Left Inguinal Mass Research Articles

Left inguinal dedifferentiated liposarcoma and primary unclassified sarcoma of the left lung as synchronous multiple sarcomas: a case report

BackgroundPulmonary nodules in patients with soft tissue sarcomas are likely pulmonary metastases, whereas synchronous primary pulmonary sarcomas are rare. Without surgery, determining whether a solitary pulmonary nodule is a primary or metastatic nodule is difficult. Herein, we report a rare case of a primary pulmonary sarcoma that presented synchronously with a primary dedifferentiated liposarcoma.Case presentationA 77-year-old man presented to another hospital with left inguinal swelling and a suspected recurrent inguinal hernia. Computed tomography revealed a left inguinal mass and pure-solid nodule in the left lung and the patient was referred to our hospital for detailed examination and treatment. The inguinal mass was pathologically diagnosed as a dedifferentiated liposarcoma using needle biopsy, whereas bronchoscopic biopsy revealed histological findings suggestive of a sarcoma; however, the primary site could not be determined. Positron emission tomography–computed tomography revealed no high-accumulation lesions except for the two sarcomas. We decided to perform surgery on both sarcomas for diagnostic and curative purposes. The surgical specimens showed that the two sarcomas were different. Based on the immunohistochemical staining findings of MDM2, a left inguinal dedifferentiated liposarcoma and primary pulmonary unclassified sarcoma were diagnosed. The patient displayed no evidence of recurrence 1 year after surgery.ConclusionsWe encountered a rare case of synchronous multiple primary sarcomas, one presenting in the lung and the other in the soft tissue. Surgery was required to achieve a definitive diagnosis for the patient, who achieved disease-free survival at 1 year. This case suggests that proactive resection of pulmonary nodules in patients with soft tissue sarcomas may be feasible as a diagnostic treatment if complete resection is achieved.

Cytopathological findings of intranodal palisaded myofibroblastoma: Case report and review of the literature.

Intranodal palisaded myofibroblastoma (IPM) is an exceedingly rare benign mesenchymal tumor of the lymph nodes. Magnetic resonance imaging (MRI) findings are unspecific, which may present diagnostic challenges to fine-needle aspiration cytology (FNAC). The histological and immunohistochemical features of IPM are unique. A previously healthy 40-year-old male patient presented a slow-growing solitary left inguinal mass. FNAC revealed clustered cells within a metachromatic stroma, single spindle cells without atypia, hemosiderin pigment, and siderophages. An MRI showed a central hyperintense septum in fat-suppressed, T2-weighted sequences. The excised lymph node contained central haphazard fascicles of spindle cells with focal nuclear palisading, hemosiderin pigment, extravasated erythrocytes, and hemorrhagic areas. Vimentin and smooth muscle actin were diffusely positive. Amianthoid collagen fibers were not clearly observed. IPM is an extremely rare mesenchymal benign intranodal tumor that should be included in the differential diagnosis of spindle cell lesions in the inguinal region.

A Case of Metastatic Melanoma in a Female Patient with Vitiligo

Patients with metastatic melanoma occasionally develop de novo hypopigmentation, pathologically indistinguishable from Sutton's nevus and common vitiligo, respectively. The case of a 68-year-old female with vitiligo of 2 years of evolution is documented, presenting a left inguinal mass and a para-aortic lymph node conglomerate. In the left inguinal region, a ganglion with thickened cortex and liquid content was identified. The laboratory results report hemoglobin of 8.30 g/dL, leukocytes 19.12 u/L, albumin 2.2 mg/dl, DHL 1222 Ul/L, alpha-fetoprotein 2 ng/ml, Ca-125 14.30 U/ml, Ca-19.9 8.60 U/ml and carcinoembryonic antigen of 2.14 ng/ml. Upon inspection, hypochromic, bilateral, and symmetrical lesions can be seen on the back of the hands, wrists, scalp, facial region, and neck. Biopsy showing malignant metastatic melanoma is performed. Starting management with Pembrolizumab 1 mg/kg every 21 days. Currently in follow-up and adjuvant treatment. Melanoma is the most aggressive form of skin cancer. The association of malignant melanoma with de novo hypopigmentation has been found, synchronously or following the diagnosis of the tumor. In recent years, it has led to the development of monoclonal antibodies. However, its diagnosis has implications for life prognosis due to high mortality.

