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In a 55-year-old woman with sigmoid colon cancer, a subcutaneous mass in the left lower abdomen was incidentally found and gradually enlarged. For further diagnosis and staging, an 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography scan was performed, which revealed a subcutaneous mass in the left lower abdomen with mild uptake of 18F-FDG, suggesting the possibility of metastasis. However, post-surgery and pathological confirmation, this mass was diagnosed as a drain-site hernia containing fallopian tube fimbria, which is extremely rare but should be considered in the differential diagnosis of subcutaneous mass in the lower abdomen. [ABSTRACT FROM AUTHOR]

Background: Pediatric glioblastoma multiforme (p-GBM) is an exceptionally rare and aggressive brain tumor, with even fewer reported cases with radiographic and intraoperative characteristics that mimic those of extraaxial lesions, often posing a diagnostic challenge. Despite advancements in imaging technologies, the diagnosis of GBM can still be intricate, relying primarily on histopathological confirmation. Case Description: We present a unique case of a 15-year-old female who presented to our hospital with a newonset focal-to-bilateral tonic-clonic seizure described as clonic movements of her left hemicorps; on clinical examination, a subcutaneous mass was evident in the right parietal region. Magnetic resonance imaging of the brain revealed a sizable extra-axial enhancing mass measuring 9 cm, located in the right parieto-occipital region with notable bone invasion. Moreover, the intraoperative findings revealed an extra-axial mass attached to the dura. Total en bloc resection was achieved. The histopathological analysis confirmed the diagnosis of glioblastoma multiforme. Subsequently, the patient underwent adjuvant radiotherapy in conjunction with temozolomide chemotherapy. Postoperatively, she exhibited clinical improvement and remained stable throughout the 6-month follow-up period. Conclusion: We present the first case of extra-axial p-GBM in a young patient, which remarkably led to the destruction of the bone and finally resulted in a sizable parietal subcutaneous lesion in the absence of prior surgery or radiation. [ABSTRACT FROM AUTHOR]

Beginning in July 2019, numerous free-ranging brown anoles (Anolis sagrei), an invasive lizard species in Florida, USA, were reported with large, soft, subcutaneous masses and disfiguring facial swellings. Postmortem evaluations of six affected animals, including cytology, histology, and electron microscopy, identified the presence of myriad chain-forming coccoid bacteria surrounded by a prominent clear capsule and abundant lightly basophilic matrix material with minimal associated granulomatous inflammation and effacement of normal tissue. Standard PCR and sequencing of the lesions revealed 100% nucleotide identity to Enterococcus lacertideformus. This bacterium was first observed in 2014 as the cause of a severe, multisystemic infection in several species of lizards (geckos and skinks) on Christmas Island, an Australian external territory in the Indian Ocean. Previously, analysis of E. lacertideformus had been hindered by an inability to grow the bacterium in standard culture conditions. We successfully cultured the organism on primary anole kidney cells. Given the growing recognition of host species diversity and geographic distribution noted for this organism, there is potential concern for spread to native North American lizards, especially the green anole (Anolis carolinensis), whose population numbers have apparently decreased due to introduced brown anoles. [ABSTRACT FROM AUTHOR]

Preeyachat Limtong, Poonkiat Suchonwanit, Kumutnart Chanprapaph, Suthinee Rutnin Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Suthinee RutninDivision of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, ThailandTel +66 2-2011141Fax +66 2-201-1211 ext 4Email suthinee.rutnin@gmail.comBackground: Erythema nodosum (EN) is the most common panniculitis associated with a wide variety of conditions. Updated studies regarding the clinicopathological manifestations related to etiologies of EN and its prognosis are limited.Objective: We aimed to explore the clinicopathological features in relation to the etiologies of EN and determine characteristics of disease recurrence and its predictive factors.Methods: A total of 169 patients with biopsy-proven EN or septal panniculitis from January 2008 to September 2018 were retrospectively reviewed. Patients were classified as either idiopathic or secondary EN. Patients’ general information, clinical manifestations, investigations, and recurrence of EN were recorded. The details on histopathological findings were reviewed by a blinded dermatopathologist.Results: The mean age at diagnosis of EN was 40.6 ± 17.3 years. The majority of patients (85.2%) were female. Idiopathic EN was found in 62.7% of patients. Tuberculosis (23.8%) and drugs (23.8%) were the leading causes of secondary EN. In univariate logistic regression analysis, lesions on upper extremities (p = 0.018), fever (p = 0.003), clinical lymphadenopathy (p < 0.001) favored secondary EN. Histopathologically, the presence of focal peripheral lobular panniculitis with eosinophils was linked to idiopathic EN (p = 0.03). However, multivariable logistic regression analysis failed to demonstrate factors associated with secondary EN. Recurrence was found in 46.6% of patients with no identifiable predictive factors.Conclusion: Although no clinical risk factors were associated with the etiology of EN, the histopathological presence of eosinophils in focal peripheral lobular panniculitis suggested idiopathic EN.Keywords: leg nodules, panniculitis, septal panniculitis, subcutaneous nodule, subcutaneous mass

