Angiomyofibroblastoma férfiban – egy ritka paratesticularis eltérés és irodalmi áttekintés

Összefoglaló. A scrotum képalkotó vizsgálóeljárásai közül elsőnek választandó az ultrahang, mivel könnyen hozzáférhető, szenzitivitása és specificitása magas. Szerepe kiemelendő mind az intratesticularis eltérések differenciáldiagnózisában, mind pedig a kevésbé ismert paratesticularis eltérések esetében. Az urológiai ambulancián egy 56 éves férfi jelentkezett kivizsgálásra tapintható terime miatt. Ultrahangvizsgálattal paratesticularis elváltozás látszódott, mely a vizsgálat során az inguinalis csatorna irányába többször elmozdult. A laesio dignitása nem volt meghatározható, ezért műtéti eltávolításra került sor. A szövettani vizsgálat a férfiak körében ritkán előforduló angiomyofibroblastoma diagnózisát véleményezte. A paratesticularis elváltozások ugyan ritkán fordulnak elő, de a gyakoribb entitások és azok ultrahangos sajátosságainak ismerete elengedhetetlen a terápia tervezése szempontjából. Orv Hetil. 2021; 162(34): 1376–1382. Summary. Ultrasonography is the basic imaging technique for the evaluation of testicular structures because it is easily accessible and has high sensitivity and specificity. It plays a significant role in the differential diagnosis of intratesticular changes, in addition, its role should be emphasised in rare paratesticular abnormalities. A 56-year-old male presented in the urology department complaining of a palpable inguinal mass and was referred to ultrasonography for further evaluation. A scrotal ultrasound was performed, and it described a mobile paratesticular mass without any specific characterizations. Therefore the lesion was removed, and the histological analysis established the diagnosis of angiomyofibroblastoma. Paratesticular lesions are rare, but it is essential to know the frequent abnormalities and the corresponding ultrasound findings for planning of treatment. Orv Hetil. 2021; 162(34): 1376–1382.

Rare presentation of metastatic adenocarcinoma of prostate as inguinal lymphadenopathy and its management

Prostate cancer is among the top ten cancers in India. Approximately half of patients with prostate cancer have metastasis on presentation, bones and regional lymph nodes being most common. A case of metastasised cancer of prostate presenting only with an inguinal mass without any other symptom is rare. A 72-year-old presented with a right inguinal mass for six months without any other complaints. Biopsy of the inguinal mass was done, and histopathology showed metastatic adenocarcinoma. His serum PSA (prostate specific antigen) was 117.325 ng/ml. PET CT (positron emission tomography-computed tomography) showed PSMA (prostate specific membrane antigen) expressing lesion in left lobe of prostate involving left seminal with metastatic pelvic, right inguinal, retroperitoneal and mediastinal adenopathy with increased tracer uptake in sclerotic skeletal lesions in right iliac bone, acetabulum and right femoral shaft. TRUS (trans rectal ultra-sonography) guided biopsy of prostate (12 CORE) was performed and showed conventional prostatic adenocarcinoma with maximum Gleason score 4+4=8, grade group IV. The patient's clinical stage was T3b N1 Mb. Patient is currently on abiraterone with degarelix with normal repeat serum PSA (0.067 ng/ml) on follow up at 5 months. Metastatic prostatic carcinoma usually presents with iliac nodes or bony metastasis, but rarely they present with inguinal lymphadenopathy and should be dealt with high clinical suspicion as they are already in advanced stage of the disease process.

A Very Rare Case: Metastatic Inguinal Mass From Primary Lung Cancer

Cancers of unknown primary (CUP) that we rarely encounter,conversely rank fourth in cancer-related deaths in males and females. In this case, we aimed to present how the primary of an inguinal mass, which could have been diagnosed as CUP in the 80’s, could be detected using advanced immunohistochemical methods.

An inguinal herniation of pregnant uterus in a Standard Wirehaired Dachshund – a case report

A 4-year-old intact female Standard Wirehaired Dachshund dog was referred with chief complaint of inguinal mass to the Small Animal Clinic at the University of Veterinary Medicine and Pharmacy in Košice, Slovakia. On physical examination, the bitch was healthy with no abnormalities other than having a non-painful and non-reducible soft tissue mass in the left inguinal region also involving the mammary gland. Ultrasonographic examination of the abdomen revealed a pregnant uterus and ultrasonography of the inguinal mass showed an organ with a lumen filled with anaechoic fluid. The diagnosis of a herniation was made and the owners decided for complete ovariohysterectomy. The left uterine horn had an incarcerated part of the inguinal hernia together with the ovary. Inside there was one macerated conceptus. The remaining part of the left uterine horn was located in the abdomen and had 2 macerated conceptuses. The bitch made an uneventful recovery from the surgery and anaesthesia with no postoperative complications and was sent home after the surgical procedure.

Mesothelial cyst in inguinal hernial sac in a male child: a case report

Mesothelial cysts of inguinal area are extremely rare and few cases have been reported in females, arising from round ligament of uterus. Inguinal hernias are a common surgical problem in children presenting as an inguinal or inguino scrotal swelling. Usually the contents of hernial sac in a male child are intestine or omentum and in females it may contain ovary. Mesothelial cyst of round ligament may present as an inguinal mass in females, but it is very rare to find in side inguinal hernial sac of a male child. Here in we report a case of 2 year 9-month-old male child, who was operated for irreducible right congenital inguinal hernia. A pedunculated cystic mass was found to be the content and was removed. Histopathology confirmed the diagnosis of mesothelial cyst. Because of rarity, we report this case.

Proximal Type - Epithelioid Sarcoma- A Rare And Aggressive Soft Tissue Neoplasm

Introduction/Objective Epithelioid Sarcoma is a rare malignant soft tissue neoplasm that is well known for local recurrence, regional lymph node involvement, and metastasis. It accounts for less than one percent of all sarcomas. Two subtypes of epithelioid sarcoma are described: the conventional or classic subtype and the proximal subtype, with the classic type being more common than the proximal type. We present a case of proximal epithelioid sarcoma involving the inguinal region, in which the patient presented with the history of weight loss for one year and a slow- growing inguinal mass for the last few months. The biopsy was done in an outside hospital and showed carcinoma of unknown origin. Imaging also failed to reveal any clear source of this mass. Methods The mass was resected and sent to pathology, where H&E staining and immunohistochemistry was done for diagnosis. Results The H&E sections of the left inguinal mass showed proliferation of large epithelioid cells with a moderate amount of cytoplasm, vesicular nuclear chromatin and prominent nucleoli. Mitosis was also seen. Necrosis was not identified. Immunohistochemical staining was done and revealed that the tumor cells were immunoreactive for epithelial marker cytokeratin AE1/AE3 and showed loss of INI-1. Tumor cells were also negative for Myogenin, ERG, HMB-45, MART-1, Myo-D1, S100, and SMA. Considering the cytomorphology and immunophenotypic findings the diagnosis of epithelioid sarcoma, proximal type was made. Conclusion Epithelioid sarcoma is a malignant mesenchymal neoplasm with epithelioid cytomorphology and phenotype. Among the two types of epithelioid sarcoma, the proximal type is reported about 50% less than the classic type and is associated with aggressive behavior and worse prognosis. The classic cytomorphology and immunohistochemistry findings helped us in making the diagnosis in this case.