Abdominal Wall Mass Research Articles

The minimally invasive resection of port-site metastasis of ovarian cancer after laparoscopy with cutaneous integrity: a case report and literature review

BackgroundPostoperative wound recovery following laparotomy for port-site metastasis (PSM) resection is a concern. Reports indicate that wound healing disorders occur in patients with PSM. The challenges associated with PSM resection include the complete removal of the lesion, ensuring rapid wound healing, and maintaining the integrity of the abdominal wall. To date, there have been no reports on a minimally invasive approach for PSM resection following ovarian cancer through the inner side of the abdominal wall.Case presentationA 66-year-old G2P1 patient with a history of high-grade serous ovarian adenocarcinoma IIA presented with two abdominal wall masses, suspected to be PSM. She underwent laparoscopic resection of the lesions under general anesthesia. The excised masses measured approximately 10 cm and 5 cm, and margins were negative. The surgery lasted 1 hour and 33 minutes, with minimal intraoperative bleeding and no complications. The postoperative recovery was smooth. No recurrence was observed during the 12-month follow-up.ConclusionsIn our view, laparoscopy may be used as a minimally invasive technique that allows for PSM in the abdominal wall.

Various Clinical Manifestation of Omphalomesenteric Duct Remnant in a Child: A Case Report

Omphalomesenteric duct (OMD) remnant is a condition in which the omphalomesenteric duct fails to obliterate completely or partially. Failure in this step can produce various patterns, such as a vitelline cyst, umbilical sinus, polyp, Meckel’s diverticulum, and patent OMD. Various clinical manifestations of OMD rarely occur in one patient. We present the case of omphalomesenteric duct remnant, manifested as anterior wall abdominal mass, intraperitoneal hemorrhage, and obstructive ileus. Case report: A four-year-old girl was referred to our hospital with obstructive ileus and abdominal wall mass on the left lower quadrant. Contrast-enhanced abdominal computed tomography (CT) scan found an irregular cystic mass in the abdominal cavity that adheres to the anterior wall of the abdomen and bowel structure with a fluid-solid level without enhancement. Further medical history was taken and found a history of intermittent watery umbilical discharge that appears three times in 2 years after birth. Omphalomesenteric duct remnant was suspected, then proceed to exploratory laparotomy. We found intraperitoneal hemorrhage and 5x4 centimeters frail mass adhering to the anterior wall of the abdomen on the left side of the umbilicus. Histopathological examination confirmed intestinal tissue, suggesting remnants of the omphalomesenteric duct and pancreatic tissue with a chronic inflammatory pattern. Diagnosing omphalomesenteric duct remnant could be challenging and should be considered a differential diagnosis of obstructive ileus, particularly if persistent umbilical discharges are also present. On the other hand, early diagnosis and appropriate management of persistent umbilical discharge could prevent a greater outcome.

Primary Hydatid Cyst of the Abdominal Wall in Children: A Case Report and Literature Review

Introduction: In endemic areas, hydatid cyst disease is a serious health problem, typically associated with parasitic infections affecting primarily the liver and lungs. However, cases of hydatid cysts in the abdominal wall are rare. We surgically treated a 13-year-old boy with this condition, and we also provided a brief literature review on this topic. Conclusion: Hydatid cyst should be sought in the differential diagnosis of abdominal wall masses. Its preoperative diagnosis plays an important role in preventing rupture with subsequent anaphylaxis and recurrence. Surgery remains the primary treatment modality.

Ligamentum teres hepatis incarcerated within linea alba hernia: A case report

Abstract Incarcerated linea alba hernia is a rare form of ventral hernia. Most of these contain pre-peritoneal fat or the omentum. Herniation of containing ligamentum teres hepatis is seldom seen. A 52-year-old man presented with an abdominal wall mass and dull pain for 2 weeks. Computed tomography and ultrasound examination of the abdomen revealed an epigastrium linea alba hernia containing the liver round ligament. A hernial sac of size 3 cm × 4 cm was explored by laparoscopic surgery and successfully managed with hernia repair.

