Soft Mass Research Articles

A Round Ligament Mesothelial Cyst Imitating an Inguinal Hernia in a Woman of Reproductive Age

Objective. A wide range of lesions, including a mesothelial cyst of the uterine round ligament, are included in the differential diagnosis of a groin mass. Our study emphasizes the rarity of this ailment and the significance of correct preoperative diagnosis in guiding our treatment approach. Case Report. A 43-year-old female patient, presented to our hospital with a five-year his- tory of swelling and slight discomfort in the right groin. A nonreducible inguinal mass with greater projection during a Val- salva maneuver was found. An abdominal CT scan revealed a well-defined lesion located near the right horn of the uterus and extending through the inguinal canal. The patient was brought to the operating room with the clinical suspicion of an inguinal hernia. A soft mass measuring 4.5×2×1.8cm was discovered in the right round ligament, and it was surgically removed. Histo- pathological examination confirmed a mesothelial cystic lesion. The patient’s condition, after a period of 12 months, continues to be satisfactory. Conclusion. Few cases of uterine round ligament mesothelial cysts have been reported worldwide. Their cause is unknown, and preoperative diagnosis is unreliable. Resection relieves symptoms, and histological examination of the surgical specimen confirms the diagnosis. Additional clinical cases are needed to create a systematic clinical approach.

Internal Jugular Phlebectasia; A Challenging Neck Mass in Children

Cystic neck masses are uncommon in children, and a minority of them are soft. Internal jugular vein phlebectasia (IJVP) is a rare cause of soft neck cysts. It presents usually as a unilateral soft neck mass of changing size. In most cases it is unilateral, right sided and predominantly in males. Imaging study modalities are diagnostic and helpful for observation and follow up. In the vast majority of cases, it decreases in size with time requiring only conservative treatment. However, surgery might be necessary in large or complicated phlebectasia. IJVP is underdiagnosed or misdiagnosed especially in pediatrics, with few cases documented in medical literature. To improve awareness of presentation and management-plan of this rare case, the authors present an extremely rare case of huge left internal jugular phlebectasia in a 14 year-old boy worsened and complicated over years of wait and see approach that needed surgical treatment.

Association of age to nutritional status and muscle mass in children with transfusion-dependent β-thalassemia: a cross-sectional study

BackgroundTransfusion-dependent β-thalassemia (TDT) is a hereditary blood disorder that often leads to complications affecting growth, nutritional status, and muscle mass in children. This study aims to investigate the associations between age, nutritional status, and muscle mass in children with TDT, providing insights into the progressive impact of age on these parameters.MethodsOne hundred twenty-two children with TDT from March 2023 to March 2024 were enrolled in this cross-sectional study. Their nutritional status was assessed using the 2006–2007 World Health Organization (WHO) Growth Charts, and their muscle mass was measured using bioelectrical impedance analysis (BIA). Data related to age, gender, weight, height, fat-free mass (FFM), skeletal muscle mass (SMM), and soft lean mass (SLM) of children were collected for comparative analysis from the hospital record room. Furthermore, Spearman’s rank correlation coefficients and regression analyses were utilized to investigate the associations between age and both nutritional status and muscle mass.ResultsThe results of this study revealed negative correlations between age and wasting (r = −0.26, p < 0.001), stunting (r = −0.28, p < 0.001), FFM (r = −0.3, p < 0.001), SMM (r = −0.23, p < 0.01), and SLM (r = −0.36, p < 0.001). The regression analysis indicated that age was an independent predictor of wasting, stunting, and reduced muscle mass in these children (all p < 0.001).ConclusionOur study observed a trend of worsening stunting, wasting, and muscle loss in children with TDT as they age. These findings highlight the importance of monitoring both nutritional and muscular health in TDT patients. Early detection and comprehensive nutritional management may improve outcomes in this population.

