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A 40-year-old woman presented with acute-onset colicky abdominal pain. On physical examination, the patient was afebrile with a heart rate of 95 beats per minute. Abdomen was soft with tenderness in the periumbilical location. No rebound tenderness or guarding was noted. There was no palpable mass.

Unperforated suprapatellar plica leading to compartmentalization of the knee joint has been seldom reported and occasionally overlooked. We report a rare case of unperforated suprapatellar plica presenting as a suprapatellar mass after trauma in a 20-year-old male. Magnetic resonance imaging (MRI) revealed haemarthrosis without abnormalities. Despite one month of conservative treatment including joint aspiration, a palpable mass was discovered at knee flexion. MRI revealed haemorrhagic fluid in the localized suprapatellar recess with an unperforated suprapatellar plica. The patient underwent successful arthroscopic plica excision and had no recurrence or complaint at the 6-month follow-up visit.

Summary Background Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal proliferative lesion of the breast. Owing to the rarity of PASH, the pathogenesis, clinical manifestation, and optimal treatment of this condition remain unclear. We aimed to clarify the appropriate management of PASH. Methods We performed a retrospective analysis of the clinicopathological data of 66 cases with a diagnosis of PASH, confirmed by core needle biopsy (CNB) or surgical excision at Severance Hospital between 2000 and 2016. The primary endpoint was pathologic results after surgical excision of the lesion that confirmed PASH by CNB. The secondary endpoint was progression after the first treatment. Result The median age of patients was 41 years (range, 14–61 years). Findings on medical imaging were nonspecific. CNB was performed in 61 cases, with a diagnosis of PASH confirmed in 39 cases (63.9%). No malignant or premalignant cells directly arising from PASH were identified after surgical excision that confirmed PASH via CNB. The progression rate after the first treatment was 16.6%, with lesion size, enlargement of palpable mass size, and a diagnosis other than PASH on CNB being factors associated with progression. Conclusion CNB is sufficient to confirm PASH what is necessary for an abnormal imaging or suspicious physical examination finding. Surgical excision is not necessarily indicated to rule out occult malignancy after a diagnosis of PASH. Close monitoring or surgical excision are required to manage large lesions (>3 cm) or progressive growth of a PASH lesion.

Patients may present in the emergency setting for a variety of head and neck complaints such as fever, trouble swallowing, or a newly palpable mass. When reviewing radiologic head and neck exams for etiology of complaints, it is important to be familiar with the multiple pseudolesions that may mimic pathology. These may be normal variant anatomy, normal anatomy located in an atypical location, as well as iatrogenic or self-introduced foreign bodies. This review article discusses ten common pseudolesions encountered in the head and neck and their typical imaging appearance so that one does not mistake them for ominous pathology, thus preventing unnecessary follow-up, biopsy, or continued concern for the patient.

Purpose: To report a patient with cavernous hemangioma (CH) presenting as a “subcutaneous” lower eyelid mass. Case report: A 37-year-old man presented with a painless and palpable mass over the right lower eyelid for two years prior to referral. Computed tomography scan revealed a well-defined, lobulated mass located in the mid and lateral portion of the lower eyelid that extended posteriorly to the anterior orbital space. A transcutaneous excisional biopsy was performed. Histopathologic findings of the tumor confirmed CH. Most CHs are intraconal lesions, making our case an unusual presentation for this condition. Conclusion: CH may present superficially in the eyelid and anterior orbital area and thus, although this location is not common, it should be kept in mind as a differential diagnosis for any well-defined eyelid tumor.

To date, almost all case reports of insulin‐derived amyloidosis described the presence of a subcutaneous mass that was observable on physical examination. This report presents two cases of insulin‐derived amyloidosis without palpable masses at insulin injection sites. In both cases, blood glucose concentrations improved, and the insulin dose could be reduced by an average of 45% after changing the insulin injection sites. The insulin absorption at the site was reduced to at most 40% of that at a normal site in one case. Magnetic resonance imaging and ultrasonography were useful to screen and differentiate insulin‐derived amyloidosis without a palpable mass. This report showed that insulin‐derived amyloidosis without a palpable mass can be present at the insulin injection site, and has similar clinical effects to insulin‐derived amyloidosis with palpable masses., This report showed that insulin‐derived amyloidosis without a palpable mass can be present at the insulin injection site and has similar clinical effects to insulin‐derived amyloidosis with palpable masses. Magnetic resonance imaging and ultrasonography were useful to screen and differentiate insulin‐derived amyloidosis without a palpable mass.

