Excision Of Mass Research Articles

A hemodialysis patient unable to walk - brown tumor as the culprit: Casereport and review of the literature.

Brown tumors are benign lesions caused by hyperparathyroidism and characterized by increased osteoclast activity and mass effect, which can lead to paraplegia when the spine is involved. Secondary hyperparathyroidism is common in patients on long-term hemodialysis therapy. We report the case of a 48-year-old man on regular dialysis who presented with leg weakness as well as back pain and was diagnosed with secondary hyperparathyroidism and thoracic spine tumor. Since the spinal cord was compressed, T12 mass excision combined with spinal canal decompression was performed under general anesthesia. Post-operative pathology demonstrated abundant fibrovascular tissue and osteoclast-like multinucleated giant cells with hemorrhage and hemosiderin pigment deposition. The patient was diagnosed with brown tumor. Following operation, the patient recovered well. He remains on regular hemodialysis with follow-ups and unaffected activities 10 years later. In dialysis patients with combined spinal tumors, brown tumors should be considered. For patients presenting with symptoms of spinal cord compression, surgical resection can lead to a favorable prognosis.

A Retrospective Single-Center Study in 20 Patients With Midline Nasal Masses: Which Site Has the Highest Risk of Recurrence?

Midline nasal masses are rare and challenging for surgeons. This study examined the site with the highest risk of recurrence following midline nasal mass excisions. Surgical outcomes were retrospectively reviewed following excision of midline nasal masses between 2010 and 2022 in the predominantly pediatric patient cohort. The primary outcome measure was the recurrence rate. Overall, 22 nasal masses were resected from 20 patients. Of these masses, 16 were nasal dermoid sinus cysts (NDSC), 2 were hamartomas, 1 was an epidermoid cyst, and 1 was a mature teratoma. Five of the nasal masses were classified as intracranial lesions, 11 were classified as intraosseous lesions, and 6 were classified as superficial lesions. The open rhinoplasty approach was chosen in 65% of the surgeries. For the intracranially extended lesions, a combined nasocranial approach was performed. Four revision surgeries were performed due to superficial recurrences at the nasal dorsum of lesions, that were primarily classified as intraosseous lesions. All recurrences had a superficial extension and were easily excised. Intraosseous NDSC have the highest risk of recurrence, but conversely, they also occur most frequently.

Plasma cell type Castleman's disease of lacrimal gland: a case report and literature review

BackgroundOrbital Castleman's disease is a rare benign lymphoproliferative disorder of extranodal origin.Case presentationA 72-year-old man presented with bilateral upper eyelid swelling. Radiology revealed enlarged lacrimal glands in both eyes. Castleman's disease (plasma cell type) was confirmed by histo-immunochemical examinations after excision of the left orbital mass. No extraorbital involvement was found in systemic evaluation. Postoperatively, corticosteroid therapy was given. After 1 year of follow-up, there was no recurrence in the left orbit, and the swelling of the right eyelid was improved.ConclusionsHere, we report a case of orbital Castleman's disease involving the lacrimal gland bilaterally and summarize previously reported cases. For bilateral orbital masses, the possibility of Castleman's disease should be considered. Before the diagnosis, it is necessary to fully distinguish from other diseases such as IgG4-related eye diseases.

A case report of aggressive angiomyxoma of vulva: first appearance deceives many

Aggressive angiomyxoma (AA) of the vulva is a rare, benign tumour of mesenchymal origin. It has marked tendency for local recurrence but rarely metastasize. We report a case of 35-years old, nulliparous women presented with bilateral, large vulval masses. Local examination revealed approximately 20×20 cm mass arising from right labia majora, nodular, firm, non-tender with overlying skin intact. Left vulval mass was approximately 15×10 cm arising from labia minora, nodular, firm, non-tender. Inguinal lymph nodes were not palpable. After thorough evaluation, she underwent excision of bilateral vulval masses with reconstruction. Histopathology revealed tumour composed of ovoid to spindle-shaped cells in a fibrous and myxomatous stroma with loosely interspersed collagen fibres suggestive of aggressive angiomyxoma. On immunohistochemistry, the tumour cells were focally positive for smooth muscle actin and desmin. Stains for acid-fast bacilli and fungus did not reveal any organisms. Her postoperative period was uneventful with good recovery. She is on follow up and no recurrence has been seen so far in follow-up period of 15 months. AA should be kept in mind as one of the differential diagnoses in evaluation of large vulval masses. Keeping this rare entity in mind and relevant investigations may help in reducing the misdiagnosis and avoiding any mutilating surgery. Multidisciplinary approach can be crucial in management of such cases.

