AME Case Reports最新文献

{"title":"Isolated anomalous right coronary artery from pulmonary artery (ARCAPA): incidental finding in the patient presenting with angina-a case report.","authors":"Fares Jamal, Shamaiza Waqas, Vincent Skovira, Luay Sayed","doi":"10.21037/acr-23-190","DOIUrl":"10.21037/acr-23-190","url":null,"abstract":"<p><strong>Background: </strong>Anomalous right coronary artery from pulmonary artery (ARCAPA) is one of four known anomalies of the coronary arteries originating from the pulmonary artery. ARCAPA is a rare congenital anomaly that is associated with possible long-term complications including myocardial ischemia and left ventricular dysfunction. Clinical presentation can vary from asymptomatic murmur to angina, dyspnea, fatigue, congestive heart failure, myocardial infarction and even cardiac arrest.</p><p><strong>Case description: </strong>We present a case of a 52-year-old male who presented to the hospital for intermittent chest pain. The patient was vitally stable and examination was unremarkable. Upon workup, electrocardiogram (EKG) on admission showed no acute ischemic changes and troponin were <0.03 ng/mL. The patient was evaluated by cardiology and had a dobutamine stress echocardiogram (ECHO) for ischemic evaluation. During the recovery phase of dobutamine stress ECHO, the patient reported having 10/10 chest pain with a drop in blood pressure to 90 mmHg systolic. He was subsequently given sublingual nitroglycerin and fluids. Pain did resolve and blood pressure improved after treatment. No wall motion abnormalities were noted on ECHO, but there were inferior ST depressions on EKG during the stress portion of the test. The patient had repeated blood work after the stress test which showed an elevated troponin level of 0.08 ng/mL. The patient was taken to the catheterization lab for diagnostic coronary angiogram. Cardiac catheterization showed a right coronary artery (RCA) arising from the pulmonary artery and diagnosis of isolated ARCAPA was made because of his intermittent chest pain. No intervention was performed as no significant lesions were found. The patient was started on medical therapy including aspirin, beta blocker and statin. The patient did not want to pursue surgery at that point and he did not want any further intervention. He was discharged home with instructions to follow up with cardiology in an outpatient setting to be referred for surgical repair.</p><p><strong>Conclusions: </strong>The purpose of writing this case is to increase awareness among physicians to be able to recognize possible anomalous coronary artery origins during cardiac catheterization and to understand the risk of long-term complications of ARCAPA and need for surgical repair.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"75"},"PeriodicalIF":0.7,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epithelioid hemangioendothelioma: a case report.","authors":"Sat Byul Park, Young Bae Kim, Seulgi You","doi":"10.21037/acr-23-51","DOIUrl":"10.21037/acr-23-51","url":null,"abstract":"<p><strong>Background: </strong>Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor with limited clinical data that can guide treatment choices. The diagnosis of EHE is based on its unique histological, immunohistochemical, and molecular characteristics. Differential diagnoses are broad and include autoimmune diseases. Treatments include hepatic resection, liver transplantation, systemic/regional chemotherapy, and radiotherapy.</p><p><strong>Case description: </strong>We describe EHE in a patient with weight loss and general weakness. The prognosis of EHE is variable, with few cases demonstrating an indolent clinical course, whereas others tend to metastasize. In our case, hepatic EHE had metastasized to the lungs and brain. Histopathological examination of the liver tissue revealed an epithelial hemangioendothelioma. On CK7 staining, hepatocytes were clearly reactive and arranged in the plates (CK7: negative), with positive immunohistochemical staining for CD34 (CD34: positive) alone. Surveillance was conducted and the clinical course was better than expected, probably due to her relatively good general condition, the lack of genetic factors associated with her familial medical history, and normal levels of tumor markers such as α-fetoprotein and carcinoembryonic antigen (CEA). During a follow-up examination, she was asymptomatic with a healthy general appearance.</p><p><strong>Conclusions: </strong>The prognosis of EHE is variable, with few cases demonstrating an indolent clinical course, whereas others tend to metastasize. The treatment method for EHE should be determined according to the patient's condition.