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Purpose: This study aimed to evaluate the outcomes of large angiomyolipoma (AML) treatment by selective arterial embolization (SAE) versus nephron-sparing surgery (NSS) using a robotic surgical system. Materials and Methods: Between January 2011 and June 2018, we retrospectively reviewed 25 patients who underwent robot-assisted partial nephrectomy (RAPN) or SAE for large AMLs. Ten patients underwent RAPN, and 15 underwent SAE. Patient demographics, AML characteristics, and operative and postoperative clinical outcomes were recorded and analyzed. Outcomes were compared between patients who underwent RAPN and patients who underwent SAE. Specifically, changes in renal function and size were evaluated after the treatment. Results: The mean age of the patients was 52.9 years, and 22 of 25 patients were female. The mean maximum AML diameter on computed tomography was 8.9 cm, and 8 patients had multiple masses. Twenty-two of 25 patients had moderate to high RENAL complexity. Patients who underwent SAE had more symptoms (p = 0.018) and higher RENAL complexity scores (p = 0.013) on average. On average, tumor size decreased by 99% among RAPN patients and by 58% among SAE patients (p = 0.001). Although the mean pretreatment estimated glomerular filtration rate (eGFR) was higher among RAPN patients (99.8 vs. 80.0 mL/min/1.73 m2, p = 0.043), there were no significant changes in eGFR in either group after the treatment. One patient in the RAPN group experienced complications, but the postoperative ileus resolved without intervention. Conclusions: Both RAPN and SAE were effective and feasible treatment options for large AMLs. The AML characteristics and the condition of the patient might be important in determining the appropriate treatment method.

This study aimed to develop a model that fused multiple features (multi-feature fusion model) for predicting metachronous distant metastasis (DM) in breast cancer (BC) based on clinicopathological characteristics and magnetic resonance imaging (MRI). A nomogram based on clinicopathological features (clinicopathological-feature model) and a nomogram based on the multi-feature fusion model were constructed based on BC patients with DM (n=67) and matched patients (n=134) without DM. DM was diagnosed on average (17.31±13.12) months after diagnosis. The clinicopathological-feature model included seven features: reproductive history, lymph node metastasis, estrogen receptor status, progesterone receptor status, CA153, CEA, and endocrine therapy. The multi-feature fusion model included the same features and an additional three MRI features (multiple masses, fat-saturated T2WI signal, and mass size). The multi-feature fusion model was relatively better at predicting DM. The sensitivity, specificity, diagnostic accuracy and AUC of the multi-feature fusion model were 0.746 (95% CI: 0.623-0.841), 0.806 (0.727-0.867), 0.786 (0.723-0.841), and 0.854 (0.798-0.911), respectively. Both internal and external validations suggested good generalizability of the multi-feature fusion model to the clinic. The incorporation of MRI factors significantly improved the specificity and sensitivity of the nomogram. The constructed multi-feature fusion nomogram may guide DM screening and the implementation of prophylactic treatment for BC.

Uterine fibroids are the commonest uterine neoplasms, they are benign tumors of smooth muscle origin. The study was done to look for the anatomical locations of uterine fibroids and their incidence in Sudanese women at Omdurman Maternity Hospital between 1st July 2014 to 5th October 2015. Their sociodemographic and ultrasound data were collected using a prepared questionnaire. The study included 138 confirmed cases of uterine fibroids out of 2968 investigated cases representing incidence rate of 4.6%. The highest incidence was found in the age group 36-40 years. Most dominant anatomical locations of uterine fibroids were intramural as a single mass (34.78%), followed by the intramural-subserosal in multiple masses (20.29%). The anatomical positions of uterine fibroids, posterior position was seen in (27.5%) which was the most dominant in single uterine fibroid mass, followed by the anterior-posterior position in multiple uterine one (18.1%). Intramural anatomical locations in single mass are the commonest uterine fibroids types which affect the Sudanese women. Key words: Anatomical locations; Uterine fibroid and leiomyomas