Abstract Background During embryogenesis, bilateral thickening of ectoderm from anterior axillary folds to inguinal folds, called mammary ridges or milk lines, develops into breast tissues. Only a pair in the pectoral area is spared from regression and continuously develops into normal breasts. Accessory breasts can result if the regression process is incomplete. These ectopic breasts can change physiologically and pathologically similar to normal breasts. Unsurprisingly, they are capable of turning malignant. Reported cases show the most common area for accessory breast cancer to be the axillary area. We report a rare case of accessory breast cancer over the costal ridge. Case presentation We present the case of a 51-year-old Asian woman who complained of an enlarged mass lower to her left breast developed over the period of 3 months while on contraceptive pills. Unaware that the mass could be an accessory breast, the primary doctor had prescribed oral contraceptives. After our patient had noticed that the mass was obviously growing, she decided to consult a surgeon as the mass continued to grow. Expected to be benign, the mass was investigated by ultrasonography and then excised surgically. A pathology report identified the mass to be a carcinoma of the ectopic breast tissue. However, sentinel lymph node biopsy showed no nodal metastasis of all four lymph nodes. Following surgery, she received chemotherapy, radiation, and antihormonal treatment. After 2 years of postoperative follow up, she remained free of disease. Conclusions This patient was diagnosed as having accessory breast cancer which presented with a subcutaneous mass. As this condition is exceptionally rare but curable by early treatments, we recommend surgeons to consider potential malignancy when patients present with a subcutaneous mass.

Rosai-Dorfman disease (RDD) is a rare disorder characterized by excessive growth of histiocytes. We present a case of a 14-year-old female with cutaneous RDD who had a subcutaneous lump on her left arm for three years. The lump became tender and progressively larger over the past year. She had no systemic symptoms, and her physical examination revealed a mobile, tender lump. Laboratory tests were normal. Surgical excision of the lump was performed, and histopathological examination confirmed RDD with the presence of epithelioid histiocytes with eosinophilic and clear cytoplasm, along with emperipolesis and positive staining for CD68, CD163, S100, and OCT2. The patient was referred for follow-up and required no further treatment. RDD can present with subcutaneous masses without systemic symptoms, and it is important to consider RDD in the differential diagnosis of such cases. Surgical excision is the main treatment, and long-term monitoring is necessary due to the potential for disease recurrence. Awareness of cutaneous RDD presentations is crucial for accurate diagnosis and management., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Al-Hashemi et al.)

In a 55-year-old woman with sigmoid colon cancer, a subcutaneous mass in the left lower abdomen was incidentally found and gradually enlarged. For further diagnosis and staging, an 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography scan was performed, which revealed a subcutaneous mass in the left lower abdomen with mild uptake of 18 F-FDG, suggesting the possibility of metastasis. However, post-surgery and pathological confirmation, this mass was diagnosed as a drain-site hernia containing fallopian tube fimbria, which is extremely rare but should be considered in the differential diagnosis of subcutaneous mass in the lower abdomen., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (Copyright© 2024 The Author. Published by Galenos Publishing House on behalf of the Turkish Society of Nuclear Medicine.)