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"65"},"PeriodicalIF":0.7,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EGFR-mutated lung cancer as a secondary neoplasm in a patient with Li-Fraumeni syndrome: case report.","authors":"Daniela Cristina Cortés Valenzuela, Pablo Andrés Vega Medina, Francisco José Palma García, Omar Castillo-Fernandez","doi":"10.21037/acr-23-206","DOIUrl":"10.21037/acr-23-206","url":null,"abstract":"<p><strong>Background: </strong>Li-Fraumeni syndrome (LFS) is a rare hereditary disorder caused by mutations in the tumor protein p53 (<i>TP53</i>). It causes a predisposition for the development of multiple malignancies, primarily including breast cancers, sarcomas, and central nervous system tumors. There are a few cases reported in the literature of patients with LFS presenting with an epidermal growth factor receptor (EGFR) mutated lung cancer. Still, it has been suggested that there may be an association between the <i>TP53</i> pathogenic variant and lung cancer with EGFR mutation in somatic cells.</p><p><strong>Case description: </strong>A 47-year-old non-smoker woman with LFS with a history of multiple tumors, including bilateral breast cancer, pecoma, and sarcoma. In one of her computed tomography, a lesion in the lingula of the lung was detected. It was biopsied, which diagnosed lung adenocarcinoma, and genetic studies detected an EGFR exon 19 deletion. She was treated with a left inferior lobectomy, followed by pemetrexed and cisplatin.</p><p><strong>Conclusions: </strong>The association between <i>TP53</i> and lung cancer with EGFR mutation has been suggested in case reports. Studies in lung cancer cell lines have shown a link between TP53 mutation and EGFR overexpression. Nonetheless, as more cases are reported, further research is needed to comprehend the interrelation between these two pathologies and the risk posed by LFS to the emergence of EGFR-mutated lung cancer.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"76"},"PeriodicalIF":0.7,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of synchronous breast and lung cancer with three different pathologic diagnoses.","authors":"Nawal Khan, Maria de la Torre, Houyar Moghaddas, Nelli Fromer, Siarhei Melnikau","doi":"10.21037/acr-23-194","DOIUrl":"10.21037/acr-23-194","url":null,"abstract":"<p><strong>Background: </strong>Multiple primary malignant tumors (MPMTs) pose a significant clinical challenge, denoting the occurrence of two or more distinct malignant tumors with differing histological characteristics, all diagnosed within a 6-month timeframe. MPMT is a rare condition and due to the unique treatment requirements for each specific cancer type, it is crucial for healthcare professionals to accurately differentiate between metastatic growth and distinct primary tumors.</p><p><strong>Case description: </strong>In this case report, we present a 41-year-old female patient who received diagnoses of three separate synchronous primary tumors. The patient presented for evaluation of a right breast mass that had been present for 1 year. Initial diagnostic tests, including mammography and ultrasound, did not provide any conclusive results. Subsequent magnetic resonance imaging (MRI) of the breast prompted an ultrasound-guided biopsy which confirmed moderately differentiated invasive ductal carcinoma (IDC). During pre-surgical testing, a suspicious opacity was detected on a chest X-ray, prompting further investigation with a computed tomography (CT) scan of the chest to distinguish between metastatic disease and a potential new primary tumor. Clinical and pathological examinations revealed the presence of bilateral masses originating from two different origins: invasive mucinous pulmonary adenocarcinoma in the left lower lobe and a neuroendocrine carcinoma in the right middle lobe of the lung.</p><p><strong>Conclusions: </strong>Cases of this nature present a complex challenge to physicians and underscore the critical importance of maintaining a high level of clinical suspicion to ensure the delivery of high-quality care. Effective management of such patients requires a multidisciplinary collaboration among breast surgeons, thoracic surgeons, and medical and radiation oncologists.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"68"},"PeriodicalIF":0.