The response of damaged Euler–Bernoulli beams with any number of unilateral cracks and subjected to one or more moving masses which remain always in contact with the beam are investigated in this paper. A flexibility switching crack model is employed here to represent a crack as either open or closed at a particular instant depending on the sign of the axial strain at the crack centre and taking into account the location of the crack either at the top or bottom of the beam. This model leads to closed-form solutions of the damaged beam mode shapes as a function of four integration constants, which can be computed by enforcing the boundary conditions, and a Boolean switching crack array which identifies the open cracks. Based on this switching crack model, an efficient computational procedure is proposed to tackle the problems of multiple masses moving on a multi-cracked beam with generic boundary conditions. The proposed procedure is applied to three beams with switching cracks under moving masses, and the results obtained are compared to the widely adopted always open cracks model, showing significant differences. In particular, it is shown that: (i) Flexible boundary conditions, multiple switching cracks and multiple moving masses can be easily accounted for with the proposed approach; (ii) the two limiting conditions of always open cracks and always closed cracks (undamaged) models do not always provide bounds on the dynamic response of a beam with switching cracks subject to moving masses; (iii) the side where each crack is located can largely affect the response.

OBJECTIVE To determine the prevalence of malignancy in masses from the mammary gland region of dogs with single or multiple masses. ANIMALS 95 female dogs from which mammary gland masses had been excised. PROCEDURES Medical records of all female dogs from which mammary gland tissue was submitted to the Angell Animal Medical Center Pathology Department from 2009 through 2014 were reviewed. For each dog, data were obtained on breed, body weight, age, reproductive status, and number, location, and histologic classification of masses. The prevalence of malignancy was compared between dogs with single versus multiple masses and among the 5 pairs of mammary glands. Dogs with single versus multiple masses were also compared with respect to age and reproductive status. RESULTS Among 161 evaluated masses, 137 (85%) were classified as benign or nonneoplastic and 24 (15%) as malignant. Five of 95 (5%) dogs had masses that were not of mammary gland origin. Age, reproductive status, and quantity of masses (single vs multiple) were not significantly associated with the prevalence of malignancy. The prevalence of malignancy in masses from the fourth (caudal abdominal) mammary gland was significantly lower than that in the other 4 mammary glands combined. CONCLUSIONS AND CLINICAL RELEVANCE Dogs with multiple masses in the mammary gland region were not significantly more likely than dogs with single masses to have a malignancy, suggesting that these 2 groups could be managed similarly. Further studies are needed to evaluate the clinical relevance of the lower prevalence of malignancy in masses from the fourth mammary gland.

Sarcomatoid carcinoma (SC) is an extremely rare carcinoma and a diagnostic challenge on imaging. We present a case of a 54-year-old man with SC involving the pleura. The computed tomography (CT) scan showed multiple masses with rim enhancement and necrotic center located in the pleura. It was difficult to distinguish from pleural tuberculoma, metastasis and malignant pleural mesothelioma (MPM). In this article we will review the radiological features of these diseases. Keywords: Pleural sarcomatoid carcinoma, Pleural tuberculoma, Metastasis, Malignant pleural mesothelioma, CT

The dynamic response of delaminated twisted stiffened cylindrical shell under low-velocity impact of multiple masses is presented. The impactors are considered to impact at two arbitrary locations ...

Metastasis to the breast from all other primary sites is unusual. Twelve patients were diagnosed between 2007 and 2017 at National Cancer Institute, Mexico. Solitary or multiple masses, round or oval, and hypoechoic and solid lesions with posterior acoustic shadowing were patterns commonly reported in these patients; other arrangements include diffuse involvement of the breast simulating an inflammatory carcinoma. The development of a breast metastasis is revealed, in our experience, as a negative prognostic factor. Thus, the radiologist should know about the varied appearance of metastatic breast lesions and provide radiopathological correlations when available.