Acute gastric dilatation with segmented abdominal paresis as a rare manifestation of herpes zoster: a case report and review of the literature

BackgroundHerpes zoster is a common disease that can affect men and women at any age. Sensory neuropathy is the most common complication while motor neuropathy of the abdominal muscles is rare complication appearing in ~ 0.7% of patients. Furthermore, visceral nerve involvement causing gastroparesis is an extremely rare postherpetic complication. We present an extremely rare case of acute gastric dilatation with segmented abdominal paresis as a rare manifestation of herpes zoster infection.Case presentationA 91-year-old Asian man was admitted to hospital with 2-day history of vomiting and left abdominal protrusion. He was previously treated for a rash on the left abdominal wall as herpes zoster infection with oral valaciclovir 2 weeks prior. On physical examination, characteristic herpes zoster rash scars and an ipsilateral abdominal bulge were observed on the left side. Computed tomography revealed no abdominal wall defect, mass, or stenosis. Remarkable distension of the stomach, asymmetrical left flank wall bulge, and a thinner abdominal wall on the left compared with the right side were shown. He was diagnosed as acute gastric dilatation owing to gastroparesis and segmental paresis of the abdominal musculature associated with herpes zoster infection. The patient showed significant improvement in symptoms and abdominal paresis within a month of conservative treatment, including nasogastric tube decompression and mosapride administration.ConclusionAcute gastric dilatation with abdominal paresis is an extremely rare complication of herpes zoster infection, and to date there have been no reports in the literature. It alerts us that, when examining patients with abdominal bulge, we should be conscious of this rare pathology for the optical diagnosis, avoiding unnecessary invasive examination or surgical exploration.

Anterior abdominal wall desmoid tumors: Reconstructive considerations and challenges in an oncoplastic unit in a low- and middle-income country: A case report

Desmoid tumors (DTs) are rare, locally aggressive tumors. When left untreated, DT can rapidly proliferate and occupy a significant portion of the anterior abdomen, making postresection reconstruction challenging. We present a 32-year-old female with a previous history of cesarean section and a 10-month history of two rapidly growing anterior abdominal wall (AAW) masses. There was no clinical or radiologic evidence of distant metastases. Abdominopelvic computed tomography scan showed no intra-abdominal extension. She had a wide local excision of the masses using an “abdominoplasty” technique and reconstruction of the extensive musculofascial defect with fascia lata grafts and polypropylene mesh. A histologic diagnosis of desmoid-type fibromatosis was made. The patient is scheduled for adjuvant radiotherapy and desires future pregnancies. This case report highlights the reconstructive considerations and challenges associated with surgical resection of huge AAW DT in an oncoplastic unit in a low- and middle-income country.

Lumps and Bumps on the Abdominal Wall: Role of Fine Needle Aspiration Cytology.

Abdominal wall masses often pose diagnostic challenges for clinicians due to their nonspecific symptoms. They include a wide spectrum of lesions ranging from inflammatory to tumor-like masses and malignancies. The majority of the malignant nodules are metastatic in origin and may be the initial presentation of a primary malignancy; hence, an early diagnosis is important. Fine-needle aspiration cytology (FNAC) is a valuable diagnostic tool in the evaluation of such lesions. This was a retrospective study of the cytomorphological spectrum of abdominal wall masses, conducted at a tertiary health care centre over a three-year period. The study included patients of all age groups presenting with an abdominal wall mass. These lesions were assessed by FNAC. The diagnosis was made on cytology smears and subsequently correlated with the histopathological diagnosis, wherever possible. Of the 70 cases, 21 were non-neoplastic and 49 neoplastic. A benign neoplasm was the most common lesion (52.9%), followed by non-neoplastic lesions (30%) and malignant neoplasms (17.1%). Lipoma was the most common benign neoplasm and metastasis was the commonest malignant neoplasm. The most common type of tumor metastasising was adenocarcinoma and the primary tumors were predominantly intra-abdominal. No false-negative results were seen. Most of the abdominal wall masses display a characteristic cytomorphology, which needs to be identified and recognized by a cytopathologist for an accurate diagnosis. FNAC plays an invaluable role in the detection of metastases, especially at sites such as the umbilicus, which may be the only manifestation of an underlying advanced malignant disease.

