoral hernia. To the best of the author’s knowledge, it is the first-ever reported case of infected femorocele. Case presentation A 30-year-old lady presented with a painful 3 cm × 2 cm swelling in the right inguinal region. Though the swelling was there for 2 years, the pain and indurations started after a trivial blunt trauma over the swelling 7 days ago. The patient was febrile and mild tachycardic but had no dysuria. The oval-shaped, tense-cystic, poorly translucent, non-pulsatile, non-reducible swelling showed no cough impulse. There was also a (1.5 cm × 0.5 cm) palpable right-sided superficial inguinal lymph node. Routine blood and urine analysis reports were normal except leukocytosis (10,000/mm3) with neutrophilia. Ultrasonography of the right inguino-labial region revealed a mildly echogenic cystic swelling without any intra-abdominal communication. Exploration of the right inguinal region revealed a cystic (3 cm × 2 cm) swelling, medial to the femoral vessels, containing amber-colored fluid. The distal sac was excised, and anatomical repair of femoral canal defect was done after transfixing the neck of the femorocele sac. Fibro-fatty-collagenous tissue with mixed inflammatory cells along with a flattened mesothelial lining cell layer was found on histopathological examination. Sections from inguinal lymph node showed reactive hyperplasia. Culture of fluid from the sac revealed growth of Escherichia coli. The patient was put on anti-inflammatory drugs and antibiotics according to a sensitivity test. Patient was discharged in stable condition after 5 days. Four months after the operation, the patient is doing well, remaining asymptomatic and without any sign of recurrence. Conclusions The hydrocele of the femoral hernia sac is an extremely rare disease. When not infected, it presents a painless inguinal soft cystic swelling, commonly in women of fourth to sixth decade. This was diagnosed intraoperatively in all cases reported till date. Excision of the sac after transfixation of the neck and anatomical repair are the treatment of choice. In elderly patients, with larger defect, the mesh repair can be opted for. The femorocele may also get infected by uropathogens, and proper antibiotics should be used after a sensitivity test.

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Hemomediastinum and bilateral hemothorax with extensive angiomatosis of anterior mediastinum

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2006.565 ◽

2016 ◽

Vol 65 (3) ◽

Author(s):

Sh. Karimi ◽

F. Mohammadi ◽

S. Pejhan ◽

M. Bakhshayeshkaram ◽

P. Akhavan-Azari ◽

...

Keyword(s):

Lymph Node ◽

Soft Tissue ◽

Vascular Tissue ◽

Anterior Mediastinum ◽

Vascular Lesion ◽

Vascular Lesions ◽

Small Vessels ◽

Pathologic Evaluation ◽

Massive Hemothorax ◽

Characteristic Features

Angiomatosis is a rare, benign but clinically extensive and serious vascular lesion of soft tissue. Hereby, we report a case of diffuse angiomatosis of mediastinum, presenting with hemomediastinum and bilateral massive hemothorax in a 19-year old boy. On medical imaging, mediastinal widening along with enhanced small vessels and capillaries were detected. On operation, hemorrhagic sponge-like vascular tissue patches were seen extensively in pericardium, pleura, lymph node and thymus as well. The lesion was debulked. The pathologic evaluation revealed characteristic features of soft tissue angiomatosis involving thymus, lymph node, pleura, pericardium and its fibrofatty tissue. Diffuse angiomatosis should be considered for differential diagnosis of vascular lesions of anterior mediastinum.

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Apocrine Adenocarcinoma of the Vulva: A Case Report and Review of the Literature

Case Reports in Obstetrics and Gynecology ◽

10.1155/2016/1712404 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4

Author(s):

Kohei Aoyama ◽

Hiroshi Matsushima ◽

Morio Sawada ◽

Taisuke Mori ◽

Satoru Yasukawa ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastases ◽

Inguinal Lymph Node ◽

Primary Source ◽

Pelvic Lymphadenectomy ◽

Japanese Woman ◽

Apocrine Adenocarcinoma ◽

Node Metastases ◽

Systemic Examination ◽

The Right

Primary vulvar adenocarcinomas are very rare. We describe the rare case of primary vulvar apocrine adenocarcinoma, a histologically rare subtype of vulvar adenocarcinoma. A 57-year-old Japanese woman presented with an enlarging vulvar mass. A dark-red, hemorrhagic, ulcerated tumor was on the right side of the anterior labial commissure measuring approximately3.5×3.5 cm. Preoperative biopsy showed poorly differentiated carcinoma with partial differentiation to adenocarcinoma. Systemic examination revealed lymph node metastases in both inguinal regions and no other primary source. We performed radical vulvectomy and bilateral inguinal and pelvic lymphadenectomy. Histopathologic diagnosis was apocrine adenocarcinoma of the vulva with inguinal lymph node metastases, pT1bN2bM0. Surgical margins were negative. The patient received no adjuvant chemotherapy or radiation. Inguinal lymph node recurrence occurred after six months. Reresection and adjuvant tomotherapy were performed. After a further 12 months of observation, no rerecurrence was observed. The patient is now on follow-up.

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