An Inguinal Endometriosis without Any Other Pelvic Endometriosis Mimicking Direct Inguinal Hernia: A Case Report

Inguinal endometriosis is a rare disease. Patients with inguinal endometriosis usually exhibit cyclic inguinal pain with a cyclic change in the size of the inguinal mass. It is more often found on the right side and commonly accompanies concomitant endometriosis lesions on pelvic organs or peritoneum. We report a case of inguinal endometriosis without any of the usual characteristics. A 48-year-old with non-severe dysmenorrhea and pelvic pain presented a left inguinal mass, palpable only when standing. Under the impression of direct inguinal hernia, laparoscopic herniorrhaphy was performed. Intraoperative laparoscopic findings revealed no other endometriosis lesion on the pelvic organ or in the abdominal cavity, and the histopathologic report confirmed it was endometriosis. Thorough inspection and excision of endometriosis lesions in the pelvic cavity are crucial for treatment. Therefore, an appropriate surgical plan following accurate preoperative diagnosis is important. If the intraoperative evaluation of endometriosis was not enough, postoperative gynecologic assessment is strongly recommended.

Inguinal Hernia Containing the Fallopian Tube and the Ovary in a Premature Infant: A Case Report

In pediatric patients, the pelvic and the abdominal contents of hernias of the canal of Nuck have increased risk of strangulation. Early diagnosis of these hernias with ultrasonography is important. We report a case of a hernia of the canal of Nuck presented as a left inguinal mass containing the ipsilateral ovary in a 26-day-old premature infant girl.&nbsp

Development of metastatic inguinal squamous cell carcinoma in a patient with Netherton syndrome: A case report

Introduction: Netherton syndrome (NS) is a rare multisystem disorder with both cutaneous and extra-cutaneous manifestations. The syndrome includes the presence of congenital ichthyosis, exhibited by hyperkeratosis and abnormal skin scaling over the entire body. In rare instances, NS has been associated with the development of squamous cell carcinoma (SCC). Case Report: A 54-year-old male with a history of NS and recurrent squamous cell carcinoma presented with an enlarging left inguinal mass. Biopsy of the mass was positive for a new invasive squamous cell carcinoma with regional lymph node involvement and invasion of the left femoral vein. The patient underwent wide local resection, superficial and deep regional lymph node dissection, and resection of the left femoral vein. His hospital course was further complicated by multiple infections and progression of his cancer. He eventually transitioned to hospice care before receiving any additional treatment for his malignancy. Conclusion: This case highlights a patient with NS and a history of recurrent inguinal squamous cell carcinoma. Further investigation is needed to better highlight the complexity of factors associated with the development of squamous cell carcinoma in patients with NS and other forms of ichthyoses.

Surgical management of colocutaneous fistulae in diverticulitis.

A 70-year-old female presented to the emergency department with a painful left inguinal mass along with intermittent nausea and vomiting but no constipation or obstipation. Her last bowel motion was on the morning of presentation. Her medical background was significant for gastro-oesophageal reflux disease, hysterectomy, a bowel containing reducible left inguinal hernia seen on ultrasound 3 months earlier for which the patient was awaiting surgical review and an episode of diverticulitis 4 years ago complicated by a 3.6 cm perisigmoid abscess. The previous episode of diverticulitis was treated successfully with intravenous (IV) antibiotics only as the abscess was not drainable. During this presentation, examination revealed a soft abdomen with the tender firm left inguinal mass with overlying erythema. Bowel sounds were present. The patient was afebrile, heart rate was 110 beats per minute and systolic blood pressure was 160 mmHg. Initial blood tests revealed a pH of 7.39, lactate of 1.1 mmol/L and a white cell count of 10.7 × 109/L. Attempts were made to reduce the left inguinal mass, but this was unsuccessful. After surgical review, a provisional diagnosis of an incarcerated left inguinal hernia was made. The patient proceeded to the operating theatre without imaging for an open groin exploration ± washout. Upon entering the inguinal canal, an abscess cavity was encountered unexpectedly (Fig. 1(a)). Laparoscopy was performed for concerns of bowel necrosis, revealing inflamed sigmoid bowel consistent with sigmoid diverticulitis as well as adherent bowel to the anterior abdominal wall and the bladder (Fig. 1(b)).