Case of Ray Fungus Presenting with Abdominal Distension

Actinomycosis is a rare infection caused by filamentous, non acid fast staining and gram positive bacteria. The diagnosis is rarely made preoperatively, and only histopathological examination can confirm it, as the condition presents with varied clinical manifestations, often resembling a malignant lesion on radiographic images. Hereby, the authors present a case of a 67-year-old female, who was admitted for evaluation of an abdominal mass. Radiologically, the mass resembled a desmoplastic fibroma, and clinically, it was suspected to be the same. The mass was excised and sent for histopathological examination. Grossly, two specimens were received. The first consisted of adherent bowel loops, including the ileum, appendix, caecum and descending colon, with the mass arising from mesentery involving the bowel, measuring 11.5x9.5x6 cm. The second specimen was a partial cystectomy specimen, with the abdominal wall mass infiltrating the bladder anteroposteriorly, measuring 11x10x8 cm. Microscopic examination revealed extensive areas of inflammation with actinomycotic organisms exhibiting the Splendore-Hoeppli phenomenon, along with numerous multinucleated giant cells and acute on chronic inflammatory infiltrate. Surrounding areas showed dense collagen bundles. The prognosis after complete surgical resection is good, along with the administration of broad spectrum intravenous antibiotics.

Abscess formation of abdominal wall mimicking lymphoma due to Morganella morganii infection in a prepubescent children

Introduction: Morganella morganii infection mainly occurred in elderly people and immunocompromised patients.However, the abdominal wall abscess due to Morganella morganii infection in prepubertal children hasn't been documented.Our presented case is a 4-year-old male patient with a 1 month history of left lower quadrant abdominal mass. Preoperative ultrasonography showed a hypoechoic, heterogeneous mass and the mass wasn't just confined to the abdominal wall, mimicking lymphoma. On CDFI, an image of highly vascularized mass was demonstrated. The patient underwent lump resection of abdominal wall.Postoperative process was uneventful except intermittent haematuria, and bladder sludge and urethral calculus on ultrasonography.By symptomatic treatment, haematuria disappeared and urethral calculus and bladder sludge decreased. Then the patient discharged home. Postoperative histopathology and immunohistochemistry were suggestive of abscess formation and Morganella morganii was isolated finally from the aspirated pus. Conclusion: Therefore, although the abdominal wall abscess due to Morganella morganii infection is rare, it should not be absent in the differential diagnosis of abdominal wall masses in children. Imaging features of abdominal wall masses should closely integrate the pertinent clinical history.

Abdominal wall mass resections: single-center closure practices and outcomes following oncologic resections of abdominal wall fascia.

Radical resections for abdominal wall tumors are rare, thus yielding limited data on reconstruction of defects. We describe surgical management and long-term outcomes following radical tumor resection. This was a single-center retrospective review of patients between January 2010 and December 2022. Variables included operative characteristics, wound complications, hernia development, tumor recurrence, and reoperation. A multivariable analysis compared wound morbidity for suture and mesh repairs while adjusting for defect width, fascial closure, and CDC wound class. 120 patients were identified. Mean follow-up was 3.9 ± 3.4years. Seventy-five (62.5%) of the masses were primary; most commonly desmoid (n = 25) and endometrioma (n = 27). Forty-five masses were metastases. Mean tumor width was 6.2 ± 3.4cm; mean defect width was 8.1 ± 4.1cm. Sixty-one patients (50.8%) had mesh placed, with variation in technique. Postoperative CT scans were available for 88 (73.3%) patients. Forty SSOs (33.3%), 11 SSIs (9.2%), and 18 (15%) SSOPIs occurred within 30 days. On multivariable analysis, increased defect width was associated with SSOPI (OR 1.17, p = 0.041) and CDC wound class II-III was associated with SSI (OR 8.38 and 49.1, p < 0.05) and SSOPI (OR 5.77 and 17.4, p < 0.05); mesh was not associated with these outcomes. Seven patients (5.8%) underwent 30-day reoperations and 35 (20.8%) required additional operations after 30 days. Thirteen percent developed abdominal wall (n = 8) or intra-abdominal tumor recurrence (n = 8) requiring reoperation. Twenty-seven (22.5%) patients developed hernias with a mean fascial defect width of 9.8 ± 7.2cm. Abdominal wall mass resections are morbid, often contaminated cases with high postoperative complication rates. Risks and benefits of mesh implantation should be tailored on an individual basis.