Deformation behaviour of strain-softening rock mass in tunnels considering deterioration model of elastic modulus

By analyzing the composite effects of the plastic shear strain and confining stress according to the laboratory test results, a model adopting a deteriorating elastic modulus for the intact rock is proposed. Soft rock such as coal and the strong rock such as granite with different quality are investigated. Geological Strength Index (GSI) is adopted to represent the integrity of rock, to be specific, from intact rock to the rock mass. Specifically, for the strain-softening rock mass, the elastic modulus is gained by introducing GSI into the deterioration model. The strength parameters are obtained by fitting GSI into Hoek-Brown failure criterion. Then, the elastic modulus and strength parameters of the rock mass are employed in the numerical procedure for solving out the rock deformation, the radii of the plastic softening and residual zones of the tunnels. The rationality of the numerical procedure is verified with the existing semi-analytical and analytical procedures. In the discussion, the influences of the critical plastic parameters and GSI, on the elastic modulus, rock deformation, radii of the plastic softening and residual zones are investigated. Five models for the variation of the modulus including the proposed deterioration model are defined. The rock mass deformation behaviours of the five models are compared. The results indicate that, in the plastic softening zone that is far away from the tunnel periphery, the elastic modulus is more sensitive to the plastic shear strain, whereas near the tunnel periphery, the elastic modulus is primarily affected by the confining stress. Regarding a linear decrease of the elastic modulus versus the plastic shear strain overestimates the elastic modulus to some extent, especially for the soft rock mass.

Leiomyoma with bizarre nuclei occurring post hysterectomy mimicking malignancy: a rare case report

Abstract Introduction/Objective Leiomyoma with bizarre nuclei (LBN), also known as symplastic leiomyoma, represents a rare subtype of benign uterine smooth muscle neoplasm. Histologically, it is characterized by significant cytological atypia in a typical leiomyoma background with rare mitoses and without tumor necrosis. Methods/Case Report We report a case of a 48-year-old woman, status post hysterectomy for symptomatic fibroids, with imaging showing multiple contiguous pelvic masses extending from the pelvis to the upper abdomen and displacing the colon laterally and small bowel posteriorly. The findings were highly suspicious for ovarian malignancy. A bilateral salpingo-oophorectomy and a partial colectomy were performed with tumor debulking and omentectomy. Grossly, multiple well-circumscribed soft masses ranging in size from 1.5-16 cm, in contiguity with pericolonic mesentery with a smooth fleshy cut surface and cystic changes were found. Bilateral ovaries were unremarkable. Microscopically the larger masses were composed of spindle cells with bizarre nuclei throughout, while smaller masses showed foci of bizarrely shaped-spindle cells with bizarre nuclei in a background of a typical leiomyoma. Mono- and multinucleated cells with smudged chromatin were also seen. The mitotic index was low confirmed with a low Ki-67 proliferation index (< 5%). Immunohistochemical stainings showed that the neoplastic cells were positive for desmin, SMA, and caldesmon; and negative for CD10, with a wild type p53 expression. Fumarate hydratase immunostain was retained. MDM2 amplification was not detected by FISH. The morphology and immunohistochemical findings were compatible with LBN. Results (if a Case Study enter NA) NA Conclusion In summary, this is a rare and challenging case of multiple LBN developed years post hysterectomy and clinically mimicking a malignancy.

Bilateral chronic cavitary pulmonary aspergillomas in an adult patient with recurrent tuberculosis: a case report and literature review

BackgroundAspergillomas are globular growths of Aspergillus fumigatus, a benign aspergillosis of the lungs. It usually affects patients who are immunocompromised and have anatomically defective lung structures. The majority of aspergilloma cases are asymptomatic, despite the fact that 10% of cases spontaneously resolve. Most patients do not have any symptoms from their lesions. Direct serological or microbiological evidence of an Aspergillus species along with radiologic evidence is required for the diagnosis of an aspergilloma.CaseWe describe a 35-year-old adult Oromo male patient who had been experiencing night sweats, an intermittent productive cough with sparse whitish sputum, loss of appetite, and easy fatigability for 3 months. At 5 years prior, he received treatment for pulmonary tuberculosis that was smear-positive and was subsequently certified healed. Objectively, he was tachypneic and had intercostal, subcostal, and supraclavicular retractions with symmetric chest movement. A high-resolution computed tomography scan revealed bilateral apical cavitary lesions with core soft tissue attenuating spherical masses and an air crescentic sign suggestive of aspergillomas, which were confirmed by sputum light microscopic examination. The patient was managed with antibiotics and antifungals.ConclusionAspergilloma is a symptom of chronic pulmonary aspergillosis, a category of lung disorders caused by a persistent Aspergillus infection. Primary aspergillomas are uncommon and frequently occur in people with compromised immune systems. A prolonged cough, fever, chest pain, and hemoptysis are all symptoms of pulmonary aspergillomas. The majority of the time, pulmonary aspergillosis is difficult to identify. Despite high mortality and morbidity rates, surgery is still the most effective treatment for pulmonary aspergilloma.

