Giant hysteromyoma after vaginoplasty in a woman with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: case report and review of the literature

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by congenital absence of both the uterus and vagina. Some patients require surgery to create a neovagina, however, the preservation of a nonfunctional rudimentary uterus after surgery may lead to long-term complications. Herein, a rare case of a giant hysteromyoma after vaginoplasty, in a 31-year-old Chinese female patient who was diagnosed with MRKH syndrome, is reported. The patient, who had undergone vaginal reconstruction 4 years previously, presented with abdominal distension for the previous 2 weeks. Transabdominal ultrasonography showed a firm mass of approximately 10 × 10 cm in the lower abdomen. The patient subsequently underwent an exploratory laparotomy, and a leiomyoma from her rudimentary uterus was removed. Beside this case, seven cases, published between 2004 and 2020, were identified during a literature search. Findings of the present and previously published cases suggest that gynaecologists should pay particular attention to the risks of pelvic complications in female patients with MRKH syndrome who have previously undergone surgery, and select appropriate therapeutic methods.

Is orchiectomy avoidable in testicular tuberculosis mimicking malignancy? A case report

Background Isolated testicular tuberculosis (TB) is extremely uncommon. It has non-specific presentation; thus, diagnosis is challenging and is often discovered on pathology examination after orchiectomy. Case presentation We report herein the case of a 73-year-old male, with no significant medical or family history, who presented with left scrotal swelling, physical examination revealed a left testicular firm mass measuring 3 cm and ultrasound was suggestive of testicular tumor. Left inguinal orchiectomy was performed and the pathologic examination revealed testicular TB. The presentation was typically mimicking a testicular cancer with no evocative evidence of TB; this can lead to a dilemma and highlights the need to consider TB in differential diagnosis of testicular tumor, especially in areas endemic for the disease. Conclusions The aim of our presentation is to argue if orchiectomy was avoidable. It also illustrates the probable hematogenous or lymphatic spread of Mtb to the testicle.

Giant Hysteromyoma After Vaginoplasty in a Woman With Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome: Case Report and Review of the Literature

Background: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by congenital absence of both the uterus and vagina. Some patients may need an operation to create a neovagina. However, the preservation of nonfunctional rudimentary uteri after surgery usually leads to some long-term complications. Case presentation: We report a rare case of a giant hysteromyoma after vaginoplasty in a woman with MRKH syndrome. A 31-year-old Chinese woman who was diagnosed with MRKH syndrome and received vaginal reconstruction 4 years ago presented with abdominal distension for half a month. Transabdominal ultrasonography showed a firm mass of approximately 10 x 10 cm in the lower abdomen. She then received an exploratory laparotomy, and a leiomyoma from her rudimentary uterus was removed.Conclusions: Gynecologists should pay attention to the risks of pelvic complications in women with MRKH syndrome who have undergone previous surgery and then choose suitable therapeutic methods.

Case report laparoscopy-assisted pre-pubic urethrostomy as a palliative procedure for resection of distal urethral tumor in a female dog

Background This paper presents the first described case of laparoscopy-assisted prepubic urethrostomy and laparoscopic resection of a tumor of the distal part of the urethra in a female dog as a palliative treatment. Case presentation An intact, 11 -year-old, mixed breed female dog, weighing 15 kg, was admitted with signs of urinary obstruction and difficulty with catheterization. Vaginal, rectal, and endoscopic examinations revealed a firm mass in the pelvic cavity at the level of the pelvic urethra. Ultrasound and computed tomography examination showed enlargement of the urethral wall (5.5 cm width and 3 cm thick), which was significantly restricting the patency of the urethra. The lesion affected only the distal part of the urethra without the presence of local or distant metastatic changes. The affected portion of the urethra was laparoscopically removed while performing pre-pubic urethrostomy with laparoscopy. The patient regained full consciousness immediately after the end of anesthesia, without signs of urinary incontinence. Histopathological examination of the removed urethra revealed an oncological margin only from the side of the bladder. In the period of 2.5 months after the procedure, the owner did not notice any symptoms that could indicate a postoperative recurrence, which was diagnosed three months after the procedure. Conclusions Pre-pubic urethrostomy can be successfully performed with the assistance of laparoscopy. The use of minimally invasive surgery will allow, in selected cases, removal of the urethral tumor, and in inoperable cases, to perform a minimally invasive palliative pre-pubic urethrostomy.

Dermatofibrosarcoma protuberans of the breast: A case report of a rare breast tumour

Introduction: Dermatofibrosarcoma protuberans (DFSP) is an intermediate and slow-growing sarcoma, arising most commonly in the trunk and extremities and rarely in the breast. It may be recurrent, but metastasis is rare. Excision with good resection margins reduces the rate of recurrence. Case Presentation: A 28-year-old lady presented with a painless lump in the left breast of 16 years duration. Examination revealed an ulcerated firm mass, well defined, with perilesional nodules on the skin of the breast. Wedge biopsy favoured Borderline Phylloides Tumour over DFSP. Patient was offered mastectomy and the histology of the specimen confirmed Fibrosarcomatous DFSP. Conclusion: This stresses the importance of histology in diagnosing a rare breast tumour. This is very important because it may show similar appearance to other benign and malignant breast lesions, which makes clear the role of pathological investigation to make a definitive diagnosis.