Nodular fasciitis occurring at the anterior abdominal wall in a 12-year-old female is reported. Nodular fasciitis has recently been recognized as a kind of neoplasm and its characteristic fusion genes such as MYH9-USP6 have been reported. The mass reported here occurred in a pediatric patient and the mass originated at the abdominal wall, whose clinical features were extremely rare.

Background: Glioblastoma multiforme (GBM) is the most common and aggressive primary malignant brain tumor. However, it rarely invades and destroys bone. We report the first case of GBM of a very old patient, which eroded the dura and bone and finally resulted in a large facio-cranial subcutaneous lesion in the absence of prior surgery or radiation. Case description: A 93-year-old woman was presumed with a low-grade glioma (LGG), and the lesion was followed up with magnetic resonance imaging (MRI). Serial monitoring revealed no tumor growth until 2 years later, when the patient was admitted to our institution for anorexia and lack of spontaneity and flow of conversation. On admission, she oftentimes complained of severe right forehead skin pain. Computed tomography (CT) revealed enhancing mass lesions in the right frontal lobe and bone destruction. Upon inspection and palpation, a soft and swelling subcutaneous mass was evident at the forehead, the site of bone destruction. Contrast-enhanced MRI revealed ring-enhancing lesions with irregular borders, and the malignant transformation of LGG into GBM was suspected. The patient had severe skin pain at the region of the subcutaneous mass, so tumor resection of the subcutaneous mass was performed for removing the pain and a definitive diagnosis. The pathological diagnosis was isocitrate dehydrogenase (IDH)-mutated glioblastoma. Immunostaining revealed that the tumor was positive for IDH-1 and p53mutations but negative for ATRX. The patient died due to aspiration pneumonitis. Conclusions: We report a first case of GBM in a very old patient untreated with surgery or radiation that invaded and destroyed the calvaria during the natural progression of the disease. Calvarial destruction without prior surgery or radiation in very old patients association with extra- and intra-axial neoplasm should include GBM in the differential diagnosis, although this is very rare.

In the present case report, we discuss a case of an uncommon giant lipoma in the left lower abdomen of a 55-year-old female. The case is presented to highlight the need to consider lipoma as one of the possibilities in cases with subcutaneous masses. Despite its abnormal location and considerable magnitude, surgical excision under short general anesthesia resulted in successful outcomes without immediate complications. Finally, by comparing with similar circumstances, it is possible to recognize that individualized management strategies based on patient characteristics can benefit surgical considerations. The significant message is that timely intervention, comprehensive assessment, and teamwork are essential in achieving satisfactory outcomes among patients with rare cases of lipomas, such as this one., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Singh et al.)

Background: During embryogenesis, bilateral thickening of ectoderm from anterior axillary folds to inguinal folds, called mammary ridges or milk lines, develops into breast tissues. Only a pair in the pectoral area is spared from regression and continuously develops into normal breasts. Accessory breasts can result if the regression process is incomplete. These ectopic breasts can change physiologically and pathologically similar to normal breasts. Unsurprisingly, they are capable of turning malignant. Reported cases show the most common area for accessory breast cancer to be the axillary area. We report a rare case of accessory breast cancer over the costal ridge.Case Presentation: We present the case of a 51-year-old Asian woman who complained of an enlarged mass lower to her left breast developed over the period of 3 months while on contraceptive pills. Unaware that the mass could be an accessory breast, the primary doctor had prescribed oral contraceptives. After our patient had noticed that the mass was obviously growing, she decided to consult a surgeon as the mass continued to grow. Expected to be benign, the mass was investigated by ultrasonography and then excised surgically. A pathology report identified the mass to be a carcinoma of the ectopic breast tissue. However, sentinel lymph node biopsy showed no nodal metastasis of all four lymph nodes. Following surgery, she received chemotherapy, radiation, and antihormonal treatment. After 2 years of postoperative follow up, she remained free of disease.Conclusions: This patient was diagnosed as having accessory breast cancer which presented with a subcutaneous mass. As this condition is exceptionally rare but curable by early treatments, we recommend surgeons to consider potential malignancy when patients present with a subcutaneous mass. [ABSTRACT FROM AUTHOR]