12243 The Case of a Metastatic Papillary Thyroid Cancer Presenting as an Unresectable Pelvic Mass

Abstract Disclosure: M. Tucktuck: None. Y. El Soufi: None. O.G. Adeniran: None. A.A. Gliwa: None. Background: Papillary thyroid cancer (PTC) represents around 85% of all thyroid cancers, of which 2-10% of patients will present with metastasis distant to the neck. The frequency of bone metastasis in PTC occurs in only 1-4% of patients. Studies have shown that distant and multi-organ metastasis is associated with higher mortality rates. Clinical case: A 69-year-old woman with diabetes mellitus, cerebrovascular accident, and right lower extremity deep venous thrombosis, presented with right foot and hip pain for 1 week after a mechanical fall. She had a 50 pound weight loss over a year without personal or family history of thyroid cancer or disease or radiation exposure. A soft and nontender mass in the right lower abdomen was noted during a physical exam. Imaging revealed a large heterogeneous lesion (16.3 x 13.3 x 15.5 cm) in the right bony pelvis with internal necrosis, destructing the right iliac bone, and extending into the right sacrum, acetabulum, and musculature, with mass effect on the surrounding vasculature, and enlarged lymph nodes suspicious for metastasis. Thyroid imaging showed a hypervascular hyperechoic 1.3 cm nodule within the right thyroid gland and a large 2 cm left thyroid nodule with scattered microcalcifications. Thyroid function tests were within normal limits. The patient underwent an initial ultrasound guided biopsy of the pelvic mass with indiscriminate results, and later a laparoscopic excisional biopsy of the pelvic mass showed neoplastic papillary proliferation with typical nuclear features, without necrosis or associated ovarian tissue. The immuno-histopathological profile was positive for PAX-8, TTF-1, thyroglobulin, and CK7, and the Ki-67 proliferation index was ∼20-30%. The patient was diagnosed with papillary thyroid cancer with metastasis to the pelvic bone, and was classified as stage IV, cT1bN0M1. As the pelvic mass was inoperable, the patient completed total thyroidectomy and was started on hormone replacement therapy. Subsequent thyroid pathology report was negative for papillary carcinoma. Further review of imaging did not show ectopic thyroid tissue in the neck or an ovarian pathology. Before the patient’s next visit to evaluate for struma ovarii, she passed away. Conclusion: Thyroid cancer is usually treated through thyroidectomy or lobectomy, with radioiodine (RAI) therapy as an effective treatment for differentiated cancers. Our patient, who presented with extremity pain revealing a distant metastasis, completed thyroidectomy with plans to undergo RAI therapy. Our case highlighted the importance of recognizing musculoskeletal presentations as an initial and possibly only finding of a distant metastasis. It also emphasized the utility of multidisciplinary collaboration in detecting and recognizing PTC as a primary thyroid cancer, as early management can reduce mortality and lead to more favorable outcomes. Presentation: 6/2/2024