A 37-year-old woman presented with a right labium majus thickening with no palpable mass, which had been evolving for a few months. A partial right labium majus ablation was performed at the request of the patient for esthetic reasons. The lesion was most histologically similar to CALME (childhood asymmetric labium majus enlargement). The lesion was benign, but several other differential diagnoses were considered. Two years after the surgery, there had been no recurrence. To our best knowledge, this is the first such case reported in an adult., Highlights • A woman presented with a labium majus thickening with no palpable mass. • Based on its histological characteristics, the lesion was similar to CALME (childhood asymmetric labium majus enlargement). • The lesion was benign, but several differential diagnoses were important to consider. • A conservative approach with close follow-up is preferred to surgery in such cases.

Ewing sarcoma is classified as Ewing’s sarcoma of the bone tissue, extraskeletal Ewing’s sarcoma, peripheral primitive neuroendocrine tumor, malignant small cell tumor of the thoracopulmonary region (Askin) and non-typical Ewing’s sarcoma. Extraosseous Ewing’s sarcoma may be seen throughout the body, however only reported at 4% in the neck. In our case patient has a painless mass growing on his posterior neck for 3 months.On the magnetic resonance imaging, a well-defined, encapsulated, well-demarcated mass lesion between the perivertebral muscles and the subcutaneus fat tissue was detected. Tumor was surgically resected and diagnosis was pathologically Ewing’s sarcoma. 22q11 translocation was detected in the molecular examination. Extraosseous Ewing sarcomas are rarely seen soft tissue masses. Although imaging features are not sufficient to make a specific diagnosis, it is important take the biopsy from the appropriate place and staging the tumor. In addition, complete surgical resection has been shown to associated with better survival rates compared to other Ewing sarcoma family. For this reason, imaging has an important role in the guidance of surgery and resectability of the tumor. Young patients with a fast growing, palpable mass should be evaluated carefully. Although the tumor is thought to be morphologically benign in the first, ekstraosseous Ewing’s sarcoma must be considered in the differential diagnosis of head and neck soft tissue masses., Ewing sarkomu, kemik dokusunun Ewing sarkomu, iskelet sistemi dışındaki Ewing sarkomu, periferik primitif nöroendokrin tümör, torakopulmoner bölgenin malign küçük hücreli tümörü (Askin) ve tipik olmayan Ewing sarkomu olarak sınıflandırılır. Ekstraosseöz Ewing sarkomu tüm vücutta görülebilir ancak boyunda %4 oranında bildirilmiştir. Olgumuzda, ensesinde 3 aydır giderek büyüyen ağrısız kitlesi olan hastada; manyetrik rezonans görütülemede perivertebral kasların arasında, yağ planlarının arasında büyüyen, kapsüllü, düzgün sınırlı kitle lezyonu saptandı. Cerrahi olarak çıkarılan tümörde patolojik olarak Ewing sarkomu tanısı koyuldu. Moleküler incelemede 22q11 translokasyonu tespit edildi. Ekstraosseöz Ewing sarkomları nadir olarak görülen yumuşak doku kitleleridir. Görüntüleme özellikleri özgün veya tanı koymada yeterli olmasa da, biyopsi için dokunun uygun yerden alınması ve tümörün evrelendirilmesi açısından önemli yer tutar. Ayrıca iskelet dışındaki Ewing sarkomunda, tam cerrahi rezeksiyonun diğer Ewing sarkomu ailesi tümörlerine kıyasla daha iyi sağkalım oranları ile ilişkili olduğu gösterilmiştir. Bu nedenle cerrahiye yön gösterme ve tümörün çıkarılabilirliğinin değerlendirilmesinde görüntüleme önemli yer tutmaktadır. Hızlı büyüyen, ele gelen kitlesi olan genç hastalarda, ilk planda morfolojik olarak benign izlenimi verse de dikkatle değerlendirip baş-boyun yumuşak doku kitlelerinin ayırıcı tanısında düşünülmelidir.