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial longitudinal fasciculus (MLF)-syndrome in a multimorbid patient with alcohol use disorder: a case report.","authors":"Simon Arvin, Peter Nørgaard Kristensen, Andreas Nørgaard Glud","doi":"10.21037/acr-23-177","DOIUrl":"10.21037/acr-23-177","url":null,"abstract":"<p><strong>Background: </strong>Patients with multiple comorbidities can present as a diagnostic challenge as overlapping symptomatology complicates the discovery of emergent pathology. Symptoms of alcohol misuse or orthostatic hypotension may especially cloud the diagnosis of insidious neurological disease, such as posterior circulation infarct. With a growing elderly population, it is expected that the complex multimorbid patient will represent a growing challenge to prompt stroke detection and treatment.</p><p><strong>Case description: </strong>Herein, we present a 69-year-old male with a history of alcohol abuse, chronic obstructive pulmonary disease, type 2 diabetes mellitus, paroxysmal atrial fibrillation, and congestive heart disease. The patient arrived at our emergency department with dizziness, ataxia, and diplopia. His symptoms had a sudden onset and gradual exacerbation over a span of 2 days, notably aggravated by standing and walking, but relieved when seated or supine. Notably, a month before admission, the patient had been treated with anti-congestive medications for severe congestive heart failure leading to a weight loss of 55 lbs over period of 2 weeks. The initial differential diagnoses were orthostatism, Wernicke's encephalopathy (WE), and ischemic stroke. Magnetic resonance imaging (MRI) revealed a subacute infarct in the medial longitudinal fasciculus (MLF).</p><p><strong>Conclusions: </strong>The case underscores the challenge in diagnosing neurological conditions in multimorbid individuals. The combination of various underlying conditions may drastically complicate the diagnosis. Successful diagnosis and treatment necessitates meticulous evaluation of clinical observations, medical history, current medications, and pertinent diagnostic evaluations to effectively narrow down the potential differential diagnoses.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"69"},"PeriodicalIF":0.7,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A sarcomatoid malignancy originating in the right cervical lymph nodes with atypical pathological characteristics: a case report of an incidental finding.","authors":"Cuixuan Pan, Danxian Jiang, Jing Huang, Zumin Xu, Donghong Yang, Fei Xue, Zhouliang Huang, Lin Xiao, Suzhu Zhou, Zhonghua Yu","doi":"10.21037/acr-23-147","DOIUrl":"10.21037/acr-23-147","url":null,"abstract":"<p><strong>Background: </strong>Primary malignancies of the cervical lymph nodes with special pathological characteristics are relatively uncommon in clinical settings, and there have been few reports on these tumors. The precise basis for their pathogenesis is poorly understood, and their diagnosis can be challenging. In addition, no clinically validated treatments have been established to date for affected patients.</p><p><strong>Case description: </strong>Here, we describe a case of a 65-year-old male patient who exhibited the enlargement of several lateral and supraclavicular lymph nodes on the right side of his neck that presented as a large mass associated with a high fever and benign leukocytosis. He did not exhibit any relevant prior history. Radiological assessment revealed that this lesion was the primary tumor and that it has since spread to the liver. Histological assessment was unable to definitively classify the pathological characteristics of this tumor. Without any relevant morphological findings, immunohistochemical outcomes were not sufficiently specific to clarify the origin of these cells. When distinguishing it from similar sarcomas of the lymphohematopoietic system, it was found to not be typical of a histiocytic or dendritic cell tumor. Treatment to this patient was performed following multidisciplinary consultation and consisted of one course of a cyclophosphamide plus doxorubicin, vincristine, and dexamethasone regimen and two courses of the cyclophosphamide plus pirarubicin, vincristine, and dexamethasone regimen. However, the tumor exhibited minimal response to such treatment. While radiotherapy was proposed, the patient lacked confidence in the approach and declined treatment. He eventually developed severe tumor-associated complications. In the discussion section of this report, we detail and analyze the pathogenesis, diagnosis, and referential treatments of this rare malignancy.</p><p><strong>Conclusions: </strong>This is the first report describing such a malignancy, and we hope that the publication of these findings can lead to the recognition of this tumor while supporting efforts to acquire greater experience in the diagnosis and treatment of affected patients.