8252 Central Adrenal Insufficiency Masquerading as Syndrome of Inappropriate Antidiuretic Hormone (SIADH): A Case Report

Abstract Disclosure: J.G. Sazon: None. J.L. Reyes: None. J.V. Chua: None. S.A. Kho: None. Hyponatremia, the most common electrolyte imbalance encountered in clinical practice, has various causes and presentation. Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) is a frequent hospital-related cause, potentially leading to misdiagnosis with adrenal insufficiency due to shared clinical features which may cause potential deleterious effect. We present a case of a 41-year-old male hyponatremic patient with a two-month history of progressive generalized body weakness and lightheadedness, initially managed as SIADH. Upon admission, the patient persistently showed low serum sodium level (122mmol/L) (NV: 135-145mmol/L), exhibited signs of euvolemic hyponatremia despite fluid restriction, intravenous furosemide, and sodium chloride tablets. Further work-up revealed normocytic normochromic anemia (Hgb 107 g/L) (NV: 120-160g/L), elevated ESR of (31mm/hr) (NV: 0-15mm/hr), low Ft4 (2.97 pmol/L) (NV: 12-22 pmol/L) and normal TSH (2.2 uIU/mL) (NV: 0.27-4.20 uIU/mL). During hospital stay, he experienced an episode of hypotension at 80/50mmHg and hypoglycemia at 65 mg/dL. Investigation revealed adrenal insufficiency secondary to pituitary macroadenoma with apoplexy as showed in magnetic resonance imaging. Patient was started on Prednisone. Pre-operatively, hydrocortisone 100mg IV every 8 hours preoperatively. He underwent transsphenoidal surgery; excising a 2.5cm soft and grayish suprasellar mass. Post-operatively, he was given Prednisone and Levothyroxine resulting in symptom improvement and normal sodium levels.The occurrence of hyponatremia due to adrenal insufficiency is relatively uncommon, emphasizing the need for heightened suspicion when assessing patients with prolonged or recurring hyponatremia. This paper highlight the need to replace glucocorticoid prior supplementation of thyroid hormone in such cases, averting the occurrence of adrenal crisis. This case indicated a mechanism of persistent hyponatremia attributed to secondary adrenal insufficiency, with added therapeutic benefits observed through the use of glucocorticoids and transsphenoidal surgery. Presentation: 6/1/2024

An Unusual Paediatric Neck Mass: Cervical Lipoblastoma with Spinal Involvement.

Lipoblastoma is a benign tumour derived from embryonic white fat and is more commonly seen in children. Spinal involvement is rare, with only 14 cases reported to date. We report a case of a 7-year-old boy who was presented with an asymptomatic right neck swelling for 5 years. Clinical examination revealed a soft multilobulated mass causing tracheal deviation with normal neurological examination. Ultrasound, Computed tomography and Magnetic resonance imaging showed a lipomatous lesion with extension to spinal foramina at C3-C5 causing displacement of the spinal cord. Near total excision of the tumour was done with a small remnant left behind at C3-C4 as it was tightly adhered to the vertebral artery. Histopathological samples were consistent with lipoblastoma. The patient developed ipsilateral ptosis and pupillary myosis which improved on the second-month postoperative review; no other neurological deficit was noted, and a follow-up cervical MRI showed no recurrence.

Supersymmetric Hybrid Inflation in Light of CMB Experiments and Swampland Conjectures

Abstract In this study, we revisited supersymmetric (SUSY) hybrid inflation considering the latest observations from CMB experiments and the swampland conjectures. We demonstrated that when incorporating radiative, soft mass, and SUGRA corrections to the scalar potential, SUSY hybrid inflation remains consistent with Planck 2018 data. It is commonly perceived that SUSY hybrid inflation with a minimal K"ahler potential results in a gauge symmetry breaking scale $M$ of ${\cal O}(10^{15})$ GeV, leading to issues with the proton decay rate. Our analysis introduces a new parameter space where the proton decay problem is mitigated by achieving $M \sim 10^{16}$ GeV with $M_{S}^{2}<0$ and $am_{3/2}>0$. This scenario necessitates a soft SUSY breaking scale $|M_{S}| \gtrsim 10^{6}$ GeV. Furthermore, we found that the tensor-to-scalar ratio $r$ spans from $10^{-16}$ to $10^{-6}$, indicating a very small value. This small ratio allows the modified swampland criteria to hold, although satisfying the trans-Planckian censorship conjecture remains challenging. To address this, we also explored non-minimal K"ahler potentials. By fixing the spectral index at $n_{S}=0.9665$, consistent with the central value of Planck 2018 data, and setting $M=2\times 10^{16}$ GeV, we presented our calculations. We showed that the canonical measure of primordial gravitational waves, $r$, for $M_{S}=$ 1 TeV, $m_{3/2}=$ 1 TeV, $\kappa_{S}<0$ for $\cal{N}=$1 and $\cal{N}=$2, ranges from $10^{-5}$ to $0.01$, making it detectable by Planck and upcoming experiments such as LiteBIRD, Simons Observatory, PRISM, PIXIE, CORE, CMB-S4, and CMB-HD. Additionally, we outlined the parametric space and provided benchmark points for the non-minimal case, ensuring compatibility with both the modified swampland and trans-Planckian censorship conjectures. Content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI. Article funded by SCOAP3 and published under licence by Chinese Physical Society and the Institute of High Energy Physics of the Chinese Academy of Science and the Institute of Modern Physics of the Chinese Academy of Sciences and IOP Publishing Ltd

Machine Learning Approach for Predicting Hypertension Based on Body Composition in South Korean Adults.