A palpable mass continues to be the most frequent manifestation of primary breast cancer. In a multinodular breast it must be of a size or consistency that is different from the other tissues of the breast. Masses are more common in the upper outer quadrant of the breast where most breast tissue is located. Some patients present with multiple masses in one or both breasts. Mammograms are important in the evaluation of breast masses for the following reasons: they can confirm the likelihood of carcinoma, and the patient is prepared in advance for the likelihood of this diagnosis; they can detect occult carcinoma in the same breast which may go undetected if the palpable mass is, in fact, benign; they can detect occult carcinoma in the opposite breast and thereby avoid missing a case of bilateral breast cancer; they may avoid a biopsy if the mammograms show the typical characteristics of a lipoma or a cyst.

The patient is a 3-year-old boy. He presented with multiple masses around the right shoulder.

Background The presence of histologically different neoplasms in the same organ is rare in pathologic practice. We report the first case of synchronous clear cell renal cell carcinoma (clear cell RCC) and papillary renal neoplasm with reverse polarity (PRNRP) with comprehensive immunohistochemical and molecular characterization using next-generation sequencing (NGS). Case presentation A 61-year-old man was incidentally found to have a left renal mass on imaging studies performed for workup of left back pain and urine color change for 1 week. A laparoscopic left radical nephrectomy was performed. Gross examination showed lobulated masses measuring 5.6 × 4.0 × 3.3 cm in the upper to mid pole and 1.1 × 1.0 × 1.0 cm in the lower pole. Microscopic findings revealed these to be two different separate masses of clear cell renal cell carcinoma and papillary renal neoplasm with reverse polarity. NGS analyses revealed KRAS gene mutation (c.35G > T/p.G12V in exon 2) in the papillary renal neoplasm with reverse polarity, with PIK3CA gene mutation restricted to the clear cell renal cell carcinoma (c.1624G > A/p.E542K in exon 10). Conclusions We report here an extraordinarily rare case of synchronous renal tumors of papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma. We identified simultaneous KRAS and PIK3CA mutations in two different renal masses in the same kidney for the first time. New pathologic assessment with comparative molecular analysis of mutational profiles may be helpful for tumor studies.

Los tumores de glándula mamaria son el tipo de neoplasia más frecuente en hembras de la especie canina. Pueden presentarse como masas únicas o múltiples afectando varias glándulas mamarias, se clasifican según el tejido de origen y sus características histológicas en carcinomas, sarcomas y tumores mixtos, con frecuencia suelen presentarse varios tipos histológicos de forma simultanea afectando diferentes glándulas mamarias en el animal. Existen varios tipos de carcinomas según la clasificación de la OMS 1999 y la de Glodschmidt 2011, con valor pronóstico para el paciente. Se presenta un caso de carcinoma de células en anillo de sello en glándula mamaria de una perra de raza rottweiler, de 8 años de edad con presentación múltiple en mamas abdominales e inguinal derecha, siendo un tipo de carcinoma poco frecuente en glándula mamaria. La paciente presentó una sobrevida de 6 meses post-cirugía, con recidiva notoria a los 4 meses y una evolución de 14 meses desde la fecha de aparición del tumor.

OBJECTIVE. Historically, management recommendations for multiple bilateral circumscribed breast masses encountered with breast imaging have varied. This article reviews the evidence and provides best-practice recommendations for managing these masses. CONCLUSION. Meticulous imaging technique and interpretation are required to correctly diagnose multiple bilateral circumscribed breast masses. Radiologists should classify such masses identified at mammography, digital breast tomosynthesis, or bilateral whole-breast sonography as benign and recommend annual follow-up. Elucidating the significance of these masses on MRI, contrast-enhanced mammography, or nuclear breast imaging requires further study.