A Single Firm Nodule of the Upper Lip: A Case Report

Canalicular Adenoma (CA) is a benign accessory salivary gland neoplasm. It represents less than 1% of salivary gland tumors. It occurs generally on the upper lips in female patients over 50 years of age. We report a case of canalicular adenoma that arose from buccal minor salivary glands of the upper lip without any symptomatology. Clinically, CA appears as an often single firm mass of 1cm, sparing the main salivary glands which is not pathognomonic of canalicular adenoma. Treatment of choice is enucleation to rule out many differential diagnoses that may present clinically as an asymptomatic nodule. Recurrences are rare. Histological features are characteristic and usually allow a definitive diagnosis to be made with confidence. However, many differential diagnoses remain to be ruled out.

Heterotopic Polyodontia: Diagnosis and Surgical Removal of a Dentigerous Cyst Comprising 2 Dental Structures in a 14-Year-Old Horse

A 14-year-old American Paint Horse mare was referred for further evaluation of a firm mass with an associated draining tract at the base of the left ear suspected to be a dentigerous cyst. Approximately three months prior, the draining tract had been excised under the presumed diagnosis of an abscess with no improvement. Physical examination revealed a firm mass palpable at the base of the left ear with a draining tract that did not elicit any pain response on palpation. Digital radiographs revealed a 6x11cm mineral mass in the left temporal region. Medially, there were two projections that extended into the left temporal bone. Cone beam computed tomography (CT) showed mild thinning of the temporal bone separating the mass and the brain at the conical extension of the caudal aspect of the mass. Both structures were isolated and elevated using a combination of osteotomes, mallet, and bone rongeurs under general inhalant anesthesia with radiographs to determine complete removal. Although histopathology was declined, gross examination of both structures resembled adult molar teeth. At eight months postoperative, the owners reported that the surgical site was healed and no discharge was present. Dentigerous cysts should remain a differential for a mass with an associated draining tract at the base of the ear in horses. Practitioners should strongly consider CT when feasible for additional diagnostics in similar cases. Although benign and removal poses risk, dentigerous cysts can be surgically excised with a positive outcome.

Osteosarcoma of the hard palate in a dog ˗ case report

ABSTRACT The osteosarcoma (OSA) is the most diagnosed primary bone cancer in canine patients. This work reports a case of a canine, six years old, mongrel, female, intact, with an OSA in the hard palate. Physical examination detected a firm mass in the palate. Thoracic radiographs, hematological and biochemical exams, histopathological exams and computed tomography were requested. A chondroblastic OSA was diagnosed and the tumor was characterized by immunohistochemistry. There was never evidence of metastasis in this case. The treatment consisted of the combination of conventional chemotherapy, metronomic chemotherapy, and palliative care, aiming at greater survival and well-being of the patient since surgical excision was not possible due to the location and extension of the tumor. Osteogenic sarcomas of the hard palate are rarely seen and described in the literature. In this article we present a characterization of the osteosarcoma with uncommon localization in the hard palate.

A rare case of retroperitoneal lymphangioma in a 74-year-old Chinese male

Retroperitoneal lymphangioma is an uncommon and benign mesodermal tumour that arises from the retroperitoneal lymphatics. Notably, it is a rare occurrence in adults, where <200 adult retroperitoneal lymphangioma cases have been published in the literature. Additionally, retroperitoneal lymphangioma is often difficult to diagnose preoperatively and formal diagnosis is frequently determined following surgical exploration. Here, we describe a rare case of retroperitoneal lymphangioma in a 74-year-old man who presented with a 6-month history of intermittent fresh per rectal bleeding with an incidental non-tender left iliac fossa firm mass on examination. Computed tomography scan established a retroperitoneal cystic lesion abutting the aorta and left common iliac vessels. Surgical exploration revealed a large cystic mass and a clean plane of dissection was performed, where the mass was completely excised with all the key structures preserved. Histology was consistent with a retroperitoneal lymphangioma.

Ossifying Fibroma in the Nasal Cavity of a 2-Year-Old Horse

A 2-year-old mare of an unknown breed was referred to the clinic due to undetermined breathing difficulties. Physical examination revealed painless swelling rostral to the nasoincisive notch and a large, firm mass protruding from the left nostril. Radiographic examination of the head revealed a mass occupying the left nasal cavity and a displaced and hypoplastic last premolar of the left maxilla. The CT scan showed a well-demarcated heterogeneous mass measuring 22 × 9 × 5 cm (length × height × width) in the left nasal cavity attached to the roots of the displaced tooth and conchae. The surgery was performed on the standing horse. Firstly, due to the oblique position of the displaced tooth, the extraction was performed extra-orally through the trephination and repulsion of the maxillary bone. In the next step, a direct surgical approach was chosen for the caudal part of the mass via the osteotomy of the left nasal bone. The mass was bluntly separated from the conchae and removed through the nostril using Fergusson forceps. The histopathological characteristics of the mass led to the diagnosis of ossifying fibroma. The horse recovered completely in seven months, without recurrence after two years.