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A 48-year old man presented with left popliteal pain. A 2.2×1.6 cm sized saccular aneurysm at the level of the left popliteal fossa was diagnosed by ultrasonography. Tangential aneurysmectomy and popliteal vein repair was performed uneventfully. The patient fared well for a year without symptoms. Popliteal vein aneurysms are rare and typically found in patients with fatal thromboembolic features without warning symptoms. Fortunately, our patient had localized pain which was helpful in its early diagnosis and treatment.

Desmoids are rare soft-tissue tumors of the abdominal wall that may sporadically occur extra-abdominally. It manifests as clonal fibroblastic proliferation with an infiltrative tendency and capacity to recur without metastasizing. An adolescent male presented with a gradually increasing globular, non-tender, firm, non-pulsatile swelling (8 × 5 × 3 cm3) in the left popliteal fossa that had been present for five months. Following thorough investigation with imaging and Tru-cut biopsy, finally, an excisional biopsy was done. Histopathological examination confirmed a desmoid tumor, and the patient received adjuvant radiotherapy. At the one-year postoperative follow-up, there was no recurrence; the patient had been explained the prognosis. This case highlights a rare site of an extra-abdominal desmoid but with classical clinical presentation, imaging, intraoperative, and histopathological findings. Awareness and knowledge of this entity are of paramount importance for clinical practitioners.

The implementation of surgical procedures in the Basic Health Unit is recommended and described in the literature. However, such practice has been less and less applied in primary care. In a context of overcrowding of tertiary hospitals and consequent inoperability of elective surgical procedures it is of utmost importance and resolutivity carrying out these procedures in the Family Clinic/Basic Health Unit. In this article, we present a case of a patient who underwent excision of a crippling giant lipoma in the left popliteal fossa, with 12 years of evolution and unsuccessful attempts of surgical resolution in a tertiary hospital.

We present herein the case of an 80-year-old woman with a keratotic plaque measuring 1.4x1.3 cm on the left popliteal fossa. The plaque was resected and diagnosed on microscopic examination as low-grade sebaceous carcinoma. Sebaceous carcinoma on the leg seems extremely rare.

We report a 58-year-old man with mycosis fungoides (MF) and occupational systemic sclerosis (SSc) induced by silica exposure. He was engaged in tunnel construction from the age of 18 to 33 years. He developed MF at the age of 30. Diagnosis of silicosis was made at the age of 52 and SSc at the age of 58. Physical examinations revealed sclerotic skin changes on his forearms and fingers and poikiloderma on the left popliteal fossa and inguinal region. Both antinuclear antibody and antitopoisomerase-I antibody were positive. We could find no apparent difference between his clinical features and those of idiopathic SSc except for the presence of silicosis and MF. Systemic therapy with interferon-gamma for MF did not improve the skin sclerosis. We discuss the relationship of silica exposure to both MF and SSc.

Background Acute generalized exanthematous pustulosis (AGEP) is a rare and severe cutaneous reaction usually triggered by drugs. Other causative factors such as viral infections are rarely involved. In this study, we report a case of AGEP caused by a spider bite. Case Summary A 56-year-old woman was referred to the allergy unit after a spider bite at the left popliteal fossa, while gardening, 5 days earlier. The offending spider was captured and identified by an entomologist as belonging to the Loxosceles rufescens species. No acute reaction was observed; however, after 24 hours, due to the occurrence of typical dermonecrotic skin lesions associated with erythema and edema, Cefuroxime and Clindamycin were administered intramuscularly after medical advice was given. Almost 72 hours after the spider bite, an erythematous and partly edematous eruption appeared locally in the gluteus area bilaterally, which progressively expanded to the trunk, arms and femors. Within 24 hours dozens of small, pinhead sized, non- follicular pustules were present, mainly in the folds. The patient complained of a burning sensation of the skin in addition to pruritus; and simultaneously had a fever of 38-39 °C as the eruption expanded. Discussion A spider bite may represent a possible causative factor of AGEP. A spider's venom contains sphingomyelinase that stimulates the release of IL8 and GM-CSF, which are involved in AGEP pathogenesis. Whether or not the con-current use of antibiotics has an effect in AGEP appearance when combined with a spider's venom, cannot be excluded.