(1) Background: Various machine learning techniques were used to predict hypertension in Korean adults aged 20 and above, using a range of body composition indicators. Muscle and fat components of body composition are closely related to hypertension. The aim was to identify which body composition indicators are significant predictors of hypertension for each gender; (2) Methods: A model was developed to classify hypertension using six different machine learning techniques, utilizing age, BMI, and body composition indicators such as body fat mass, lean mass, and body water of 2906 Korean men and women; (3) Results: The elastic-net technique demonstrated the highest classification accuracy. In the hypertension prediction model, the most important variables for men were age, skeletal muscle mass (SMM), and body fat mass (BFM), in that order. For women, the significant variables were age and BFM. However, there was no difference between soft lean mass and SMM; (4) Conclusions: Hypertension affects not only BFM but also SMM in men, whereas in women, BFM has a stronger effect than SMM.

EP110 - Chyloperitoneum in Follicular lymphoma – presenting as an inguinal hernia

Abstract Introduction Follicular lymphoma is one of the subtypes of slow growing Non-Hodgkin Lymphoma. Rarely, follicular lymphoma can present with chyloperitoneum or chylous ascites which is characterized by a milky-white coloured fluid with raised triglyceride levels. Case Report We present a case of a 60-year-old diabetic male, complaining of a right sided inguinal swelling for 1 year. Examination revealed a reducible right inguinal swelling with a positive cough impulse. The laboratory workup was unremarkable. Ultrasound scan of anterior abdominal wall showed a defect of 2.1 cm in right inguinal region with protrusion of abdominal contents and a positive cough impulse. A diagnosis of right sided reducible direct inguinal hernia was made. Patient was scheduled for Lichtenstein repair. Per-operatively, the hernial sac contained healthy omentum with milky-white ascitic fluid. Omentum was reduced and suture repair was performed. A drain was placed intra-peritoneally. The postoperative course of the patient was uneventful. Ascitic fluid analysis showed high triglyceride levels and no evidence of malignant cells, suggesting chylous ascites. Contrast enhanced CT scan of abdomen and pelvis revealed a large homogenous minimally enhancing soft tissue density retroperitoneal mass in peri aortic and paravertebral location with abdominal lymphadenopathy suggesting retroperitoneal lymphoma. Excisional biopsy of an enlarged inguinal lymph node confirmed follicular lymphoma with positive BCL2 and CD10 markers. Conclusion Follicular lymphoma presents in a variety of ways including chylous ascites in an inguinal hernia and a high index of suspicion is required to diagnose it.

Identification of Marijuana Using Silver-Phosphine Ion Complexation and a Semi-Quantitative 1% Decision-Point Assay

Due to the strict federal regulations concerning ∆9-tetrahydrocannabinol (∆9-THC) content for the differentiation of hemp and marijuana outlined in the 2018 Farm Bill, the ability to quickly and reliably differentiate cannabis as marijuana or hemp is crucial within both the seized drug community and hemp industry. This study provides a novel direct mass spectrometry approach for the identification of marijuana using Ag-phosphine ion complexation and a semi-quantitative 1% decision-point assay. The main constituents of hemp and marijuana, cannabidiol (CBD) and ∆9-THC, are isomeric and cannot be differentiated using soft ionization mass spectrometry techniques alone. However, the incorporation of [Ag(PPh3)(OTf)]2 enables the formation of unique MS/MS product ions at m/z 421/423, m/z 353/355, and m/z 231 for CBD due to differences in binding affinity, allowing CBD to be differentiated from ∆9-THC. Likewise, the isomeric cannabinoid precursors ∆9-tetrahydrocannabinolic acid (∆9-THCA) and cannabidiolic acid (CBDA) can be differentiated due to the formation of unique MS/MS product ions at m/z 465/467 and m/z 379/381, which are specific to CBDA. Eight additional cannabinoids were also characterized utilizing the proposed Ag-phosphine ion complexation approach. To reduce the potential for false positives, a more conservative 1% decision-point assay was developed by fortifying 1% weight-by-volume ∆9-THC-d9 into methanolic extracts of authentic cannabis plant material, followed by assessing if the total ∆9-THC content (containing ∆9-THC and ∆9-THCA) was greater than or less than the intensity of the spiked internal standard. When the developed approach was applied to 20 methanolic extracts of authentic cannabis samples with known cannabinoid compositions, 90% of the samples were correctly identified as marijuana or not marijuana based on the 1% administrative threshold for the total ∆9-THC content. The two lone misidentifications were due to the presence of elevated ∆8-THC, which highlights the necessity to explore more selective ligands in the future. This study provides the first application of Ag-ligand ion complexation for the identification of marijuana based on a semi-quantitative 1% decision-point assay, which shows great promise as an alternative method for the rapid identification of marijuana.