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"71"},"PeriodicalIF":0.7,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First case report of benign subcutaneous thyroid tissue implantation following transoral endoscopic thyroidectomy vestibular approach (TOETVA).","authors":"Sirasit Laohathai, Tanyanan Jamikorn, Angkoon Anuwong","doi":"10.21037/acr-24-15","DOIUrl":"10.21037/acr-24-15","url":null,"abstract":"<p><strong>Background: </strong>Following the era of remote access thyroid surgery in the 1990s, several techniques were developed including transoral endoscopic thyroidectomy vestibular approach (TOETVA), which was invented in 2016. TOETVA has gained acceptance and proven comparable results to the conventional open thyroidectomy. Despite the potential complications that may occur as a result of remote access thyroid surgery, such as nerve, vascular, and tracheal injury, seroma, and hypoparathyroidism, there was an extremely rare late complication of a benign subcutaneous thyroid implantation, which have not been reported following TOETVA.</p><p><strong>Case description: </strong>A 28-year-old female was developed multiple subcutaneous nodules after undergoing right lobe TOETVA for 2 years due to a 3.1 cm benign nodular goiter. The nodules were excised via submandibular incision and the pathological results were shown as benign.</p><p><strong>Conclusions: </strong>Thyroid tissue implantation may result from intracorporeal thyroid tissue rupture, as reported in this research. Extending the vestibular incision to 2-2.5 cm and partially cutting the specimen within the retrieval bag were options to prevent further tissue damage or spillage during specimen extraction. Meanwhile, a separate incision, such as the axillary or submandibular incision, may be required to retrieve the larger nodules. Even though there were no absolute guidelines or contraindications for patient selection in TOETVA, an awareness of tissue breakage should always be considered. The optimal size of the nodule for vestibular removal, which would minimize the risk of tissue breakage, still required additional research.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"73"},"PeriodicalIF":0.7,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infected stent graft and severe aortitis after transcaval glue embolization of type II endoleak: a case report.","authors":"Nathaniel Robinson, Tiziano Tallarita, Jason Beckermann, Vinay Nijhawan, Jeremy McBride, Nishant Saran, Thomas Carmody, Joseph Wildenberg","doi":"10.21037/acr-23-148","DOIUrl":"10.21037/acr-23-148","url":null,"abstract":"<p><strong>Background: </strong>Type II endoleaks are common and embolization is often performed if treatment is necessary. Although transarterial embolization is common, other methods including trans-caval embolization are also utilized. Complications can occur and we report a case of infection that was challenging to diagnose and treat. There is no data regarding the risk of aortic stent graft infection after trans-caval embolization with n-butyl 2-cyanoacrylate (n-BCA) glue of a type II endoleak.</p><p><strong>Case description: </strong>We report a rare case of infected, Gore Excluder infrarenal stent graft after transcaval embolization with coil and n-BCA glue to treat a type II endoleak in a 71-year-old male. The endoleak caused a rapid sac enlargement. The stent graft was placed 5 years earlier electively. Soon after the endoleak embolization, the patient experienced abdominal pain and malaise. There was an intense inflammatory reaction involving the aneurysm wall and the adjacent bowel mesentery. Our differential included normal inflammation after embolization vs. infection and this was difficult to distinguish. The infection was confirmed by positron emission tomography scan and tissue biopsy. The patient was deemed high-risk for surgery because of his extensive cardiac history, status post coronary bypass and tissue mitral valve replacement, congestive heart failure with residual left ventricular ejection fraction of 36%. He was optimized by correcting fluid status, administration of intravenous antibiotic, and nutrition consultation with dietary supplementation before surgery over the course of 2 weeks. The graft was explanted through a transabdominal approach, and the aorta was reconstructed with cryopreserved allograft. Interestingly, the small and large intestine with their mesentery were found to be plastered to the aneurysm sac. The post-operative course was unremarkable except for a transient acute kidney injury that resolved within 1 week. Follow-up computed tomography scan at 6 months showed widely patent bypass.