Subcutaneous Mass Research Articles

Prognostic impact of adipose tissue loss at 1month after surgery in patients with gastric cancer.

The postoperative impact of short-term changes in skeletal muscle loss (SML) and adipose tissue loss (ATL) on treatment outcomes is unclear in patients with gastric cancer (GC). We investigate the role of SML and ATL at 1month after surgery in determining postoperative survival and recurrence rates in patients with GC. We analyzed 540 patients with GC and assessed their skeletal muscle mass, visceral fat mass, and subcutaneous fat mass using computed tomography scans preoperatively and 1month postoperatively. Patients were categorized into high and low groups based on their levels of SML, visceral ATL (v-ATL), and subcutaneous ATL (s-ATL). Additionally, they were classified into three groups (high ATL, intermediate ATL, and low ATL) based on their v-ATL and s-ATL measurements. Patients with higher v-ATL and s-ATL had lower overall survival (OS) and recurrence-free survival (RFS) rates. High ATL was an independent prognostic factor for decreased OS (hazard ratio [HR] 2.27; 95% confidence interval [CI] 1.16-4.42; and P=0.02) and RFS (HR 2.51; 95% CI 1.34-4.71; and P=0.004) rates. A reduction in adipose tissue volume shortly after surgery (1month) could potentially indicate an increased risk of recurrence and mortality in patients with GC.

Effect of adipose tissue deposition on insulin resistance in middle-aged and elderly women: Based on QCT and MRI mDIXON-Quant.

To explore the relationship between adipose tissue deposition and triglyceride-glucose (TyG) index, an indicator clinically used to assess insulin resistance (IR), in middle-aged and elderly women using quantitative computed tomography (QCT) and MRI mDIXON-Quant sequence. All participants underwent quantitative computed tomography (QCT) and MRI mDIXON-Quant examination and calculated the TyG index based on the fasting blood glucose and triacylglycerol. Bounded by the median TyG index, all participants were divided into low TyG group and high TyG group. Visceral fat mass (VFM) and subcutaneous fat mass (SFM) were measured on QCT images. Hepatic proton density fat fraction (H-PDFF), pancreatic proton density fat fraction (P-PDFF), and lumbar bone marrow fat fraction (L-BMFF) were measured on MRI mDIXON-Quant images. Adjusting for age and body mass index (BMI), TyG was moderately positively correlated with H-PDFF, and r/P was 0.416/<0.001, TyG index was weakly positively correlated with VFM and P-PDFF, and r/P were 0.385/<0.001 and 0.221/0.030. There was a difference of VFM, H-PDFF, and P-PDFF between low TyG group and high TyG group (P < 0.05). Adjusting for age and BMI, VFM, and H-PDFF were the risk factors of high TyG, and H-PDFF was the independent risk factor of high TyG. VFM and H-PDFF were the risk factors of IR, and H-PDFF was the independent risk factor. Early identification and active treatment of adipose tissue deposition, especially hepatic fat deposition, may reserve and delay the progression of IR and even metabolic syndrome.

Superficial Neurocristic FET::ETS Fusion Tumor: Expanding the Clinicopathological and Molecular Genetic Spectrum of a Recently Described Entity

Superficial neurocristic EWSR1::FLI1 fusion tumor is a very recently described, clinically indolent tumor of the skin and superficial soft tissues, which differs in essentially all ways from Ewing sarcoma, despite harboring an identical fusion event. The EWSR1 and FLI1 genes are members of the FET and ETS gene family, respectively, and very rare examples of Ewing sarcoma harbor alternative FET::ETS fusion events, such as EWSR1::ERG, FUS::FLI1, FUS::ERG, EWSR1::ETV4 and others. We report 5 new cases of this very rare entity, harboring in 3 cases alternative FET::ETS fusion events. The tumors occurred in 2 males and 3 females (median age 14 years; range 8-69 years) and presented as solitary dermal/ subcutaneous masses of the thigh, foot, shoulder, arm and back (median size 1.8 cm; range: 1-2 cm). All patients underwent wide excisions; one received adjuvant chemotherapy. Clinical follow-up on 3 patients (median: 24 months; range: 18-31 months) showed all to be without disease. Morphologically, all tumors displayed typical features of this entity as described, with nests of cytologically bland, diffusely S100 protein/SOX10-positive round cells without mitotic activity, surrounded by fibrous bands containing spindled cells with similar nuclear features. The tumors also showed membranous CD99 (4/5) and nuclear NKX2.2 (3/3) expression. RNA sequencing (4 cases) demonstrated FUS::FLI1, FUS::ERG, EWSR1::FLI1, EWSR1::ERG, and a novel FUS::ETV5. Methylation profiling (4 cases) showed all to cluster with previously reported superficial neurocristic EWSR1::FLI1 fusion tumors and apart from conventional and “adamantinoma-like” Ewing sarcoma.Our findings confirm the distinctive clinicopathological features of this very rare, recently described entity and expand its molecular genetic spectrum. Reflecting these findings, we propose modifying the name of this entity to “superficial neurocristic FET::ETS fusion tumor”.