Introduction Idiopathic granulomatous mastitis (IGM) often mimics breast cancer. Presentation includes pain, palpable mass, suppuration or suspicious imaging. Widely reported in Asia and the Middle East, IGM is diagnosed after excluding specific granulomatous mastitis (SGM). Aetiology remains unknown. Lactation, prolactinaemia, ethnicity, autoimmune disease and Corynebacteria are associated. Treatment is controversial and the prevalence rising. Surgery and non-operative treatments including antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), steroids, methotrexate and observation have advocates. Methods A retrospective chart review of 63 patients with IGM from 2008 to 2018 was undertaken focusing on birthplace, age, clinical presentation, wound cultures, imaging, treatments and outcomes. Results Sixty-one of 63 patients were Hispanic; 53 were Mexican-born women aged 23–46. Clinical presentation included pain, painful mass, painless mass, suppuration and abnormal imaging. Some 31/61 ultrasound examinations and 17/33 mammograms were deemed Breast Imaging Reporting and Data System (BI-RADS) score 4 or 5. Management included antibiotics (43), incision and drainage (24), NSAIDs (29), steroids (8), lumpectomy (18) and observation (12). Some 12/20 patients with painless masses resolved with observation, 3 received NSAIDs, 2 received steroids and 3 underwent lumpectomies. Antibiotics resolved 8/43 cases, 5 needed incision and drainage, 26 received NSAIDs, 6 received steroids and 5 underwent lumpectomies. Nineteen patients had indolent disease or recurrence. Conclusions Excluding malignancy is critical, treatment challenging and recurrence common in IGM. A preponderance of patients were Mexican-born, similar to other reports from the USA. Over 50% of IGM cases had suspicious BI-RADS scores. Best management remains a challenge and ranges from observation to lumpectomy.

The caecum is one of the rarest sites of intestinal duplication cysts. The most common symptomatology includes vomiting, abdominal pain, abdominal distention, palpable mass and rectal bleeding. Most of the duplications are diagnosed within the first two years of life, including prenatal diagnosis. Only few cases of caecal duplication have been reported in the literature up to the present day. We are going to present a case of a five-years old girl with caecum duplication who reached our ward due to abdominal distension with no other symptoms.

Undescended testis is most common congenital malformation in boys. Most common location is inguinal canal but rarely it is found in intraabdominal. 10% of them will grow become mass if left untreated. This case report describes cases of men of 40s with unilateral UDT and not noticeable until they felt heavy and feel palpable mass in abdomen revealed as seminoma. He is sterile and not be able to reproduce. Chemotherapy was done and the response was remarkable. This case report reiterates the need for a scrotal examination in men presenting with an abdominal mass, so as to rule out an intra-abdominal seminoma.

A 44-year-old man presented to the emergency department with a painful, palpable mass in the area of the right carotid triangle lasting for 1 week. He was otherwise healthy without any trauma or further otorhinolaryngological symptoms. Other than a pain at the right carotid triangle on pressure

Herein, we present a case of left paraduodenal hernia in a middle-aged male who presented to emergency department with complaints of abdominal pain, palpable mass in the left side of abdomen and vomiting. At laparotomy, diagnosis was made as strangulated left paraduodenal hernia, for which decompression of sac along with resection of gangrenous small bowel and reestablishing its continuity with repair of the defect was done.

El objetivo del presente estudio, fue describir los aspectos psicológicos derivados del diagnóstico, tratamiento y secuelas del cáncer de mama masculino, mediante una metodología cualitativa. Se utilizó el método de estudio de caso, con el propósito de determinar el grado de afectación psicológica de un paciente masculino con patología mamaria maligna. La técnica empleada para la recolección de datos fue el inventario de depresión de Beck, para medir la severidad de la depresión. Se estudia un paciente de sexo masculino de 46 años, que consultó por masa palpable en la tetilla derecha, de seis meses de evolución, no dolorosa, de 3 cm de diámetro. Se realizó Mastectomía total derecha con diagnóstico de Carcinoma Ductal Infiltrante grado Histológico III. Acude después de 5 años de operado con sintomatología respiratoria y se demuestran metástasis pulmonares, hepáticas y óseas. Se encuentra en tratamiento con radioterapia paliativa. En los resultados obtenidos el paciente se encontró dentro de la escala de depresión en el rango de 21-30 lo cual indica que este se encuentra en Depresión Moderada. Se sugiere considerar el apoyo psicológico dentro de los tratamientos médicos de la enfermedad, así como también promover estrategias para el trabajo de la expresión emocional y la calidad del apoyo social familiar. Es importante enfatizar el papel que desempeña la intervención terapéutica en el diseño, la puesta en práctica, la evaluación y los cambios significativos dentro del proceso de la enfermedad, de la calidad de la vida del paciente, familia o pareja a partir del diagnóstico y a través de la trayectoria de la enfermedad oncológica. Abstract The objective of this study was to describe the psychological aspects derived from the diagnosis, treatment and sequelae of male breast cancer, using a qualitative methodology. The case study method was used, with the purpose of determining the degree of psychological affectation of a male patient with malignant mammary pathology. The technique used for data collection was Beck's depression inventory, to measure the severity of depression. A 46-year-old male patient was studied, who consulted for palpable mass on the right nipple, of 6 months of evolution, not painful, 3 cm in diameter. Total right mastectomy was performed with diagnosis of Infiltrating Ductal Carcinoma, Histological grade III. He comes after 5 years of surgery with respiratory symptoms and pulmonary, hepatic and bone metastases are demonstrated. It is in treatment with palliative radiotherapy. In the results obtained, the patient found himself within the depression scale in the range of 21-30, which indicates that he is in Moderate Depression. It is suggested to consider psychological support within the medical treatments of the disease, as well as to promote strategies for the work of emotional expression and the quality of family social support. It is important to emphasize the role of therapeutic intervention in the design, implementation, evaluation and significant changes within the disease process, the quality of life of the patient, family or partner from the diagnosis and through of the trajectory of the oncological disease.