</p><p><strong>Conclusions: </strong>Glue embolization induces inflammation promoting thrombus formation inside the aneurysm sac. With a transcaval approach to the sac, there is the risk of extravasation of glue outside the sac as well as contamination of the graft with instrumentation. Differentiating between inflammation and infection can be difficult, and tissue biopsy provided the most conclusive diagnosis. Risk minimization considerations include, pre-operative optimization, a transabdominal approach, ureteral stenting, and tissue buttressing of anastomosis.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"70"},"PeriodicalIF":0.7,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metaplastic thymoma in the middle mediastinum: a rare case report and surgical treatment analysis of a 32-year-old female patient.","authors":"Zheng Wang, Wenkang Zong, Shuo Liang, Daqiang Sun","doi":"10.21037/acr-23-213","DOIUrl":"10.21037/acr-23-213","url":null,"abstract":"<p><strong>Background: </strong>Metaplastic thymoma (MT), an exceedingly rare variant of primary thymic epithelial neoplasms, is distinguished by its indolent progression and unique histopathological profile. It presents a biphasic pattern characterized by solid epithelial and spindle cell components, potentially leading to diagnostic confusion with type A thymomas or the type A component of type AB thymomas. Accurate diagnosis is pivotal for optimal therapeutic strategies and prognostication.</p><p><strong>Case description: </strong>We document an exceptional case of a 32-year-old woman, incidentally discovered to have a mediastinal nodule in the middle compartment on chest computed tomography (CT). The lesion was excised via video-assisted thoracoscopic surgery. Histological evaluation revealed a biphasic cellular architecture comprising epithelioid and spindle cells. Immunohistochemical analysis demonstrated significant positivity for CK5/6 and P40 in epithelial cells, and vimentin and epithelial membrane antigen in spindle cells, with a low proliferation index marked by Ki-67. Noteworthy, fluorescence in situ hybridization (FISH) analysis identified a <i>YAP1::MAML2</i> gene fusion, with a predominant pattern suggestive of fusion gene presence, thus corroborating the diagnosis of MT.</p><p><strong>Conclusions: </strong>This report underscores the critical role of a multifaceted diagnostic approach, including histopathological, immunohistochemical, and genetic analyses, in the identification of MT. The detection of the <i>YAP1::MAML2</i> gene fusion through FISH analysis provides a robust diagnostic marker, highlighting the necessity for clinical and pathological vigilance for this rare tumor.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"64"},"PeriodicalIF":0.7,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Well-differentiated liposarcoma of spermatic cord presenting as recurrent inguinal hernia: a case report.","authors":"Juan G Favela, Madison B Argo, Sergio Huerta","doi":"10.21037/acr-23-69","DOIUrl":"10.21037/acr-23-69","url":null,"abstract":"<p><strong>Background: </strong>Well-differentiated liposarcoma arising from the paratesticular region is rare, with only a few hundred cases reported in the literature. Due to their unexpected location, these tumors are often confused for common pathologies found in the groin, including inguinal hernia, seroma, or lymphoma. Standardized diagnostic and treatment pathways have not been established for patients with paratesticular liposarcoma, thereby elevating the importance of sharing our experience.</p><p><strong>Case description: </strong>This case describes the presentation of a 65-year-old man with a well-differentiated liposarcoma of the spermatic cord. Diagnosis was made after he underwent open herniorrhaphy to repair what was presumed to be a recurrent left inguinal hernia. Although a recommendation for formal oncologic resection and orchiectomy was made, the patient elected to proceed with watchful waiting and remains well up to last known contact.</p><p><strong>Conclusions: </strong>Paratesticular liposarcoma remains a rare clinical entity. While a few hundred cases have been reported in the literature, only a handful describe its presentation masked as an early recurrence of a groin hernia. Wide local resection along with orchiectomy and potential radiation therapy have been the mainstay of treatment. Clinicians should maintain a healthy level of suspicion for this uncommon pathology, especially in cases where patients present with early recurrence of an inguinal hernia.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"8 ","pages":"72"},"PeriodicalIF":0.7,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}