A SPINAL TRAUMA, A TUMOR AND EVERYTHING IN BETWEEN

Introduction Burkitt lymphoma is a male predominant (3:1 male:female ratio) aggressive B-cell non-Hodgkin lymphoma that can present as a sporadic variant with meningeal involvement in about 20% of cases. Therefore, it can manifest with neurologic deficits due to compression of the spinal cord or spine nerve root. Case Report We report the case of a 6 years-old girl who presented in the emergency department following a traumatic vertebral injury (fall from around 1.5 meters) with no spinal cord involvement. She accused upper back pain, walking and orthostatism difficulties and manifested a light to moderate inferior paraparesis (MCR 3/5) The MRI revealed a space-occupying epidural mass between T1-T4, severely compressing the spinal cord initially thought to be an epidural hematoma. Emergency surgery was performed with duro-radicular decompression and mass excision through a T1-T4 laminotomy followed by a laminoplasty. The unveiled mass was white, minimally vascularized and adherent to the dura raising the suspicion of a tumor. Postoperatively the patient exhibited significant neurological improvement with resolution of the paraparesis and normal gait restoration. Three weeks later, the patient returned with complaints of abnormal gait, lumbar pain radiating in the right lower leg and upon examination a light right lower limb monoparesis (MRC 4/5) following another traumatic event. Emergency MRI of the whole spine with contrast was requested just as the pathologist in charge of the case suggested a diagnosis of Burkitt lymphoma, prompting a whole-body MRI. A severe recurrence was noted at the site of the previous lesion along with a new lumbar lesion, and several intraabdominal, intrathoracic, ovarian tumor sites with diffuse infiltration of the bone marrow. The patient was urgently referred to the pediatric oncology department and started on steroidal anti-inflammatory treatment and chemotherapy. Conclusions Burkitt lymphoma involving the nervous system in children requires increased medical attention during the clinical, histopathological examination and treatment phase, due to the association with advanced disease and, although rare, should be considered as a differential diagnosis in pediatric patients with epidural lesions. The management of such lesions demands a solid collaboration between neurosurgeon, pediatrician, pathologist and oncologist for an early diagnosis and proper treatment.

A Novel Endoscopic Approach to Fibroadipose Vascular Anomaly

BackgroundOpen surgery is the standard treatment for fibroadipose vascular anomalies (FAVA). This study evaluated an endoscopic approach for FAVA, assessing its safety and feasibility. MethodsData from October 1, 2019, and May 1, 2024, were analyzed from the Vascular Anomalies Center database at our institution. Patients with FAVA Stage I (pain stage) or II (contracture stage) were included and divided into the endoscopic surgery group (ESG) and open surgery group (OSG). ResultsIn total, 101 patients underwent 110 procedures. In ESG, 42 patients (16 males and 26 females; 31 with Stage I and 11 with Stage II) underwent radical excision (with tendon lengthening in 2 patients). Ten patients underwent an open surgery. In OSG, 63 patients (18 males and 45 females; 30 with Stage I and 33 with Stage II) underwent radical excision (with tendon lengthening in 12 patients). The OSG had significantly shorter operative time than the ESG (p = 0.009). Furthermore, The OSG had longer hospitalization time (p = 0.022) than the ESG. The blood loss in the OSG was greater than that in the ESG, but without statistical difference (p = 0.069). During follow-up, the incidence of wound complications (p = 0.121) and residual symptoms (p = 0.179) were slightly higher in the OSG. ConclusionsEndoscopic surgery is a safe and effective treatment for FAVA, promoting faster habilitation and improved patient satisfaction. This method may also serve as a reference for the excision of other benign muscle and soft tissue masses.