Proximal Type - Epithelioid Sarcoma- A Rare And Aggressive Soft Tissue Neoplasm

Abstract Introduction/Objective Epithelioid Sarcoma is a rare malignant soft tissue neoplasm that is well known for local recurrence, regional lymph node involvement, and metastasis. It accounts for less than one percent of all sarcomas. Two subtypes of epithelioid sarcoma are described: the conventional or classic subtype and the proximal subtype, with the classic type being more common than the proximal type. We present a case of proximal epithelioid sarcoma involving the inguinal region, in which the patient presented with the history of weight loss for one year and a slow- growing inguinal mass for the last few months. The biopsy was done in an outside hospital and showed carcinoma of unknown origin. Imaging also failed to reveal any clear source of this mass. Methods The mass was resected and sent to pathology, where H&E staining and immunohistochemistry was done for diagnosis. Results The H&E sections of the left inguinal mass showed proliferation of large epithelioid cells with a moderate amount of cytoplasm, vesicular nuclear chromatin and prominent nucleoli. Mitosis was also seen. Necrosis was not identified. Immunohistochemical staining was done and revealed that the tumor cells were immunoreactive for epithelial marker cytokeratin AE1/AE3 and showed loss of INI-1. Tumor cells were also negative for Myogenin, ERG, HMB-45, MART-1, Myo-D1, S100, and SMA. Considering the cytomorphology and immunophenotypic findings the diagnosis of epithelioid sarcoma, proximal type was made. Conclusion Epithelioid sarcoma is a malignant mesenchymal neoplasm with epithelioid cytomorphology and phenotype. Among the two types of epithelioid sarcoma, the proximal type is reported about 50% less than the classic type and is associated with aggressive behavior and worse prognosis. The classic cytomorphology and immunohistochemistry findings helped us in making the diagnosis in this case.

Low-Grade Follicular Lymphoma with Highly Unusual Flow Cytometric, FISH, Molecular, and Classical Cytogenetic Results: A Case Report

We present a low-grade follicular lymphoma case with highly unusual ancillary study results. The patient is a 50-year-old female with a 4.3 x 3.8 x 2.2 cm left inguinal mass, from which fine needle aspiration and excisional biopsy specimens were obtained. H&E sections showed effacement of the lymph node architecture by closely packed follicles comprised of mainly centrocytes and without tingible body macrophages. Immunohistochemical stains revealed the follicle cells positive for CD20, PAX5, BCL6, CD10 (weak), and BCL2 (weak), while CD3 highlighted small T lymphocytes mainly in the interfollicular areas.

1181 Laparoscopic Management of Hernia Uterus Inguinale with Associated Unicornuate Uterus: A Case Report

Video Objective This video demonstrates the laparoscopic management of a surgical emergency due a non-communicating herniated rudimentary uterine horn and ipsilateral torsed adnexa. Setting NA. Interventions This case is a 36-year-old healthy woman undergoing elective oocyte cryopreservation with normal baseline pelvic ultrasounds. On day 7 of oocyte stimulation, an enlarging inguinal mass was identified associated with severe inguinal pain; an incarcerated ovary was suspected. She was taken to the operating room for surgical management. The diagnosis of a Mullerian anomaly was made laparoscopically, noting that she had a right unicornuate uterus with associated normal-appearing right adnexa and ureter. Notably, the left non-communicating rudimentary uterine horn was found herniated through the deep inguinal ring, drawing with it a portion of the left tube and ovary, torsed around its associated pedicle. A left ureter could not be visualized. After decompressing and de-torsing the left inguinal mass, the rudimentary horn, fallopian tube, and necrotic portion of the left ovary were excised using a bipolar sealing device; the inguinal hernia was repaired. The viable left ovarian tissue was retained. A postoperative renal ultrasound confirmed left renal agenesis. Two months later, she successfully underwent oocyte cryopreservation with eggs aspirated from both ovaries. Conclusion Hernia uterus inguinale is a rare condition in which uterine tissue and occasionally adnexa herniate through the inguinal ring. It can present as an asymptomatic palpable mass or rarely as pelvic pain. Most reports have focused on its association with persistent Mullerian duct syndrome, which affects phenotypically male infants. While there are few reports of hernia uterus inguinale occurring in adult females, this case highlights the importance of keeping it in the differential in a patient with an inguinal mass and recognizing the potential for its associated morbidity and the ability to manage it surgically, if needed, through a minimally invasive approach.