Cardiac papillary fibroelastoma is a rare, benign cardiac tumor. It often arises from the valvular endocardium and is usually solitary. Nonvalvular location is rare and even more rare is the presentation as multiple masses. A 71-year-old female patient was referred for echocardiographic evaluation due to progressive fatigue. The presence of multiple left atrial masses was observed on echocardiographic evaluation. The patient was treated surgically for the prevention of embolic complications, and the histologic diagnosis of multiple nonvalvular papillary fibroelastoma was made. This case highlights the need to consider this unusual location and presentation for this type of tumor.

The purpose of this study is to describe the imaging features of pregnancy-associated breast cancer (PABC) on breast MRI and to consider the impact of preoperative MRI on patient management.A retrospective review of medical records from January 1994 to May 2014 identified 183 women who presented with a new diagnosis of breast cancer during pregnancy or within 1 year postpartum. MR images were available for 53 of these patients, all of whom were included in the study. Clinical history and available breast images were reviewed. The clinical impact of preoperative breast MRI was also recorded.Of the 53 women, nine (17%) presented during pregnancy and 44 (83%) presented during the first year postpartum. The sensitivity of MRI was 98% (52/53). Among the 53 patients, the most common findings of PABC on MRI included a solitary mass (29 patients [55%]), nonmass enhancement (12 patients [23%]), and multiple masses (eight patients [15%]). For 12 patients (23%), MRI showed a pathologically proven larger tumor size or greater extent of disease than did mammography or ultrasound, with an additional eight patients (15%) having findings suspicious for greater extent of disease but having unavailable pathologic data. Breast MRI changed surgical management for 15 patients (28%), with four patients (8%) requiring a larger lumpectomy, seven (13%) no longer being considered candidates for lumpectomy, two (4%) having contralateral disease, and two (4%) having unsuspected metastasis.Breast MRI had a high sensitivity for PABC in our study population. MRI may play an important role in PABC because it changed the surgical management of 28% of patients.

The purpose of this article is to describe a clinical case of relapsing metallic bezoar in the gastroinstestinal tract, observed in a psychiatric patient treated at the Hospital Universitario Sul Fluminense, located at city of Vassouras/ RJ. Bezoars are foreign bodies that impact the lumen of the digestive tract and are formed by the continued, prolonged and intentional ingestion of exotic materials or continuous use of medications. The bezoars may extend in continuity to the small intestine or could be presented as multiple masses detectable in any gut segment. By exploratory laparotomies, the metallic bodies in the gastric and intestinal region were removed. The patient evaded the Hospital and monitoring of the case by a multidisciplinary team was not possible

We prove global existence of small solutions to the initial value problem for a class of cubic derivative nonlinear Schr\"odinger systems with the masses satisfying suitable non-resonance relations. The large-time asymptotics of the solutions are also shown. This work is intended to provide a counterpart of the previous paper (arXiv:1507.07617) in which the mass resonance case was treated., Comment: 17 pages

Clear cell carcinoma affects primarily adults and presents at a mean age of approximately 60 years. Women are involved more than men. The majority of cases involve minor salivary glands in the oral cavity, presenting as single or multiple masses. Most cases of clear cell carcinoma behave as low-grade malignancies. Clear cell carcinoma is infiltrative, comprised of one cell type (ductal), and may exhibit a variety of architectural patterns (single cells, nests, trabeculae, and solid) with or without hyalinized stroma (Figs. 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 12.8, 12.9, 12.10, 12.11, 12.12, 12.13, 12.14, 12.15, 12.16, 12.17, 12.18, 12.19 and 12.20).

Warthin’s tumor affects primarily adults and presents at a mean age of approximately 60 years. Women are involved less than men. The majority of cases involve the parotid gland, presenting as single or multiple masses. Warthin’s tumor may be well-circumscribed or multinodular, comprised of multiple cell types (columnar and cuboidal), and exhibit a variety of architectural patterns (solid, cystic, and papillary) (Figs. 28.1, 28.2, 28.3, 28.4, 28.5, 28.6, 28.7, 28.8, 28.9, 28.10, 28.11, 28.12, 28.13, 28.14, 28.15, 28.16, 28.17, 28.18 and 28.19).