Oncocytic lipoadenoma of the parotid gland: a case report and a review of the literature.

Oncocytic lipoadenomas are a rare sub-category of fat-containing tumors of the salivary glands. These tumors are characterized by their oncocyte-predominant epithelial component admixed with mature adipocytes. This condition has been rarely reported to affect the parotid and the submandibular glands. We report a case of a 69-year-old male who presented to our otolaryngology outpatient department with a complaint of a gradually growing right-sided infra-auricular neck mass. A surgical full mass excision was performed, and a histopathological evaluation yielded a tumor with oncocytes organized in tubular structures. This paper presents the fourth unusual case of a giant oncocytic lipoadenoma of the parotid gland measuring 11.5 × 10.5 × 11.5cm in anteroposterior, transverse, and cranial planes, respectively.

Yield of Echocardiography with Bubble Studies Among Acute Ischemic Stroke Patients.

Background: Transthoracic (TTE) and transesophageal (TEE) echocardiographic studies with agitated saline, also known as "bubble studies" (BSs), are used to diagnose patent foramen ovales (PFOs) in cryptogenic strokes (CSs). Guidelines limit PFO closure recommendations to CS patients ≤ 60 but BSs are often performed as part of standard order sets, leading to inappropriate studies in older patients with already-established stroke etiologies. Methods: This retrospective single-center study included acute ischemic stroke patients between January 2021 and June 2022 and assessed the stroke etiology and number of the echocardiographic studies performed. Results: A total of 663 patients were admitted during this period with 413 (62.3%) classified as non-CS. Overall, 390 (58.8%) TTE and 40 (6.0%) TEE with BSs were conducted. Of that, non-CS patients received 252 TTE and 17 TEE with BSs. PFOs were diagnosed in 36 CS and 18 non-CS patients and 14 of the 15 PFO closures were performed in the CS patients for primary stroke prevention. The one closure in the non-CS patient was performed in conjunction with the open excision of a mitral valve mass. Conclusions: Therefore, the majority of the BSs performed in non-CS patients yielded no change in management. Our study identifies a large volume of diagnostic studies that are not supported by current clinical guidelines and instead, may contribute to healthcare waste. A new institutional protocol should be established to improve operational efficiency and reduce the downstream implications of diagnostic overuse in ischemic stroke care.

Biological knee joint reconstruction using patella following giant cell tumor excision: a case report

A 20-year-old female patient presented to us with a large expansile swelling over right knee diagnosed clinically and confirmed histopathological and radiologically to be Giant Cell Tumor of upper end of Tibia involving both condyles with a breach in the posterior cortex. In this case report we tried to retain the joint function by biological reconstruction using the Patella after the wide excision of the tumor mass. A radical excision of the upper end of the Tibia was done. The Patella was used as an articular surface supported by ipsilateral Fibula and cortico-cancellous bone chips from the ipsilateral iliac crest as struts and complemented with synthetic bone graft pieces. Thus, the joint was reconstructed biologically. The case was followed for 1 year. The tumor was excised in toto, the knee joint was restored by the Patella and the bone graft struts. The results were discussed in detail.

Cervical angiofibroma of soft tissue: A rare case report with literature review.

Angiofibroma of soft tissue (AFST) is a rare benign fibrous tumor recently included in the 2020 WHO classification of soft tissue and bone tumors. Currently, there are limited reports on AFST, and pathologists lack sufficient understanding of its clinical and pathological characteristics. There is scarce literature available on AFST in the cervical region. We presented a case of a 49-year-old woman who was admitted to our hospital for emergency treatment due to vaginal bleeding and fatigue. Ultrasound revealed a 63 × 27 mm hypoechoic mass extending from the cervical opening to the external opening, with a hemoglobin level of 58.0 g/L on blood routine. The tissue exhibited a pale-yellow mucinous appearance with distinct tissue boundaries and a fibrous capsule under a microscope. HE staining revealed spindle-shaped fibroblast-like cells with a consistent morphology, thin-walled branching small blood vessels, and dilated blood vessels. Regions with abundant cells and areas with sparse cells were alternately distributed and migrated gradually. Immunohistochemical analysis indicated positive expression of P53, desmin, progesterone receptor, estrogen receptor, epithelial membrane antigen, vimentin, CD68, CD163 in the tumor, but negative expression of P16, S-100, smooth muscle actin, CD117, CD10, STAT-6. CD34 was negative in the tumor cells but positive in the vascular endothelium. The Ki-67 index value was 5%. Pathological examination confirmed a soft tissue angiofibroma of the cervix. Emergency hysteroscopic surgery was performed following infusion of 3 units of packed red blood cells. A local excision of the cervical mass was performed. A 1-month follow-up ultrasound showed no abnormal mass in the cervical canal, and there have been no signs of recurrence to date. Cervical angiofibroma of soft tissue is a rare tumor with a benign clinical manifestation, minimal local recurrence, and no significant metastatic potential. Treatment primarily involves local resection with a focus on achieving negative surgical margins. By presenting this case, we aim to enhance the diagnostic and differential diagnostic capabilities of pathologists in identifying uterine tumors and preventing misdiagnosis.