Metachronous metastasis to inguinal lymph nodes from sigmoid colon adenocarcinoma with abdominal wall metastasis: a case report

BackgroundInguinal lymph node metastasis from rectum is uncommon but well-known occurrence, whereas that from colon adenocarcinoma is extremely rare. Inguinal lymph node metastasis from colon adenocarcinoma has only been reported in previous cases involving primary tumor invasion of the abdominal wall, or in those involving colon cancer metastasis to external iliac lymph nodes. We describe a case of inguinal lymph node metastasis from colon cancer without primary tumor invasion to the abdominal wall.Case presentationA 42-year-old female, who had undergone twice cesarean sections before, underwent open sigmoidectomy for sigmoid colon adenocarcinoma and received 12 cycles of FOLFOX regimen as adjuvant chemotherapy. Two years after sigmoidectomy, a follow-up CT scan revealed enlarged inguinal lymph nodes as well as growth of enhanced mass lesions on the abdominal wall at site of the cesarean section scar. Biopsy of both lesions revealed well-differentiated adenocarcinoma, and immunohistochemistry demonstrated positive expression of CDX2, substantiating its gastrointestinal origin. We therefore performed dissection of left inguinal lymph nodes and mass lesion of the abdominal wall. The patient died 51 months after lymph node dissection.ConclusionsThis is the first reported case of inguinal lymph node metastasis from colon cancer without invasion of the primary tumor to the abdominal wall or without involvement of the external iliac lymph nodes, suggesting that the pathway of inguinal metastasis originated from the abdominal wall metastasis. When inguinal lymph node metastasis from colon cancer is suspected, if an R0 resection was possible, inguinal lymph node dissection may be a potentially effective treatment.

Diagnosis and treatment of testicular torsion: a clinical analysis of 95 cases

Objective To analyze the clinical features, diagnosis and treatment of testicular torsion. Methods The clinical data of 95 patients with testicular torsion admitted from March 2001 to April 2017 were analyzed retrospectively. Results The age of patients ranged from 13 to 42 years (mean 19.6 years). Among 95 patients, 91 cases had essential clinical symptoms of scrotal pain; 1 case reported the right testicular enlargement without pain, and 3 cases presented with left inguinal mass. Color Doppler flow imaging (CDFI) was performed in 91 patients, reduction or loss of blood flow signals were detected in 88 cases, and normal blood flow signals were presented in 3 cases. The diagnosis of testicular torsion was confirmed by CDFI in 91 cases before surgery, and 4 cases were diagnosed by medical history and physical examination. The duration from onset to surgery was 10 h in 60 cases. All the patients received operation, 92 cases were diagnosed as testicular torsion in scrotum and 3 cases as cryptorchidism torsion after surgery. Among 92 cases of testicular torsion in scrotum, twisted testicles were removed in 41 cases and the testicles were retained in 51 cases; while testicles were removed in 1 case of cryptorchidism torsion, and the testicles were fixed in the scrotum in other 2 cases of cryptorchidism. Sixty eight patients were postoperatively followed-up for 1 month to 15 years, the retained necrotic testis atrophy occurred in 1 case, and the testicular size was normal in other 67 cases. In the 68 cases, there was no testicular discomfort and no testicular torsion after operation. Conclusions CDFI is valuable in preoperative diagnosis of testicular tortion. Once the diagnosis is made, it should be operated as soon as possible to retain the testicular function, and the affected testicle should be retained with caution for cryptorchidism torsion. Key words: Spermatic cord torsion; Cryptorchidism; Ultrasonography, Doppler, color; Diagnosis; Treatment

Lipossarcoma do Cordão Espermático

Introdução: O lipossarcoma do cordão espermático é uma doença rara, com poucos casos descritos. Apresentamos dois casos clínicos de doentes com lipossarcoma do cordão espermático.
 Caso Clínico: Caso 1: Doente de 76 anos, avaliado por uma massa inguinal esquerda indolor. O estudo imagiológico evidenciou uma massa sólida, com cerca de 38 x 31 cm na região inguinal esquerda. Caso 2: Doente de 55 anos, avaliado por uma massa escrotal esquerda indolor. Imagiologicamente apresentava lesão sólida com 28 x 27 cm, sugestiva de neoformação na dependência do epidídimo esquerdo. Ambos os doentes foram submetidos a orquidectomia radical com excisão local alargada. O exame histopatológico revelou lipossarcoma nas duas situações, tendo sido efetuado tratamento complementar com radioterapia adjuvante. No seguimento efetuado, oito anos no caso 1 e quatro anos no caso 2, não ocorreu recidiva neoformativa locorregional ou à distância.
 Conclusão: O tratamento recomendado do lipossarcoma do cordão espermático é a orquidectomia radical com excisão local alargada. A radioterapia adjuvante reduz o número de recorrências locorregionais e torna-se necessário um período longo de seguimento destes doentes, dada a elevada probabilidade de recorrência.