Basal cell adenocarcinoma is the malignant counterpart of basal cell adenoma. Basal cell adenocarcinoma affects primarily adults and presents at a mean age of approximately 65 years. Women and men are involved with similar frequency. The majority of cases involve the parotid gland, presenting as single or multiple masses. Basal cell adenocarcinoma is infiltrative, comprised of multiple cell types (ductal and basal), and may exhibit a variety of architectural patterns (solid, trabecular, tubular, and membranous) (Figs. 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8, 9.9, 9.10, 9.11, 9.12, 9.13, 9.14, 9.15, 9.16, 9.17, 9.18, 9.19, 9.20, 9.21, 9.22 and 9.23).

Salivary duct carcinoma affects primarily adults and presents at a mean age of approximately 60 years. Women are involved less than men. The majority of cases involve the parotid gland, presenting as single or multiple masses. Most cases of salivary duct carcinoma behave as high-grade malignancies. Salivary duct carcinoma is infiltrative, comprised almost exclusively of one cell type (ductal), and exhibit a variety of architectural patterns (solid, trabecular, cribriform, and microcystic) (Figs. 25.1, 25.2, 25.3, 25.4, 25.5, 25.6, 25.7, 25.8, 25.9, 25.10, 25.11, 25.12, 25.13, 25.14, 25.15, 25.16, 25.17, 25.18, 25.19, 25.20, 25.21, 25.22, 25.23, 25.24, 25.25 and 25.26).

Small cell neuroendocrine carcinoma affects children and adults and presents at a mean age of approximately 65 years. Women are involved more than men. The majority of cases involve the parotid gland, presenting as single or multiple masses. Most cases of small cell neuroendocrine carcinoma behave as high-grade malignancies. Small cell neuroendocrine carcinoma is infiltrative, comprised almost exclusively of one cell type (neuroendocrine), and exhibit a variety of architectural patterns (solid and organoid) (Figs. 27.1, 27.2. 27.3, 27.4, 27.5, 27.6, 27.7, 27.8, 27.9, 27.10, 27.11, 27.12, 27.13, 27.14, 27.15, 27.16, 27.17, 27.18, 27.19, 27.20, 27.21, 27.22, 27.23, 27.24 and 27.25).

Hydatid cyst disease is one of the zoonoses caused by the larval stage of Echinococcus granulosus, mostly involving the liver and the lungs; but its complications can be seen in every site and organ. Sometimes it can cause suspicious and complicated cases that mimic malignancy. For instance, axillary involvement of hydatid cyst is very rare. It is important to differentiate hydatid cyst disease from cancer, since it may show malignant features when pulmonary or other distant organ involvement takes place. In this study, we present a case of multiple masses in the lungs and the axillary region in a 48-year-old woman. The ultrasonography was unable to detect hydatid cysts. Biological values were normal except for serum sodium (Na) and potassium (K); and enzyme-linked immunosorbent assay (ELISA) test was negative. Hydatid cyst was diagnosed while taking a biopsy from the axillary tumor.

This work investigates the application of a deformable localization/mapping method to register lesions between the digital breast tomosynthesis (DBT) craniocaudal (CC) and mediolateral oblique (MLO) views and automated breast ultrasound (ABUS) images. This method was initially validated using compressible breast phantoms. This methodology was applied to 7 patient data sets containing 9 lesions. The automated deformable mapping algorithm uses finite element modeling and analysis to determine corresponding lesions based on the distance between their centers of mass (dCOM) in the deformed DBT model and the reference ABUS model. This technique shows that location information based on external fiducial markers is helpful in the improvement of registration results. However, use of external markers are not required for deformable registration results described by this methodology. For DBT (CC view) mapped to ABUS, the mean dCOM was 14.9 ± 6.8 mm based on 9 lesions using 6 markers in deformable analysis. For DBT (MLO view) mapped to ABUS, the mean dCOM was 13.7 ± 6.8 mm based on 8 lesions using 6 markers in analysis. Both DBT views registered to ABUS lesions showed statistically significant improvements (p ≤ 0.05) in registration using the deformable technique in comparison to a rigid registration. Application of this methodology could help improve a radiologist's characterization and accuracy in relating corresponding lesions between DBT and ABUS image datasets, especially for cases of high breast densities and multiple masses.