Case Report : Undifferentiated Synovial Sarcoma Presenting as a Large Thoracic Mass: A Rare and Challenging Diagnosis

Background: Undifferentiated synovial sarcoma (USS) is a rare and aggressive subtype of soft tissue sarcoma. Its presentation as a large thoracic mass poses significant diagnostic and therapeutic challenges.  Case Presentation: A 34-year-old male presented with a three-month history of progressive chest pain and hemoptysis. Imaging studies revealed a large, cystic thoracic mass with pleural effusion. Initial serological testing suggested hydatid cyst, but subsequent testing revealed negative Echinococcus (Hydatid) IgG antibodies.  Diagnostic and Therapeutic Interventions: Repeat fine-needle aspiration cytology (FNAC) was deferred due to revised ultrasound findings indicating a solid fibrocystic vascular lesion. Bronchial artery embolization (BAE) was performed to control life- threatening hemorrhage. Thoracotomy and en-bloc mass excision were subsequently undertaken.  Histopathological Diagnosis: Histopathological examination of the resected specimen revealed undifferentiated synovial sarcoma and spindle cell sarcoma.  Clinical Implications: This case highlights the importance of correlating imaging and serological findings, managing vascular complications, and the efficacy of BAE in controlling hemorrhage. The significance of thoracotomy and mass excision in achieving diagnostic clarity and therapeutic success is underscored.  Conclusion: Undifferentiated synovial sarcoma presenting as a large thoracic mass poses significant diagnostic and therapeutic challenges. A multidisciplinary approach, incorporating imaging, serological testing, and surgical intervention, is crucial for achieving optimal patient outcomes.

Splenic Epidermoid Cyst arising within an Intrapancreatic Accessory Spleen Masquerading as a Pancreatic Mucinous Cystic Neoplasm-a diagnostic enigma

Abstract Introduction/Objective Accessory spleens are congenital embryological aberrations usually found within the splenic hilum with no clinical significance. An IntraPancreatic Accessory Spleen (IPAS) is an uncommon benign pancreatic lesion encountered clinically. A splenic epidermoid cyst arising within an IPAS is exceedingly rare and is discussed below. Methods/Case Report A 68-year-old male presented with intermittent post-prandial epigastric pain radiating to the left flank for >1.5 years. Radiological imaging identified a 5.2 cm calcified cyst in the pancreatic tail with a differential of mucinous pancreatic neoplasm/ pancreatic pseudocyst. Additionally, a 2.8cm lobulated solid hypoechoic mass was seen at the porta hepatis with a differential of enlarged lymph node/benign neoplasm. Laboratory biochemical tests were within normal limits except for mildly elevated ferritin. Fine needle aspiration biopsy was indeterminate. The patient elected to proceed with surgical resection. A laparoscopic distal pancreatectomy with splenectomy and excision of the hilar mass was performed. The hilar mass was analyzed by hematopathology and revealed a hyaline- vascular variant of Castleman disease. On gross examination of the distal pancreatic/splenectomy specimen, a well- demarcated cystic lesion with brownish fluid was noted within the pancreatic tail. Microscopic examination revealed a nonpathological pancreas separated by a fibrous capsule with a large cyst arising within an intrapancreatic accessory spleen. The cyst was lined with multilayered non-keratinized CK5/6, and p63 positive squamous epithelium with no lymphocytic infiltrates and absent hair/ dermal appendages confirming a splenic epidermoid cyst. Post-operative follow-up at 6 weeks was uneventful. Results (if a Case Study enter NA) NA Conclusion An epidermoid cyst arising within an intrapancreatic accessory spleen (ECIAS) is extremely rare thus precluding accurate preoperative diagnosis as this entity shares similar radiological imaging characteristics as other cystic lesions such as mucinous pancreatic cysts. It is important for anatomic pathologists to recognize and consider the intrapancreatic compartment as a possible location for accessory spleens. Accurate preoperative diagnosis can prevent unnecessary surveillance and/or extensive surgical resection.

