Perforating Rheumatoid Nodule Mimicking Malignant Soft-tissue Mass of the Forearm

Rheumatoid nodule1, one of the most characteristic manifestations of rheumatoid arthritis (RA), occurs in approximately 30% of patients, is generally associated with positive rheumatoid factor, smoking, and high disease activity2, and occurs in some patients with specific genotypes receiving methotrexate (MTX)3. An 83-year-old woman with a history of anticitrullinated protein antibody–positive RA treated by oral MTX, as well as gout, was hospitalized for a growing tumor of her right forearm.

Sacral Rheumatoid Nodule: An Unusual Indication for Coccygectomy

Here, we present a case report of a woman who presented with a large sacral rheumatoid nodule. This patient failed conservative treatment and presented in search of a surgical solution. We successfully removed her rheumatoid nodule using a surgical approach typically reserved for traumatic coccydynia. We show how coccygectomy, although a rare surgical procedure, was effective in treatment of a large rheumatoid nodule.

Subcutaneous nodules in children: Don’t forget deep granuloma annulare: A Case Report

Deep granuloma annulare is an uncommon benign granulomatous skin disorder that presents almost exclusively in the paediatric population. It presents as an asymptomatic subcutaneous nodule with normal overlying skin on distal extremities, the scalp, or the forehead. It shows a deep palisading granuloma with areas of central necrobiosis on histologic examination. Due to its self-limited nature, clinical follow-up is recommended over surgical interventions. We present a case of cephalic deep granuloma annulare in a healthy 5-year-old girl who remains free of recurrence after surgical excision at the 6-month follow-up. Our case emphasizes the importance of differentiating the lesion from its clinical and histopathological mimickers, such as the rheumatoid nodule. The awareness of this entity is important to avoid the overinvestigation and overtreatment of a benign and self-limited disease.