A five-year-old female cockatiel weighing 117 g was presented with a fast-growing mass beside the uropygial gland. Excisional biopsy was performed and the mass measured 5 × 3. 5 × 4 cm in size and weighed 30.6 g. On the surface of cut sections, the mass was yellow-brown with white or yellow colloidal substances and red exudate. Histopathology showed that the tumor mass was covered by the skin and located in the deep dermis and hypodermis. The tumor consisted of abundant vascular adipose tissue and lipoblasts with intracytoplasmic lipid droplets, which varied in size. Also, small, well-differentiated blood vessels, with varied degrees of congestion and dilation, were observed within the tumor. Histochemically, staining with Oil red O produced a positive reaction in which the lipid droplets presented a reddish color. Immunohistochemistry produced positive staining for Desmin and successfully marked the muscular layers of blood vessels. On the basis of these results, a rare case of liposarcoma with microvascular proliferation adjacent to the uropygial gland was diagnosed in a cockatiel. [ABSTRACT FROM AUTHOR]

• Think of undifferentiated pleoimorphic sarcoma as a differential in older adults with a history of radiation therapy. • It is important to discover the type and grade of the tumor. • Patients should be thoroughly worked up for the best possible outcome. An 85 year old male presented to his General Practitioner with a vague history of a lump on his back that was mobile and non tender. He had a previous history of advanced prostate cancer and radiotherapy treatment. We present an unexpected diagnosis of malignant fibrous histiocytoma of a subcutaneous lesion removed from the patient's back. Excisions of subcutaneous lesions along with cutaneous lesions form the majority of cases on a usual minor operations list. All lesions are sent for histopathological analysis and most are confirmed benign sebaceous cysts or lipomas. However the entity of malignant fibrous histiocytoma, now referred to as undifferentiated pleomorphic sarcoma (UPS) should be kept in mind. Patients will usually present late with advanced local disease or metastasis, usually to lungs and lymph nodes. Treatment is surgical with wide local excision and neoadjuvant/adjuvant radiotherapy has been advocated as well. Undifferentiated pleomorphic sarcoma should be a differential in subcutaneous lesions in older adults with a previous history of malignancy, radiation therapy and a mass in the subcutaneous tissue of the back. [ABSTRACT FROM AUTHOR]

An approximately 42-year-old, wild-caught, red-crowned Amazon parrot (Amazona viridigenalis) was evaluated for a subcutaneous mass to the right of the keel. Cytologic examination of a fine needle aspirate of the mass were suggestive of granulomatous inflammation. The mass was surgically excised, and the parrot was treated with oral nonsteroidal anti-inflammatory drugs. Histologically, the mass was diagnosed as a teratoma with stratified squamous epithelial and neuroectodermal components. Tumor cells extended to surgical margins. Two years later, the neoplasm recurred, with regrowth of only the neuroectodermal component. The neoplasm was again removed surgically, but it recurred again 14 months later, necessitating a third surgery. Histopathologic examination confirmed recurrence of the original neoplasm in both instances, with incomplete margins on both excisions. [ABSTRACT FROM AUTHOR]

Introduction: Kimura’s disease is a rare chronic inflammatory disease of unknown etiology, presenting as painless subcutaneous nodules with lymphadenopathy and peripheral eosinophilia, mainly disturbing the head and neck region. It mainly affects Asian males in their 2nd to 4th decade of life. One such case of Kimura’s disease, which is uncommon in Indian natives, is reported. Case Report: A male patient presented with an insidious onset of a progressive painless disfiguring swelling over his nose since four years, which was associated with nasal obstruction and postaural swelling with a history of an inconclusive incisional biopsy. Clinical examination showed a bilobed subcutaneous swelling present over the nose and a collapsed nasal valve area on anterior rhinoscopy. FNAC was non-diagnostic and CT scan showed a mildly enhancing mass lesion over the external nose. Complete surgical excision was performed. Diagnosis was confirmed upon postoperative histopathology. During his 2nd week follow up, the patient had a small nasal recurrence, which was treated medically with oral steroids, cetirizine, and pentoxyphylline for 4 weeks. The patient was disease free for 6 months. Conclusion: Kimura’s disease, although difficult to diagnosis clinically, should be considered in the differential diagnosis of patients who have a primary lymphadenopathy with eosinophilia with or without subcutaneous nodules. It should be investigated accordingly as the disease has an indolent course and good prognosis