Cystic cardiac myxoma: a rare variant of cardiac myxoma in a woman with acute stroke

BackgroundCardiac myxomas are the most common primary benign tumors of the heart usually presenting as an oval mass attached to the interatrial septum. Mild heterogenous enhancement is typically seen upon contrast administration. Myxomas are benign, however can present with embolic episodes necessitating prompt diagnosis and treatment.Case presentationA middle-aged woman presenting with acute ischemic stroke was detected to have a complex cystic mass in the left atrium on echocardiography. Further evaluation with cardiac magnetic resonance imaging narrowed a differential diagnosis to hemangioma, hemangioendothelioma, sarcoma, hydatid cysts, bronchogenic cysts, and cystic variant of cardiac myxoma. CTA demonstrated arterial supply from the left circumflex artery supplying the lesion. Following surgical excision, histopathology analysis suggested a cystic cardiac myxoma with secondary degeneration.ConclusionCystic masses in the heart are challenging to diagnose due to similar imaging characteristics, and misdiagnosis may lead to further major downstream complications such as stroke, hemorrhage, and hemodynamic alterations causing syncope. Therefore, surgical excision of a cystic cardiac mass is justified to establish a definitive histopathological diagnosis and prevent further downstream complications. We hereby report a rare case of cystic cardiac myxoma in the left atrium showing intense progressive enhancement in CMR and CTA in a middle-aged woman presenting with acute stroke. This case highlights an exceedingly rare variant of cystic cardiac myxoma.

6574 Pheochromocytoma In A Patient With ESRD; Clinical Challenges And Lessons From A Successful Evaluation

Abstract Disclosure: S. Younes: None. A. Sayed: None. K. Selk: None. L.A. Willard: None. Introduction: Pheochromocytomas are rare tumors that arise from the chromaffin cells in the adrenal medulla, that secrete norepinephrine, epinephrine and dopamine. Common presentations include resistant hypertension (HTN) and adrenergic spells with headaches, sweating and tachycardia. The literature has few cases of pheochromocytoma in the setting of end stage renal disease (ESRD). Case: A 46-year-old male with a history of resistant HTN on amlodipine, lisinopril, and labetalol, complicated by ESRD on hemodialysis (HD) and secondary hyperparathyroidism initially presented with gross hematuria. The patient reported sporadic, intermittent headaches associated with palpitations and sweating. A renal ultrasound revealed a left-sided complex renal cystic mass. CT abdomen/pelvis demonstrated an enhancing left adrenal lesion and MRI abdomen/pelvis confirmed an enhancing 4.6 x 2.8 cm adrenal mass. Laboratory studies revealed elevated normetanephrine of 1186 pg/mL (ref <149 pg/mL), elevated metanephrine at 139 pg/mL (ref <57 pg/mL) and elevated epinephrine at 128 pg/mL (ref <95 pg/mL). Given the laboratory and imaging findings in conjunction with clinical presentation, an excision of the adrenal mass was set. Two weeks prior to the surgery, alpha blockade was started with doxazosin 1mg daily with a goal blood pressure <130/80. He was admitted to the hospital with a goal to keep him 1-1.5kg above his dry weight. His dry weight was 81.5kg close to admission weight, so he was started on gentle IV hydration. He had a left robotic assisted adrenalectomy and was given stress dose steroids and a steroid taper given no preoperative Cushing’s screen was completed. No postoperative complications reported, and doxazosin was discontinued. 2 weeks later, he reported his adrenergic spells had resolved. Surgical pathology confirmed pheochromocytoma and he was referred for genetic consultation. Conclusion: Although there is little in the literature regarding management of a pheochromocytoma in patients with ESRD, similar principles of management in patients with normal renal function apply, including blood pressure control, alpha blockade, and establishment of euvolemia with recommendation of a high-sodium diet and 1-2 liters of saline the day prior to the procedure. This case highlights successful perioperative management with traditional use of alpha blockade but also incorporated maintaining the patient 1-1.5 kg above their dry weight for surgery to limit postoperative hypotension. Presentation: 6/3/2024