Confronting Minimal Supersymmetric Standard Model Flat Direction Inflation with Planck/BICEP Data

Abstract We study the scenario of inflection point inflation where a flat direction of the minimal supersymmetric standard model (MSSM) is identified with the inflaton. Specifically, we consider in full generality the cases where an MSSM flat direction is lifted by a higher-dimensional superpotential whose dimension is $n=4,5,6,7,9$. We confront the inflection point inflation scenarios with various n with the Planck and BICEP data, and thereby constrain the soft supersymmetry breaking mass and the coefficient of the higher-dimensional operator that lifts the flat direction.

Epidermoid Cyst at the Root of the Sphenoidal Pterygoid Process: A Rare Case Report.

Epidermoid cysts of the skull base are rare. We present the case of a woman with an epidermoid cyst at the root of the sphenoidal pterygoid process. She experienced tightness of the forehead skin without headache. Computed tomography (CT) scan revealed a hypodense lesion at the base of the skull in the right middle cranial fossa, which had partly eroded the pterygoid root. Magnetic resonance imaging (MRI) scan revealed a soft cystic mass that eroded the pterygoid root with hypo-/iso-intense on T1-weighted images, hyperintense on T2-weighted images, inhomogeneous hyperintense on diffusion-weighted images, a slightly low apparent diffusion coefficient, and no enhancement, suggesting a diagnosis of an epidermoid cyst. Surgical excision was performed using a nasal endoscope via the pterygoid process-root approach. A histopathological examination confirmed the diagnosis of an epidermoid cyst. At the 6-month follow-up, no recurrence was found on MRI or nasal endoscopy, and the symptoms of forehead tightness disappeared. In conclusion, epidermoid cysts at the root of the sphenoidal pterygoid process are exceptionally rare. Preoperative MRI and CT scans are necessary for the correct diagnosis and differentiation of other low-growing lesions. Nasal endoscopy is crucial for surgical excision and postoperative follow-up for potential recurrence.

Water-rock interfacial softening model of cemented soft rock: An experimental and numerical study

Cemented soft rock is prone to softening when exposed to water, and its mechanical properties deteriorate rapidly, which is an important reason to induce the instability and failure of engineering soft rock mass. The softening mechanism of soft rock is essentially the deterioration of microstructure caused by the change of water-rock interface. Considering the general characteristics of soft rock, the microstructural evolution characteristics and element loss over varying immersion time are then compared and analyzed. The Interfacial Cemented Bonding (ICB) structure is proposed to describe the evolution of water-rock interface. Based on the diffusion theory, the theoretical equation describing the evolution of water-rock interface is derived and compared with the experimental results. The meso-softening damage factor (MSDF) of soft rock is proposed and introduced into a numerical method to establish a strength degradation discrete element method (SD-DEM) model. The results show that the softening process of soft rock is accompanied by the shedding and suspension of particles and the dissolution of soluble substances. Besides, the softening of soft rock has obvious nonlinear dynamic characteristics. The fitting degree between the theoretical values and the experimental results is relatively high, which verifies the reliability and rationality of the dissolution-diffusion interfacial softening model. The numerical results are in good agreement with the experimental ones. This study provides a new idea for understanding the mechanism of water-induced softening characteristics and strength degradation of soft rock.