Metastatic malignant fibrous histiocytoma (MFH) in the stomach is extremely rare. We report a 73-year-old man with MFH in the left popliteal fossa that metastasized to the stomach. Whole-body F-FDG PET/CT showed abnormal tracer uptakes in the stomach, which was subsequently confirmed as metastatic MFH.

Pseudoaneurysms of the popliteal artery arising from blunt knee trauma is an exceedingly rare condition and to our knowledge only less than 20 cases have been reported so far. We present the case of a 72 year old lady who presented with painful pulsatile swelling left popliteal fossa. Investigations revealed a large pseudoaneurysm of the left popliteal artery. She was treated by aneurysmectomy and reconstruction with an interposition PTFE graft. We are reporting this case for the rarity of its occurrence and because the possibility of such a pathology should be kept in mind when evaluating popliteal fossa swellings.

Primary venous aneurysms are infrequently noted. We present a case of a venous aneurysm arising in the lesser saphenous vein. A previously healthy 76-year-old woman was seen at the hospital because of a soft mass at the left popliteal fossa. On the ultrasonography and ascending venography, the mass was diagnosed as venous aneurysm (saccular type) at the left lesser saphenous vein. The mass was saccessfully resected and vascular reconstruction by the end to end anastmosis between the inflow and outflow veins was done. Since venous aneurysm can cause thromboembolism, aggressive resection is recommended. Vascular reconstruction without vascular prosthesis is an ideal procedure to prevent the venous congestion.

Introduction Popliteal aneurysms are the second most common aneurysm. This case report describes a case of angiosarcoma in a popliteal aneurysm, illustrating the importance of post-operative surveillance in expanding popliteal aneurysms post-treatment. Report A 79-year-old male presented with an enlarging mass in the left popliteal fossa, 18 months post-ligation and bypass for a left popliteal aneurysm. The case proved to be metatstatic epithelioid angiosarcoma, arising in the left popliteal fossa. Discussion Epithelioid angiosarcomas are rare, aggressive vascular neoplasms. An awareness of these lesions during surveillance of patients with expanding popliteal aneurysms post-treatment, would allow for earlier diagnosis and more timely interventions.

A 15-year-old girl was admitted to the hospital with a persistent fever, headache, and myalgia. A solitary, painful, black, crusted ulcer with a peripheral erythematous halo was noted in the left popliteal fossa; the ulcer had begun as an asymptomatic erythematous papule 1 week previously.

A 77-year-old male presented to the emergency department with a 2-day history of increased swelling and pain in the left knee and distal thigh. He was unable to flex the knee without severe pain. On examination, the patient had a large pulsatile mass in the left popliteal fossa and distal thigh.

Es el caso de una mujer de edad media sin antecedentes de importancia que presenta una masa de crecimiento rápido en el hueco poplíteo izquierdo, cfinica y radiológicamente interpretada como una neoplasia de tejidos blandos, bien circunscrita, posible lipoma vs. tumor fibrohistiocítico. El estudio de patología quirúrgica corresponde a un liposarcoma mixoide. Los reportes de la literatura llaman la atención a la presencia de este tipo de tumor en el hueco poplíteo. Por ello, recomendamos considerar esta posibilidad diagnóstica en masas localizadas en esta región anatómica.

The very rare condition of multicentric desmoid tumours involving two distant and apparently independent sites is reported in a 17-year-old man. The tumours grew simultaneously and reached approximately equal size. No evidence of familiar polyposis or any other feature of Gardner's syndrome were noted. The proximal desmoid tumour developed from the left hip region and extended into the femoral bone, whereas the distal mass was attached to the left popliteal fossa infiltrating the flexor muscles, the nerves and vessels. On the basis of the good results published recently in the literature and our own earlier experiences, the intralesional resection of the desmoid tumours was completed with postoperative fractionated radiotherapy.