Blindness due to the third eye: Sudden visual loss in pineal gland tumor

We report a rare case of sudden visual loss in a 9-year-old child with a pineal gland tumor. At presentation, examination revealed nil light perception in both eyes, features suggestive of Parinaud’s syndrome and one-and-a-half syndrome, and a normal fundus. Neuroimaging revealed a pineal region mass compressing the midbrain, aqueduct of Sylvius, and third ventricle, with the latter being displaced anteriorly. The patient underwent ventriculoperitoneal shunting, after which the visual perception recovered and was followed by mass excision. Although the mechanism of brainstem symptoms is typical, pineal gland tumors are not a known cause of sudden vision loss.

Preoperative Serum Glycan Levels Reflect Progression of Patients With Hepatocellular Carcinoma.

Abnormal glycosylation is associated with tumors. The clinical value of serum glycans in assessing progression of hepatocellular carcinoma (HCC) patients remains a challenge. A study dynamically comparing levels of fifteen lectin-specific glycans between preoperative and postoperative serum of 65 HCC patients was conducted via lectin biochip technology. Multivariable logistic regression analysis was used to address associations between serum glycan levels and clinicopathological characteristics. Kaplan-Meier analysis was used to evaluate the impacts of serum glycan levels on overall survival (OS) and progression-free survival (PFS) of the HCC patients. HCC patients presented significantly higher levels of the lectin-specific glycans in preoperative serum than disease-free individuals (p < 0.001 - p = 0.029), except ConA. The glycans in preoperative sera were significantly related to tumor size, pTNM, metastasis, BCLC stage, portal hypertension (PHT), and platelet count (PLT), respectively (p < 0.05). Multivariate logistic analyses indicated that tumor size and pTNM independently impact on glycan-specific lectins either LTL, UEA-I, VVL, NPL, WGA, PNA, MAL-I, SNA, or PHA-L (p = 0.003 - p = 0.044); BCLC stage and PLT were independent factors influencing the serum glycans recognizable DSA (p = 0.024) and SNA (p = 0.050), respectively. Surgical excision of tumor mass significantly reduced glycan levels in sera. Tumor differentiation, albumin, and ABO type significantly revealed independent influence on glycan-specific lectins, such as RCA-I (p = 0.024), VVL (p = 0.024), and Con A (p = 0.026) in the postoperative serum. HCC patients with high levels of VVL-binding glycans significantly benefited from a longer OS time (p = 0.016, HR: 0.460, 95% CI: 0.237-0.892) and a better PFS time (p = 0.004; HR: 0.435, 95% CI: 0.237-0.799), respectively. Serum glycans could reflect surgical outcomes in at-risk patients and become valuable biomarkers in evaluating the progression of HCC patients.

Primary osseous leiomyosarcoma of humerus misinterpreted as aneurysmal bone cyst: A case report and literature review.