RET/PTC rearrangement in papillary thyroid carcinoma arising in malignant struma ovarii with abdominal wall metastasis and cervical thyroid gland: a case report and review of the literature

BackgroundStruma ovarii refers to rare mature cystic teratomas containing at least 50% of thyroid tissue, and malignant transformation is known to be even rarer. The synchronous development of malignant struma ovarii and cervical thyroid carcinoma are also scarce and poorly understood due to limited data about molecular features. Here, we present the first report of RET/PTC 1 rearrangement in synchronous metastatic malignant struma ovarii to the abdominal wall and cervical thyroid cancer.Case presentationWe described a 47-year-old multigravida woman with bilateral adnexal and lower abdominal wall masses detected during the evaluation of abnormal uterine bleeding. The patient underwent a hysterectomy, bilateral salpingo-oophorectomy, and surgical removal of abdominal wall mass. Then, the pathological evaluation revealed papillary thyroid carcinoma (PTC) within struma ovarii and metastatic PTC in the abdominal wall fibro adipose tissue. Further, cervical thyroid gland physical examination and ultrasound illustrated a nodule within the left lobe. Subsequently, a total thyroidectomy was performed, and a histological examination revealed PTC. Furthermore, all affected tissue, i.e., struma ovarii, abdominal wall metastasis, and cervical thyroid gland tested for BRAF and RAS mutations and RET/PTC 1 rearrangement. RET/PTC 1 rearrangement was identified among all three different sites. Finally, after six years of follow-up, the patient had no evidence of recurrence or distant metastasis.ConclusionsIn light of these findings, malignant struma ovarii might yield a clue to cervical thyroid carcinoma, and the molecular analysis could provide valuable information for understanding the underlying mechanism, tumor clinicopathological behaviors, and prognosis.

Abdominal Wall Schwannoma: A Case Report and Review of the Literature

Abdominal wall schwannomas are rare neoplasms originating from peripheral nerve sheaths. We present a case report of a 21-year-old patient with a ten-year history of a subcutaneous mass on the left flank of the abdomen. The mass exhibited a hard consistency and was adherent to the deep plane. Palpation elicited pain, and magnetic resonance imaging (MRI) initially suggested a dermoid cyst in intimate contact with the external oblique muscle. The patient underwent wide excision of the mass with a 2 cm margin and subsequent closure of the resulting muscle and aponeurotic defect by direct suturing. Histopathological examination confirmed the diagnosis of a completely excised subcutaneous schwannoma. This case emphasizes the importance of considering schwannomas as a differential diagnosis for abdominal wall masses and highlights the challenges in diagnosing and managing abdominal wall schwannomas. By presenting a comprehensive review of the literature, we aim to contribute to the existing knowledge of this rare entity, facilitating early recognition and appropriate management of abdominal wall schwannomas in clinical practice.

Assessment of incidental cardiac uptake in bone scintigraphy across Spain. ECCINGO study