Metastatic Melanoma of Uncertain Primary with 5-Year Durable Response after Conventional Therapy: A Case Report with Literature Review

A 51-year-old Thai woman presented with bilateral leg edema and painful left inguinal mass for 6 months. Physical examination revealed matted bilateral inguinal lymph nodes up to 9 cm in size. Otherwise, physical examinations including skin were unremarkable. The result of the lymph node incisional biopsy is consistent with that of metastatic melanoma. The extensive investigation demonstrated multiple intra-abdominal and inguinal lymph nodes without detectable primary tumor. Palliative radiation and conventional chemotherapy were prescribed. The CT scan between treatments showed that the response was stable disease, but the following CT scan demonstrated a gradual decrease in size from August 2012 to November 2017 including the lesions outside radiation fields. Moreover, she developed vitiligo during a follow-up visit. The previous data reported the median overall survival among the patients who were treated with conventional chemotherapy ranging from 9.1 to 9.3 months and whose 5-year survival was less than 10%. This case represented a metastatic melanoma of unknown primary who achieved a durable response by conventional treatment. The clinical features including nodal-only disease, vitiligo, and abscopal effect of radiation were considered to be the favorable factors.

Large, extra-abdominal leiomyoma of the round ligament with carneous degeneration

Round ligament tumours represent a rare entity that can present similarly to an incarcerated hernia. Basic understanding and appropriate preoperative management is imperative in order to differentiate between the two...

A Case of Subcutaneous and Gastrointestinal Basidiobolomycosis in Singapore

Entomophthoromycosis due to Basidiobolus is a known cause of subcutaneous zygomycosis. It occasionally causes invasive disease involving the gastrointestinal tract. We describe a case of proven subcutaneous entomophthoromycosis, with subsequent development of gastrointestinal basidiobolomycosis, in a 67 year old Singaporean Chinese male. He presented with a progressively enlarging left inguinal mass with intra-abdominal extension, causing compression of the ureters and hydronephroses. He underwent multiple biopsies to ascertain the cause of the mass. Workup for malignancy, bacteria, fungal, parasitic and tuberculous infections were negative. He developed worsening gastrointestinal distension a year from initial presentation. Imaging showed mucosal thickening extending from the descending colon to the rectum. Based on the clinical presentation, he was treated as for basidiobolomycosis. He responded poorly to treatment and passed away two months after initiation of therapy. With the help of our counterparts in India, we proved our clinical suspicion by polymerase chain reaction on tissue specimen.

A Case Series of Non-Hodgkin's Lymphoma Recurrence in Lower Extremities Mimicking Deep Vein Thrombosis