Introduction Myxoma is the most common cardiac benign tumour. While a typical myxoma is generally a straightforward diagnosis, some myxomas have unusual features that can make the diagnosis challenging. Glandular myxomas and metastatic adenocarcinomas, the most common type of metastatic carcinoma to the heart, can have very similar features. Case presentation We report a 60-year old man who presented with progressive shortness of breath on exertion. Echocardiography demonstrated a large heterogeneous, cystic left and right atrial mass. He was referred for surgery where a smooth and multilobulated left atrial mass was excised. Histopathological analysis with special stains revealed an unusual form of cardiac myxoma with extensive glandular differentiation. Discussion Cardiac myxomas can present with diverse clinical, radiological, and pathological features. Echocardiography is a modality of choice for diagnosis but can also miss small or multiple masses. Cardiac myxoma with glandular features is a rare type of myxoma. In our case, there was extensive glandular differentiation and the echocardiographic appearance provided clues for the unusual features of the tumour, suggesting a potential role for echocardiography in the detection and recognition of this morphologic histologic variation.

Neurofibromatosis originates from the Schwann cells of the nerve sheath of the nerve which is benign in nature. In von Recklinghausen's disease multiple masses arises all over the body. It may occur from internal nerves sporadically. These are the white glistening round or lobulated masses arise in the course of nerves involved. Neurofibroma of larynx is seldom reported. Women are more affected than men in the ratio 3:2. Hoarseness is the earliest and common symptom, the patient present with. If the mass increase in the course of time, the dyspnoea, later dysphagia symptoms wills result. The arytenoid is the common site of origin, later aryepiglottic fold, false vocal cord, ventricle of the larynx. As the tumor is benign in nature, total excision of tumor is recommended. In the literature, very few cases of laryngeal involvement are reported. This article presents a case report of neurofibroma of larynx involving false vocal cord and ventricle presented submucosally with symptom of hoarseness, primarily with mild stridor on exertion. In this large endolaryngeal mass, laryngofissure surgical approach is selected as a choice.

RATIONALE: Ectopic liver tissue can develop at various sites near the liver. Ectopic hepatocellular carcinomas (HCCs) arising from ectopic liver tissue have a rare clinical incidence. A very rare case has been observed to have metastasis after operation. PATIENT CONCERNS: We report an extremely rare case with multiple masses which were identified in the head and body of the pancreas. DIAGNOSES: Ectopic hepatocellular carcinomas. INTERVENTIONS: The masses were removed by surgical resection. Histopathological analysis showed that both masses were ectopic HCC. OUTCOMES: The patient was still alive and did not have metastasis and relapse. LESSONS: The literature review for this rare case is also presented to highlight the risk of ectopic HCC and good prognosis of operation for ectopic HCC.

Though most primary brain gliomas present as a single mass lesion in the brain, this potential diagnosis must be considered in the differential diagnosis when faced with a case of multifocal brain mass lesions. Among the most common brain tumors in humans, glioblastomas can be classified into four classes, one of which consists of anaplastic astrocytomas (AA). Due to its significant malignant potential, a prompt stereotactic brain biopsy should be considered to allow for early diagnosis. Karyotypic analysis of the specimen may allow for the discovery of 1p12q and IDH132 gene mutations. This knowledge can be used to best determine prognosis and guide therapy.