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Pfizer SLU Introduction Myocardial uptake on bone scintigraphy with diphosphonates has become a useful tool for the early detection of transthyretin cardiac amyloidosis (ATTR-CM), the prevalence of which remains unknown. Purpose To assess the prevalence of myocardial uptake in bone scintigraphy in patients without previous clinical suspicion of cardiac amyloidosis (CA). Methods Observational, retrospective, multicentre study in 21 hospitals across Spain, their reference population represented 24.38% of the total national population. All scans performed for non-cardiac reasons during the months of September, October and November 2019 were reviewed. Scans with positive cardiac uptake (Perugini scores 1-3) were evaluated by a central laboratory. Medical histories of the patients with positive uptake were reviewed. Results 9864 scans were reviewed. Cardiac uptake was observed in 71 patients (0.72%) over 18 years of age (85.90% male). According to the central laboratory assessment the distribution in the Perugini grading scale was, grade 1 (23.90%), grade 2 (29.60%) and grade 3 (46.50%). No relationship between sex and Perugini grade was observed. Heart/Contralateral ratio (H/CL) was available for 24 patients with a mean of 2.1 ± 1.1 (95% CI 1.7–2.6). A third of the patients (33.80%) also presented extracardiac uptake, being the most common: bone metastasis (7.04%) abdominal wall (5.60%) and lower limbs muscular mass (4.20%). A previous heart failure (HF) diagnosis was found in the 16.90% of the patients with positive uptake, being most of them 57.10% in NYHA class II. Patients ≤ 80 y.o. were diagnosed with heart failure earlier than patients &amp;gt; 80 y.o. (p = 0.02) and with atrial fibrillation earlier than patients &amp;gt; 80 y.o. (p = 0.05). Ten patients with cardiac uptake were subsequently diagnosed with ATTR amyloidosis (ATTR-Y) with a mean delay of 10.8 months (95% CI: 6.0–16.8). All ATTR-Y patients were &amp;gt; 70 y.o., 90.00% were male, had left ventricular hypertrophy (LVH) compared to 25.49% of patients in whom a diagnosis of ATTR (ATTR-N) was not confirmed (p = 0.00003). Patients in the ATTR-Y group presented some episode of orthostatic hypotension and involuntary weight loss in the clinical history (30.00% in both) compared to 3.77% (p = 0.025) and 5.88% (p = 0.05) of the ATTR-N group respectively. Conclusions This national study found a prevalence of 0.72% of incidental cardiac uptake in bone scintigraphies performed for non-cardiac reasons in adult patients. The results of this study bring light on the profile of the elderly patients with incidental cardiac uptake. The referral of these patients can facilitate the early diagnosis of CA with the consequent impact on the management and prognosis of patients.

Granuloma formation after repeated episodes of peritoneal dialysis catheter–related infection, a case report

BackgroundPeritoneal catheter related infection is one of the main complications and the major cause of technical failure of peritoneal dialysis (PD) treatment. However, PD catheter tunnel infection can be difficult to diagnosis and resolve. We presented a rare case in which a granuloma formation after repeated episodes of peritoneal dialysis catheter–related infection.Case presentationA 53-year-old female patient with kidney failure due to chronic glomerulonephritis treated with peritoneal dialysis for 7 years. The patient had repeated exit-site and tunnel inflammation, and repeated suboptimal courses of antibiotics. She switched to hemodialysis after 6 years in a local hospital without the peritoneal dialysis catheter being removed. The patient complained of an abdominal wall mass that lasted for several months. She was admitted to the Department of surgery to undergo mass resection. The resected tissue of the abdominal wall mass was sent for pathological examination. The result showed foreign body granuloma with necrosis and abscess formation. After the surgery, the infection did not recur.ConclusionsThe following key points can be learned from this case: 1. It is important to strengthen patient follow-up. 2.The PD catheter should be removed as early as possible in patients who do not need long-term PD, especially in patients with a history of exit-site and tunnel infections. 3. For patients presenting abnormal subcutaneous mass, attention should be paid to the possibility of the granuloma formation of infected Dacron cuffs of the PD catheter. If catheter infection occurs repeatedly, catheter removal and debridement should be considered.