Ultrasound is currently underutilized in dermatology practice. However, ultrasound provides clinicians with precise and unique information on cutaneous and subcutaneous lesions, while minimizing costs and complications related to more common and invasive diagnostic methods. We report a patient who presented with a tender subcutaneous mass that was diagnosed and treated using point-of-care ultrasound-guidance at the dermatology clinic. Ultrasound revealed features consistent with a ganglion cyst, which was subsequently injected with triamcinolone acetonide under ultrasound-guidance with the resolution of symptoms upon follow-up one month later. Our study demonstrates the utility of ultrasound as an effective, time-efficient diagnostic and interventional aid that can modify dermatology practice. [ABSTRACT FROM AUTHOR]

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Lung cancer is a common malignancy that is frequently associated with distant subcutaneous metastasis. However, reports of subcutaneous metastasis of lung cancer after three surgeries for recurrent brain metastasis are scarce. The present study describes the case of a 49-year-old female patient who was admitted to our hospital with a cutaneous mass. The patient had a history of lung cancer and had undergone three surgeries for brain metastases. The subcutaneous mass was considered to be an implantation metastasis from the previous brain metastases. The cutaneous mass was grossly resected and histopathological examination revealed adenocarcinoma. This case highlights the need to perform a comprehensive analysis for suspected subcutaneous masses in lung cancer patients. Furthermore, pathological examination is crucial for accurate diagnosis and timely treatment. [ABSTRACT FROM AUTHOR]

Introduction: Kimura's disease is a rare chronic inflammatory disease of unknown etiology, presenting as painless subcutaneous nodules with lymphadenopathy and peripheral eosinophilia, mainly disturbing the head and neck region. It mainly affects Asian males in their 2nd to 4th decade of life. One such case of Kimura's disease, which is uncommon in Indian natives, is reported. Case Report: A male patient presented with an insidious onset of a progressive painless disfiguring swelling over his nose since four years, which was associated with nasal obstruction and post aural swelling with a history of an inconclusive incisional biopsy. Clinical examination showed a bilobed subcutaneous swelling present over the nose and a collapsed nasal valve area on anterior rhinoscopy. FNAC was non-diagnostic and CT scan showed a mildly enhancing mass lesion over the external nose. Complete surgical excision was performed. Diagnosis was confirmed upon postoperative histopathology. During his 2nd week follow up, the patient had a small nasal recurrence, which was treated medically with oral steroids, cetirizine, and pentoxyphylline for 4 weeks. The patient was disease free for 6 months. Conclusion: Kimura's disease, although difficult to diagnosis clinically, should be considered in the differential diagnosis of patients who have a primary lymphadenopathy with eosinophilia with or without subcutaneous nodules. It should be investigated accordingly as the disease has an indolent course and good prognosis. [ABSTRACT FROM AUTHOR]

Ossifying fibromyxoid tumor (OFMT), a rare soft tissue tumor, is generally located in the extremities with a distinct morphology characterized by bland, small cells lying in a fibromyxoid stroma and a peripheral rim of the lamellar bone. These tumors mostly express Leu-7, neuron specific enolase in addition to S-100 and vimentin. Some tumors may have malignant cytological features with aggressive behavior but even in classical morphology, recurrence or metastasis can be detected. Thus, the outcome of the tumor remains a mystery and depends on the different results detected during the follow up. Herein, we report a case of OFMT regarding this entity in the differential diagnosis of subcutaneous masses. [ABSTRACT FROM AUTHOR]

The article presents a case study of a great white pelican referred to asses a subacute-onset, nonpainful swelling in the pectoral region. Topics discussed include circumscribed subcutaneous mass revealed in physical examination, cytological findings of a mesenchymal tumor, and the diagnosis of xanthomatosis. Also mentioned are unknown etiology of avian xanthomatosis, assumptive cases of trauma, metabolic and nutritional disorder, and xanthoma in the family of Pelecanidae.