Objective To assess the long term efficacy and safety of surgical management of orbital cavernous haemangiomas (OCH) as performed in a tertiary eye hospital in China. Methods A retrospective study with 74 OCH patients treated in the Eye Hospital, at the Zhongshan Ophthalmic Center, of Sun Yat-Sen University was performed covering a period from January 2002 to April 2010. The surgical approach, treatment results and visual outcome were recorded and analysed. Results Surgery was performed in all 74 patients and all tumours were completely removed. Among them, 93% of the cases (69/74) underwent anterior orbitotomy, with 43% (30/69) by a cutaneous approach, 57% (39/69) by a conjunctival approach and only 7% of the cases (5/74) used a lateral orbitotomy. The mean follow-up time was 4.6 years (range 2.0 to 10.0 years). Visual acuity improved in 32.4% of cases and deteriorated in 8.2% of cases. No residual proptosis existed. A complicated permanent pupil change was present in three cases and only one case showed a permanent slight motility deficit. Two cases with multiple masses recurred at two years after the first surgery, but neither recurring as assessed at 2 and 5 years after the second surgery. Conclusions Most OCHs can be removed by anterior orbitotomy, using either a cutaneous or conjunctival approach. Anterior orbitotomy is a safe, convenient and effective surgical approach for OCH.

We report the case of a 64-year-old otherwise healthy woman who presented with left facial swelling. Imaging of the neck revealed multiple masses in the salivary and thyroid glands. The mass in the left parotid gland was associated with an intravenous extension into the retromandibular, facial and internal jugular veins in the left neck. Based on multiplicity of these masses and the presence of radiologic venous invasion, the diagnosis of metastatic renal cell carcinoma (RCC) was suggested on imaging, which was subsequently confirmed on systemic workup and pathology findings. Although RCC metastasizes to the salivary glands, the primary presentation of RCC with both salivary and thyroid gland masses is extremely rare, with only a few reports. The above feature and its imaging diagnosis based on local venous invasion are the highlights of this report.

Rationale: Spindle cell hemangioma (SCH) is considered a benign vascular lesion. It typically develops as a solitary nodule or multiple masses located in the dermal or subcutaneous layers of the distal extremities. To the best of our knowledge, there are no prior reports of SCH in the spleen. Patient concerns: A 41-year-old male was admitted to our hospital with recurrent headaches, nausea, and vomiting persisting for 5 days. Ultrasound, computed tomography, and magnetic resonance imaging revealed multiple space-occupying lesions in the spleen, and the biggest lesion was 4.8 cm × 5.4 cm in size. Interventions: The patient underwent laparoscopic splenectomy. Diagnosis: A diagnosis of spindle cell hemangioma of the spleen was made based on the histopathology. Outcomes: No evidence of local recurrence or distant metastases was observed over 4-year follow-up. Lessons: Splenic SCH may exhibit relatively high proliferative activity and be comorbid with epithelioid hemangioendothelioma or angiosarcoma, raising the possibility of malignant potential. However, the patient remained alive and disease-free 4 years after the operation. The nature of SCH in deep soft tissues requires further study.

A 76-year-old woman came to us because of staggering, fever, dysarthria, and appetite loss. Magnetic resonance imaging (MRI) of the brain revealed multiple masses with surrounding edema. Chest X-ray and computed tomography demonstrated a mass-like lesion in the left lung and left pleural effusion. Lung cancer and multiple brain metastases were suspected. However, the brain lesions demonstrated a high intensity through diffusion-weighted MRI. The finding was an important key to differentiate brain abscesses from lung cancer metastases.

Almost always, Hodgkin's lymphoma presents with lymph node involvement. Primary extranodal lymphoma is rare and mostly has a type of non-Hodgkin's lymphoma. We present an unusual presentation of a Hodgkin's lymphoma in a 33-year-old man. There were numerous soft tissue masses localized in the subcutaneous tissue of the left arm along the neurovascular bundle and the ipsilateral axillary region. We found only one Hodgkin's lymphoma case that presented as an upper extremity mass reported in the literature. In cases where a great number of successively lined up soft tissue masses are detected on the extremity, lymphoma takes place among the differential diagnoses.