P-055 COMPLEX ABDOMINAL WALL RECONSTRUCTION AFTER THE RESECTION OF ADVANCED OVARIAN CANCER SPREAD TO ABDOMINAL WALL AND ILIAC VESSELS

Abstract Aim We present the case of an advanced ovarian cancer spread to the abdominal wall and iliac vessels where a complete resection was performed with immediatly reconstruction of the abdominal wall to achieve a complete R0 resection. Material and Methods A 66-year-old woman with history of hysterectomy, double adnexectomy and adjuvant chemotherapy for ovarian cancer 36 years ago. The CT scan showed an 8×7 cm lesion involving the anterior rectus muscle with compression of the ipsilateral iliac vessels. A biopsy was positive for adenocarcinoma with gynecological origin. She received neoadjuvant treatment with chemotherapy. In the control CT scan persisted a mass the abdominal wall mass with slight reduction in size and compressing the iliac vessels. Results Following a karakousys incision, an anterior abdominal wall tumor intimately attached to the pubic symphysis was observed. The tumor measured 6 cm, it infiltrated the femoral vein but there was not invasion of the artery. A completed resection of the anterior abdominal wall musculature up to the pubic symphysis was performed, disconnecting the inguinal ligament and leaving a 10×10 cm wall defect. This defect was repaired with the placement of a preperitoneal biological mesh to provide a reinforcement plane and a polypropylene mesh above the previous one. Conclusions Wide abdominal wall resections may be necessary to obtain R0 resections. Numerous studies have shown that morbidity rates associated with these procedures are not high. In fact, in our case, an immediate abdominal wall reconstruction achieved good functional and aesthetic results in a single surgical procedure.

Dual-phase contrast-enhanced multislice computed tomography scans play a key role in the diagnosis of abdominal wall desmoid-type fibromatoses.

Abdominal wall desmoid-type fibromatoses (AWDF) are occasionally encountered in clinical work, but related CT reports are rare, and most cases were misdiagnosed as malignant tumors. We aimed to determine the diagnostic value of multislice computed tomography (MSCT) in relation to the clinical diagnosis of AWDF. The medical records of 14 patients whose pathology results provided initial confirmation of AWDF were reviewed, and data describing their clinical characteristics, tumors' MSCT characteristics, and the condition of the surrounding tissues were analyzed and summarized retrospectively. Intraobserver and interobserver reproducibilities were evaluated. AWDF tended to occur in women of childbearing age (24-32 years). They occurred more frequently during the first year following pregnancy. The mean disease duration was 5.64 ± 3.78 months. All isolated tumors were growing along the musculoaponeurotic layer, and their maximum diameters were between 32 and 76 mm. Tumors' capsules were incomplete, and although the tumors infiltrated the surrounding muscles, the surrounding fat tissue and vessels were not infiltrated. None of the patients' tumors showed cystic degeneration, calcification, necrosis, or peritumoral edema. The tumors had slightly lower densities on the pre-contrast enhancement scans and mild-to-moderate enhancement after contrast enhancement. All tumors contained ribbon-like structures, and approximately 65% of the tumors encircled vascular structures. Dual-phase contrast-enhanced MSCT scans were associated with a high level of diagnostic efficacy for AWDF. The abdominal wall masses grew along the musculoaponeurotic layer, which, together with the ribbon-like structures within the tumors, should prompt clinicians to consider the presence of AWDF.

ABDOMINAL WALL SCAR ENDOMETRIOSIS AFTER CESAREAN SECTION; A RARE CASE REPORT WITH MULTI FOCUS

Endometriosis is described as the presence of functional endometrial tissue outside the uterine cavity. Scar endometriosis (SE) is a rare condition which usually develops after gynecologic operations involving the uterus and fallopian tubes. The symptoms are usually nonspecific and cyclic incisional pain increasing by menstruation is the most common symptom. Diagnosis of the disease can be difficult and may be confusing with various other post-surgical conditions. Histopathological examination reveals the final diagnosis. This article presents a case with cesarian SE of which the largest reaches 5x4x3 cm with multiple foci. Scar endometriosis should be considered in the differential diagnosis of abdominal wall masses in the patients with a history of abdominal surgery and cyclic painful solid mass.