Giant Atypical Spindle Cell Lipomatous Tumor of Retroperitoneal Origin Presenting with Lung Metastasis and Extension to the Thigh: A Case Report with Literature Review

AbstractRetroperitoneal liposarcomas are rare, and their variants, atypical spindle cell lipomatous tumor (ASCLT), are rarer. Though ASCLTs are benign, they have high recurrence despite complete surgical excision. We present a rare case of a 22-year-old male presented with insidious-onset, and gradually progressive swelling over left inguinofemoral, and iliac fossa region. Also, the patients had a history of weight loss, pricking-type pain radiating to left lower limb, and breathlessness on exertion. Contrast-enhanced computed tomography (CECT) abdomen revealed a large well-defined heterogeneously enhancing soft mass located in pelvis, and involving left-sided iliopsoas muscle suggestive of retroperitoneal soft tissue sarcoma and CECT thorax showed metastasis. The CT-guided core biopsy led to the definitive diagnosis of low-grade ASCLT. Subsequently, the patient was initiated on concurrent neoadjuvant chemoradiotherapy followed by complete surgical excision. The findings in this report make it critical to enhance our understanding of this rare tumor, with surgery being the best treatment option.

Folliculectomy for the treatment of pre-ovulatory follicular stasis in three illegally captured West Coast green geckos (Naultinus tuberculatus) to enable wild rehabilitation

ABSTRACT Case history In 2023, the New Zealand Department of Conservation seized 63 endemic reptiles that were being held without a permit. This group included three adult female West Coast green geckos (Naultinus tuberculatus) that had been illegally removed from the wild 2 years earlier. They had been held in an outdoor enclosure with a pair of goldstripe geckos (Woodworthia chrysosiretica). Clinical findings On physical examination, all three geckos had at least two soft palpable masses in the coelom. Repeated ultrasonographic examination over several months confirmed the diagnosis of pre-ovulatory follicular stasis (POFS) in each gecko, and in subsequent weeks, more ovarian follicles developed in each animal. Laboratory findings All three geckos were negative on culture of cloacal swabs for Salmonella spp., and negative on PCR assay of a cloacal flush for Cryptosporidium spp., despite other reptiles in the seized group showing positive results for multiple Salmonella spp., and one other gecko being positive for Cryptosporidium parvum, subtype IIcA5G3. Treatment and outcome For all three geckos, para-midline ventral coeliotomy was performed under general anaesthesia, and folliculectomy of degenerate ovarian follicles was performed. Post-operative complications were seen in all three animals, which developed suture-line infections following disruption of normal skin shedding and entrapment of shed keratin in the surgical sites. A second surgery was undertaken to remove impacted keratin and caseous inflammatory material from the surgical wounds of all three animals and buried sutures were placed to close the coelomic wounds. The geckos were treated with 20 mg/kg ceftazidime IM every second day for 2 weeks post-operatively. Subsequent ecdysis (skin shedding) occurred without complication and the geckos were released back to the wild 10 months after admission. Clinical relevance The recommended treatment for POFS in reptiles is ovariectomy, which is not appropriate for wild animals. The use of folliculectomy to resolve preovulatory follicular stasis should be considered for animals where retaining reproductive ability is essential.

QCD with an infrared fixed point and a dilaton

Following previous work we further explore the possibility that the chirally broken phase of gauge theories admits an infrared fixed point interpretation. The slope of the β function, β*′, is found to vanish at the infrared fixed point which has several attractive features such as logarithmic running. We provide a more in-depth analysis of our previous result that the mass anomalous assumes γ*=1 at the fixed point. The results are found to be consistent with N=1 supersymmetric gauge theories. In a second part the specific properties of a dilaton, the (pseudo-) Goldstone, due to spontaneous symmetry breaking are investigated. Dilaton soft theorems indicate that a soft dilaton mass can only originate from an operator of scaling dimension two. In the gauge theory this role is taken on by the q¯q-operator. The quantum chromodynamics (QCD) dilaton candidate, the σ=f0(500) meson is investigated and the singlet-octet mixing is found to be relevant. We briefly discuss the dilaton as a candidate for the Higgs boson, which relies on the ratio of dilaton to pion decay constant being close to unity. In QCD this is approximately satisfied but it is remains unclear if this is accidental or whether there is yet to be uncovered principle behind it. Published by the American Physical Society 2024

Atypical presentation of lipoma in left groin resembling as 3rd testis

Lipoma are benign adipose tumor which usually present in the subcutaneous tissues. Lipomas are characterized as slow-growing, soft, mobile, round and asymptomatic masses on the head, neck, shoulders, and the back. They usually develop between the ages of 40-60.