Vibration energy harvesting extracts energy from the environment and can mitigate reliance on battery technology in wireless sensor networks. This article presents the nonlinear responses of two multi-mass vibration energy harvesters that employ a velocity amplification effect. This amplification is achieved by momentum transfer from larger to smaller masses following impact between masses. Two systems are presented that show the evolution of multi-mass vibration energy harvester designs: (1) a simplified prototype that effectively demonstrates the basic principles of the approach and (2) an enhanced design that achieves higher power densities and a wider frequency response. Various configurations are investigated to better understand the nonlinear dynamics and how best to realise future velocity-amplified vibration energy harvesters. The frequency responses of the multi-mass harvesters show that these devices have the potential to reduce risks associated with deploying vibration energy harvester devices in wireless sensor network applications; the wide frequency response reduces the need to re-tune the harvesters following frequency variations of the source vibrations.

Ganglioneuromas (GNs) arising from neural crest sympathogonia are rare benign neurogenic tumors. The most commonly affected sites are the posterior mediastinum, the retroperitoneum and the adrenal gland. GNs often present as a solitary, painless and slow-growing mass, and multiple occurrences in the cervical region are extremely rare. Here, we report a case of massive multiple cervical GN in a 4-year-old girl, and review cases of cervical GN that have been reported in the past 10 years. The results demonstrated that cervical GN, compared to other sites, is seldom secretory. The signs and symptoms of cervical GN are unspecific; the ultimate diagnosis of GN depends on pathological examination. Fine-needle aspiration biopsy has limited value in diagnosis. Surgical excision is the treatment of choice and the prognosis is excellent even in cases where complete excision cannot be achieved. Furthermore, GNs should be considered in patients with multiple masses in the neck.

Osteoma is an uncommon benign neoplasm composed of mature bone. Growth is slow and continuous and located principally in the cranio-maxillo-facial region, and can be central (endosteal) or peripheral (periosteal). Osteomas can be solitary or multiple masses, and they are generally asymptomatic. We discuss a case of ivory osteoma of the mandible in a 35-year-old female, which was present at the left body of the mandible since she was 10 years old, and was gradually increasing in size. The osteoma was removed surgically through an intraoral approach, and no recurrence was observed.

Although the sacrococcygeal area is the most common site for a teratoma in infants, it is a rare site for a teratoma in older patients. Most of the teratomas found in this area in adults are single mass, but in a few cases, multiple masses have been reported. The author reports on the case of an 18-year-old female patient with 3 presacral teratomas. The tumors were surgically removed via a transabdominal approach and were pathologically diagnosed as mature cystic teratomas. This case report indicates that an adult presacral teratoma can appear as multiple tumors, although it is very unusual.

This article describes the mechanism of precursor events; the mechanism was determined through an experiment and simulation by considering non-uniform normal loading. In the experiment, real-time observations of a contact zone were performed using a longitudinal line contact of PMMA specimens (i.e., a slider on a stationary base block) under a total normal load of 400 N. Partial propagations of the detachment front were considered as precursor events, and it was found that non-uniform normal loading influences the occurrence frequency of the precursor events and the increasing rate of the propagation length. In the simulation, the time evolution of a multi-degree-of-freedom system with Coulomb friction was studied. The model considered in the simulation comprised multiple masses serially connected by linear springs on a stationary rigid plane. By regarding the precursor in the experiment to correspond to a partial slip (i.e., simultaneous slip of some of the masses) in the simulation, the influence of non-uniform normal loading on the precursor events can be explained to a certain extent. Additionally, it was found that the apparent static friction coefficient (i.e., the ratio of the maximum tangential load to the total normal load) could be lesser than the real static friction coefficient due to the residual strain in the slider.