Primary musculoskeletal echinococcosis is rare and accounts for 2-3% of the patients with hydatid disease. We report a case of giant primary hydatid cysts of the thigh and the gluteal region in an 82-year-old female, who presented with a painful multiple palpable mass. The diagnosis was confirmed by imaging and serology. Total resection was performed through an extended lateral approach of the thigh and intraoperative findings revealed infected giant hydatid cysts. The postoperative outcome was uneventful. Albendazole drug (400mg per day) was given for the next 3 months. At 6 months follow-up, the patient was satisfied with no complications or recurrence.

Ileocolic intussusception is the most common abdominal emergency in early childhood and is usually idiopathic.1 Diagnosis requires a high index of suspicion as the pathognomonic triad of redcurrant jelly stools, palpable mass and intermittent abdominal pain is present in less than a quarter of cases.1 It should be differentiated from ileoileal intussusception, which is typically transient and self-limiting.2 However, if children present to the emergency department (ED) with acute, severe abdominal pain due to recurrent intussusception, an underlying diagnosis should be considered, as in the case reports detailed below.

An anatomical variant of flexor digitorum superficialis brevis is an uncommon condition that may be a pitfall in diagnosing carpal tunnel syndrome, involving palpable mass and even characteristic symptoms. We present an unusual case of bilateral symptomatic carpal tunnel syndrome related to the presence of a flexor digitorum superficialis brevis muscle of the little finger, and a critical review of the literature.

A 63 year-old postmenopausal woman presented to her family physician with a tender palpable mass in the right lower quadrant in November 2019. She noticed that this pain was reproducible with pressure on the right hip. Her medical history was significant for hypothyroidism, tubular adenomas, and

Breast implant-associated anaplastic large-cell lymphoma is a rare type of non-Hodgkin lymphoma that occurs years after placement of textured surface breast implants. Patients typically present after the development of pain, a palpable mass, or swelling. We present a case of a 45-year-old woman with recurrent breast implant-associated anaplastic large-cell lymphoma presenting as refractory fluid collections, and the unusual finding of low uptake on FDG PET/CT scan despite being confirmed by cytology.

Adenoid cystic carcinoma of the breast is a rare type of breast cancer. Most patients present with a bilateral palpable mass. Ultrasound and mammography are non-specific and can sometimes lead to misdiagnosis because of their variable imaging features. Pathological examination is the standard reference. Surgery is the mainstay of treatment for patients. Although adenoid cystic carcinoma has an excellent prognosis, metastatic cases have been reported. This report aims to discuss the clinical and imaging features of one case of adenoid cystic carcinoma with a poor prognosis and four cases with a good prognosis at our center.

Background A cutaneous ciliated cyst (CCC) is a rare, benign tumor in young female adults, which is usually found on the lower extremities. Case summary We found an uncommon location of CCC in the anterolateral cervical area and reviewed the literature. A 20-year-old female complained of a well-defined, painless, palpable mass that started several years ago. The mass was tense and movable and located at the anterolateral aspect of the neck. Imaging showed a non-enhancing round mass. Surgical excision biopsy was performed, and the cystic mass was revealed to be a CCC. Conclusion The rare location of CCC can be found in anterior neck area, which should be another diagnostic option for mass on anterior neck.

Immunoglobulin G4-related sclerosing mastitis (IgG4-RM) is a recently recognised member of the IgG4-related disease (IgG4-RD) family, a multisystem fibroinflammatory condition that can affect any organ system. IgG4-RM is rare and predominantly occurs in middle-aged women. It may present with painless palpable mass and/or lymphadenopathy thereby mimicking breast cancer. Although there is an abundance of literature describing the clinicopathological characteristics of IgG4-RD in a variety of organs, data on IgG4-RM are limited due to its rarity. This review describes the manifestation of the disease in the breast based on reported cases, emphasising the clinicopathological features, pathophysiology, differential diagnosis, treatment and prognosis.