A large type Va dermoid sinus (true dermoid cyst) on the dorsal thoracic region in an English Springer Spaniel dog

AbstractA 3.5‐year‐old, male, neutered English Springer Spaniel dog presented for a large subcutaneous mass on the dorsal thoracic region. Magnetic resonance imaging and computed tomography scan confirmed a fluid‐filled subcutaneous lesion with no evidence of connection to the spinal cord. Complete surgical excision was performed. Histopathological examination was consistent with a dermoid sinus. A seroma developed post‐operatively and was successfully managed surgically. The patient made a full recovery. This is the first reported case of a type Va dermoid sinus on the dorsal thoracic region in an English Springer Spaniel dog.

Characterizing body composition modifying effects of a glucagon-like peptide 1 receptor-based agonist: A meta-analysis.

Diabetes is an independent risk factor for muscle mass loss, with possible mechanisms including impaired insulin signalling and chronic inflammation. The use of a glucagon-like peptide 1 (GLP-1) receptor-based agonist could lead to weight reduction, which might result from the loss of both fat and skeletal muscle. However, the body composition-modifying effects of GLP-1 receptor-based agonists have not been systematically characterized. PubMed, EMBASE, the Cochrane Center Register of Controlled Trials for Studies and Clinicaltrial.gov were searched from inception to October 2023. Randomized controlled trials of GLP-1 receptor agonist or glucose-dependent insulinotropic polypeptide/GLP-1 receptor dual agonist, which reported the changes of body composition, were included. The results were computed as weighted mean differences (WMDs) and 95% confidence intervals (CIs) in a random-effects model. In all, 19 randomized controlled trials were included. When compared with controls, substantial reductions in fat body mass were observed in patients using GLP-1 receptor-based agonist treatment (WMD = -2.25 kg, 95% CI -3.40 to -1.10 kg), with decrease in areas of both subcutaneous fat (WMD = -38.35 cm2, 95% CI, -54.75 to -21.95 cm2) and visceral fat (WMD = -14.61 cm2, 95% CI, -23.77 to -5.44 cm2). Moreover, greater reductions in lean body mass were also observed in GLP-1 receptor-based agonist users compared with non-users (WMD = -1.02 kg, 95% CI, -1.46 to -0.57 kg), while the changes in lean mass percentage were comparable between GLP-1 receptor-based agonist users and non-users. Compared with the controls, GLP-1 receptor-based agonist users experienced greater reductions in fat body mass, with body shaping effects in terms of both subcutaneous fat mass and visceral fat mass. Although greater reductions in lean body mass were also observed in GLP-1 receptor-based agonist users, the changes in lean mass percentage were comparable between the users and non-users.

B-Flow and Contrast-Enhanced Ultrasound (CEUS) Features of Subcutaneous Masses and Nodular Lesions in Dogs.

Subcutaneous lesions in dogs are common in clinical practice. This prospective clinical study aims to compare B-flow and CEUS for the characterization of subcutaneous lesions evaluating their usefulness to distinguish benign subcutaneous lesions from malignant ones. Dogs were enrolled and ultrasound cine-loops were achieved in B-mode, Colour Doppler, Power Doppler, B-flow and CEUS. Lesions vascularisation highlighted through B-flow and CEUS were classified into five patterns: P1, absence of contrast uptake; P2, enhancement only in the peripheral area of the lesion; P3, thin (<2 mm) and few vessels (<5/field); P4, thicker (>2 mm) and more numerous vessels (>5/field); P5 enhancement with a reticular aspect and both thick and thin bands inside. Patterns highlighted with B-flow and CEUS were compared to a histological diagnosis of subcutaneous lesions. A total of 24 dogs and 30 subcutaneous nodules were included and divided into three groups: 3 non-neoplastic, 16 benign tumours and 11 malignant tumours. There was a statistically significant difference for B-flow and CEUS to differentiate benign tumours from malignant tumours. B-flow and CEUS had an excellent agreement. B-flow and CEUS displayed similar ability to evaluate different patterns and could be helpful in the evaluation of subcutaneous nodules.