Primary leiomyosarcoma of the bone (LMSB) is a rare aggressive sarcoma with limited treatment options. Histopathologic and immunohistochemical features are similar to their more common uterine and soft tissue counterparts. However, its broader spectrum of histopathologic features and rarity make diagnostic challenges. We present a case of LMSB in a 20-year-old female who presented with left shoulder aching pain for 3 months. An osteolytic intramedullary lesion was found in the left proximal humeral epi-metaphysis. Initial open biopsy showed a giant cell tumor of bone with aneurysmal bone cyst (ABC)-like changes. However, an open biopsy followed by extended curettage showed LMSB with ABC-like changes. Wide excision of the lesion and bipolar hemiarthroplasty followed by concomitant chemoradiation therapy was conducted. The mass was completely removed without significant problems. Complete mass excision and symptomatic improvements were achieved, and no subsequent relapses were observed. The authors encountered a rare case of LMSB. Most occurrences are in the lower extremity and trunk, respectively. ABC-like changes in bone tumors can lead to misdiagnosis. In this case, the ABC-like changes developed from the underlying LMSB as a secondary alteration. A careful examination of the underlying bone tumor is crucial to avoid misdiagnosing it as ABC or exhibiting ABC-like changes. Moreover, there has been no case report of LMSB with secondary ABC-like changes in bone.

Pediatric Occurrence of Osteonevus of Nanta: A Case Report

Secondary ossification is a process that occurs in various cutaneous conditions. When this occurs within a melanocytic nevus, it is termed Osteonevus of Nanta (ON). This rare phenomenon typically presents in elderly female individuals usually located on the upper trunk. In this report, we present a unique presentation of ON in a pediatric patient. A 2-year-old female with no significant past medical history presented to a plastic surgeon for excision of an asymptomatic soft tissue mass on the right scalp. The parents described the gradual postnatal development of the 1.2 x 0.4 x 0.3 cm red-brown nodule. Excisional biopsy was performed and histopathological analysis found the lesion to be most consistent with ON. To our knowledge, there are no other published reports of ON in the pediatric population. This exceedingly rare case serves to expand our current understanding of this lesion and may provide further insight into the pathogenesis of these nevi.

A case report of retroperitoneal liposarcoma.

Retroperitoneal liposarcoma is a rare and complex tumor originating from the mesenchymal tissues, with no specific manifestations in the early stage, and a large tumor size in the late stage. Patients often consult a physician because of large abdominal mass, increased abdominal circumference, and abdominal pain, and rarely because of leukocytosis. A 54-year-old female presented to our hospital with complaints of "abdominal distension for over 3 months, left lumbar pain for over 2 months." Considering the comprehensive symptoms, examinations, computed tomography scans, and pathological results, the possibility of retroperitoneal liposarcoma is high. Retroperitoneal liposarcoma with leukocytosis. Open retroperitoneal mass excision along with transcystoscopic left ureteral Double-J Ureterl Stent Insertion tube placement and left nephrectomy. The postoperative pathological findings of the abdominal mass, combined with morphological and immunohistochemical results, are consistent with retroperitoneal liposarcoma. The patient had no recurrence in 7 months of postoperative follow-up conducted on the telephone and is now in continued follow-up. Retroperitoneal liposarcoma is highly malignant and prone to recurrence. Radical surgery is currently the primary treatment modality for patients with this condition. Analogous to cancer patients, those with elevated white blood cell counts and retroperitoneal liposarcoma may have poor prognoses, with a high likelihood of local recurrence and distant metastasis. Close postoperative follow-up is necessary. Therefore, regular postoperative review of blood routine may be a relatively economical and convenient method for the early detection of recurrence and metastasis of retroperitoneal liposarcoma.

Orbital Pigmented Epithelioid Melanocytoma Tumor Associated With Nevus of Ota (Oculodermal Melanocytosis).

The authors report a patient with nevus of Ota (oculodermal melanocytosis) who presented with pigmented epithelioid melanocytoma in the right orbit. A 36-year-old female patient attended with proptosis OD and diplopia for 3 months. MRI disclosed an expansive lesion adhered to the right inferior rectus muscle, enlargement of the superior orbital fissure, and filling of the right cavernous sinus. Excision of the orbital mass through a transconjunctival inferior fornix access disclosed a heavily pigmented lesion. Anatomopathological study revealed a diagnosis of pigmented epithelioid melanocytoma. A positron emission tomography scan did not show any metastasis. The patient was submitted to radiotherapy, had an improvement of the proptosis and diplopia, and showed no distant metastases for 3 years now. Pigmented epithelioid melanocytoma belongs to the group of heavily pigmented neoplasms, as do atypical blue nevus, which is characterized by prominent melanin production and a low degree of malignancy.