SUBCUTANEOUS ENDOMETRIOSIS: USUAL ENTITY AT AN UNUSUAL SITE

Background: Endometriosis is dened as a chronic, oestrogen- dependent, benign inammatory disease characterized by growth of endometrial glands and/ or stroma outside the uterine cavity. 25% of women affected with endometriosis are asymptomatic, other may present with symptoms like chronic pelvic or abdominal pain and/ or infertility. Common sites or ectopic locations include primarily the pelvic peritoneum, ovaries and rectovaginal septum. We are presenting a case of 30-year-old Indian women with com Case: plains of pain in abdomen and a palpable mass in the anterior abdominal wall in right iliac fossa. Computed Tomography (CT) abdomen and pelvis (Plain and contrast) showed large well dened abnormal soft tissue density mass lesion with inhomogeneous enhancement on contrast – Favouring: ? Infective ? Neoplastic etiology. Result: Excision was done and tissue was sent for histopathology. Histopathological diagnosis was made as Endometriosis. Keeping this case Conclusion: in mind, for patients with subcutaneous mass in anterior abdominal wall and complains of abdominal pain, endometriosis should always be kept as a differential diagnosis. Histopathology stands as a gold standard for the diagnosis as CT (Plain and contrast) is insufcient in the denitive diagnosis of such lesions.

Giant cell tumor of soft tissue: A case report

Giant cell tumor of soft tissue (GCT-ST) is a rare primary neoplasm of soft tissues. It usually involves superficial and deeper soft tissues of upper and lower extremities, followed by trunk. A 28-year-old female, presented with a painful mass in left abdominal wall for three months. On examination, it measured 4×4cm with ill-defined margins. CECT showed ill-defined enhancing lesion deep to muscle planes with possible invasion of peritoneal layer. Histopathology showed multinodular architecture with intervening fibrous septa and metaplastic bony tissue encasing the tumor. Tumor composed of round to oval mononuclear cells and osteoclast like multinucleated giant cells. Mitotic figures were eight per hpf. A diagnosis GCT-ST of anterior abdominal wall was made. Patient was treated with surgery followed by adjuvant radiotherapy. Patient is disease free at one year follow up. These tumors mostly involve extremities and trunk and usually presents as a painless mass. Clinical features depend upon the exact location of the tumor. Common differential diagnosis includes tenosynovial giant cell tumors and malignant giant cell tumors of soft tissue and GCT of Bone. Diagnosis of GCT-ST is difficult on cytopathology and radiology alone. Histopathological diagnosis should be done to rule out the malignant lesions. Complete surgical resection with clear resection margins is the mainstay of treatment. Adjuvant radiotherapy should be considered in case of incomplete resection. Long follow-up is necessary for these tumors as local recurrence and risk of metastasis cannot be predicted.

URACHAL ANOMALIES IN CHILDREN (ANALYSIS OF MEDICAL LITERATURE AND OWN OBSERVATIONS)

Currently, a significant number of publications have been accumulated on the disorders of urinary duct, urachus involution. However, the world literature data on the timing of obliteration and the frequency of urachal anomalies vary significantly, which makes it difficult to assess the risk of complications. There is also no consensus on the tactics of management of these patients. This paper analyzes 62 medical sources on the issues of urinary duct involution, disorders of its obliteration, clinical manifestations of urethral complications and treatment of related conditions. The article also presents data of our own observations of 37 patients with various urachal pathology over a ten-year observation period, including 21 (56.76%) children had umbilical fistulas, 14 (37.84%) children - urachal cysts, 2 (5.4%) patients - bladder diverticula. The data of diagnosis and treatment of children with this pathology are presented.Purpose: analysis of medical sources and own data on the diagnosis and treatment of urinary duct pathology in children, highlighting important and practically significant recommendations on problematic issues of this pathology.Conclusions.1. Urachus is an embryonic formation that connects the bladder with the allantois. According to pathological and anatomical studies, impaired obliteration of the urinary duct occurs in approximately 30% of cases.2. The presence of discharge from the umbilicus, recurrent omphalitis, the presence of a tumor-like mass of the anterior abdominal wall, symptoms of urinary tract infection should be indications for targeted examination for possible urethral pathology.3. The main methods of diagnosing the pathology of the urinary duct are ultrasound and fistulography.4. Data on the age involution of urachus, which occurs in the postnatal period, determine the need to choose the treatment tactics in childhood.