Background: While uncommon, non-Hodgkin's Lymphoma (NHL) can relapse in extranodal sites in the lower extremities. It is well established that venous thomboembolism occurs in higher incidence in patients with underlying malignancy. We describe 3 cases of NHL in which relapsed disease was discovered after lower extremity swelling prompted evaluation for deep vein thrombosis (DVT), and revealed recurrent NHL. CASE 1: A 61 YO F with history of Stage IEA Marginal Zone Lymphoma (MZL) of the dura diagnosed in 2012 received treatment with whole-brain and local brain radiation. In 2016 she developed recurrence in cervical lymph nodes. Six months after receiving 4 cycles of bendamustine and rituximab she developed left leg pain and calf swelling. PET/CT showed a hypermetabolic lesion in left tibia. MRI confirmed large lesion in mid-shaft of tibia extending down the length of the bone. CT-guided bone biopsy confirmed MZL. CASE 2: A 67 YO F with history of triple-negative inflammatory breast cancer treated in 2000 with neoadjuvant chemotherapy and mastectomy. PET/CT in 2008 showed 2 left femoral lesions. She underwent CT-guided bone biopsy of femoral lesion which confirmed follicular lymphoma (FL). Interim PET/CT in 2010 showed decreased FDG uptake in left femur. She was followed with watchful waiting. Then in 2014 patient developed leg swelling and pain, thought to be a DVT. Duplex ultrasound of the lower extremity was negative. PET/CT showed a left inguinal mass and left calf mass. MRI confirmed large mass within the left lower leg centered on the left fibular diaphysis with a very large associated soft tissue component with extensive muscular and neurovascular involvement. Biopsy of left inguinal lymph node confirmed diffuse large B-Cell lymphoma (DLBCL). CASE 3: A 61 YO M with history Stage IV FL in 1988 and initially treated with 4 cycles of PROMACE-CytaBOM. He relapsed nodally in 1995 and was treated on the IDEC investigational protocol with rituximab which led to a complete remission. In 2001 he developed a subcutaneous nodule on his back, biopsy showed FL, grade 1. A staging CT scan of neck, chest, abdomen, and pelvis was unremarkable, but a PET scan showed left axillary disease. He was re-treated with rituximab and local radiation which led to a complete response. Patient presented in 2008 with right calf swelling. Ultrasound at that time showed no DVT but confirmed swelling and suggested right inguinal adenopathy. PET/CT showed FDG uptake in multiple areas in groin and pelvis plus extensive uptake in thickened calf muscles extending from the right knee to the toe. Biopsy of right inguinal lymph node confirmed FL. Conclusion: Among NHLs, relapse patterns can vary significantly. Timing and frequency of relapse is largely dependent on whether NHL is classified as indolent or aggressive. However, location of relapsed disease in NHL is less well established. NHL relapse can occur in a fashion mimicking DVT with lower extremity swelling. When patients with history of NHL present with lower extremity swelling, relapsed disease should be included in the differential diagnosis. Table Patient characteristics Table. Patient characteristics Disclosures Cohen: Takeda Oncology: Honoraria; Pharmacyclics: Honoraria; Seattle Genetics: Honoraria; Amgen: Honoraria. Broome:True North Therapeutics: Honoraria; Alexion Pharmaceuricals: Honoraria.

Epiploic appendagitis masquerading as incarcerated left inguinal hernia

Epiploic appendagitis is a rare condition resulting from acute inflammation of an epiploic appendage. This condition occurs usually within the abdominal cavity and is frequently misdiagnosed; as an unexpected hernia content, it is a very rare entity. We herein report the case of a 38-year-old male patient with a known left inguinal hernia who presented acutely with a painful left inguinal mass. Emergent surgical exploration was mandatory to rule out a possible incarcerated bowel loop; it revealed a hernia sac containing a 3 cm thick, swollen, inflamed and incarcerated epiploic appendage of healthy sigmoid colon. The patient recovered after resection of the epiploic appendage and a tension-free hernioplasty.

Giant seminoma in an undescended testicle metastasizing to the neck and liver.

Germ cell tumors account for 98% of all testicular malignancies. Delays in seeking treatment are unfortunately common and may lead to metastatic spread. The present study reported a case of a 24-year-old man with a giant 12×10 cm left inguinal mass and a left neck mass that had grown rapidly during recent months. Computed tomography confirmed that the mass measured 12.1×9.4 cm and was a left undescended testicle malignancy, and also revealed widespread metastasis to the liver and a large retroperitoneal mass (12.6×8.2 cm). Immunohistochemical staining confirmed seminoma. The patient was treated with chemotherapy with the VIP protocol (cisplatin, etoposide and ifosfamide). Following courses of chemotherapy, the patient received complete clinical remission and was disease-free at the 6 month follow-up.

Low grade myoepithelial carcinoma: a mini case series analysis including a case with sacral disease and a case with forearm disease

Myoepithelial (ME) tumours of soft tissue are rare tumours that were first described in 1995. A wide spectrum of architectural and histological patterns make diagnosis difficult; as is differentiating benign or low grade from malignant or high grade tumours to guide treatment and predict patient outcome. We report two cases of low grade ME tumours of soft tissue treated at our institution in 2013. The first one was in a 24 year old previously healthy male who presented with three separate deposits of tumour. The two largest were a sacral mass measuring 8 x 12 x 21cm and left inguinal mass measuring 8.6 x 10 x 8cm. He was successfully treated with neoadjuvant chemotherapy and wide local excision with flap reconstruction. The second case was in a 35 year old female who presented with a slowly growing right forearm mass. Due to positive margins she underwent three excisions and post operative brachytherapy for recurrence prevention. Both patients are disease free at 6 month follow up. A review of the current literature surrounding presentation, epidemiology, histopathological findings and management of ME tumours of soft tissue is correlated with findings from this mini case series analysis.