Euphorbia helioscopia inhibits proliferation, invasion, and migration and promotes apoptosis of non-small cell lung cancer cells

To investigate the effect of Euphorbia helioscopia on biological behaviors of non-small cell lung cancer (NSCLC) cells. NSCLC cell lines PC-9 and A549 treated with different concentrations of Euphorbia helioscopia preparations were examined for changes in proliferation, apoptosis, invasion and migration using CCK-8 assay, colony formation assay, flow cytometry, wound healing assay and Transwell assay. Western blotting was performed to detect the changes in protein expressions of Bax, Bcl-2, E-cadherin, vimentin, MMP2, and MMP9 in the treated cells. PC-9 cells were injected subcutaneously into BALB/C nude mice to establish a nude mouse subcutaneous tumor model. According to the growth of subcutaneous tumors, mice were randomly divided into control group: gavaged daily with saline; Euphorbia helioscopia-treated group: gavaged daily with Euphorbia helioscopia 65 mg/mL, and Euphorbia helioscopia granules were dissolved in saline; cisplatin-treated group: injected intraperitoneally with cisplatin 4 mg/kg every 5 days, 6 mice per group. The subcutaneous tumor volume and mass changes of mice were measured, and the toxic effects of Euphorbia helioscopia on heart, liver, spleen, lung and kidney as well as the therapeutic effects of Euphorbia helioscopia were observed in the mice bearing tumor. Euphorbia helioscopia granules concentration-dependently inhibited the proliferation and survival of PC-9 and A549 cells, significantly promoted cell apoptosis, suppressed invasion and migration abilities of the cells, up-regulated the expression levels of E-cadherin and Bax, and down-regulated the expressions of Bcl-2, vimentin, MMP2, and MMP9. In the tumor-bearing mice, treatment with Euphorbia helioscopia significantly inhibited tumor growth without producing obvious toxicity in the vital organs. Euphorbia helioscopia can inhibit proliferation, invasion, and migration and induces apoptosis of NSCLC cells in vitro.

Importância da análise histopatológica no diagnóstico de sarcoma de tecidos moles

The present work aimed to inform the importance of diagnosis through histopathological analysis of a grade II soft tissue sarcoma in a mixed breed bitch. Soft tissue sarcoma (STS) is a type of malignant neoplasm that originates from mesenchymal tissues, affecting several species, but is more prevalent in medium and elderly dogs. Clinical signs are variable and depend on the location of the tumor, generally occurring in the pelvic limbs. In the present report, the patient in question had a history of a subcutaneous mass measuring 30 cm in diameter, weighing 5 kg, located on the right flank and pelvic limb. Therefore, the diagnosis was initiated through laboratory and cytopathological tests; however, definitive confirmation was obtained through histopathological analysis, confirming the diagnosis. That said, histopathological diagnosis is extremely important for determining the prognosis and choosing the most effective treatment, with surgical resection being the most indicated treatment for these cases. Although the prognosis is generally favorable after complete removal of the neoplastic mass, factors such as size, location and grade of the tumor significantly influence clinical results as in the case discussed. Reinforcing the need for a multidisciplinary approach in the diagnosis and treatment of STS, in order to promote quality of life for patients.

Irregular, firmly adhered subcutaneous mass on the ventrolateral thorax wall in a 14-year-old Siberian Husky.

Irregular, firmly adhered subcutaneous mass on the ventrolateral thorax wall in a 14-year-old Siberian Husky.

CK20-negative Merkel Cell Carcinoma with Concomitant Squamous Cell Carcinoma In-Situ and Metastasis to the Parotid Gland

Abstract Introduction/Objective This report presents a patient with an aggressive CK20-negative neuroendocrine tumor of the dermis with metastasis to the parotid gland and a concomitant squamous cell carcinoma in-situ (SCCIS) and highlights diagnostic challenges of CK20-negative tumors. Methods/Case Report A centennial female with a history of non-melanoma skin cancer and leukemia presented to the dermatology clinic with a one-year history of an enlarging skin lesion on her right cheek and a subcutaneous mass on the right central lateral neck. On examination, the lesion appeared as a rough and raised red papule with a central crust. On CT, a large heterogeneously enhancing right parotid mass with surrounding satellite nodules, adjacent necrotic adenopathy, and an ulcerating subcutaneous mass in the adjacent right face. An incidental 3 mm right upper lobe nodule was identified. The pathology report noted two distinct malignant neoplasms within the specimen. Microscopy revealed ulceration with acanthosis and full thickness keratinocyte atypia, suggesting Bowen’s disease. On microscopic examination of the separate dermal tumor, there were sheets of uniform small cells with a high nuclear to cytoplasmic ratio and scant cytoplasm. IHC staining was positive for the neuroendocrine markers AE1/AE3, CAM5.2, synaptophysin, and CD56. CK20, CK7, and TTF-1 were negative. As some MCC may be negative for CK20, CK20 was performed twice. Differential diagnoses included SCCIS with CK20-negative MCC versus a metastatic neuroendocrine carcinoma of parotid gland to the skin. The patient transitioned to hospice care soon after the diagnosis. Results (if a Case Study enter NA) NA. Conclusion Our patient presents with an interesting case of a CK20-negative MCC with metastasis to the parotid gland. Since CK20 was stained negative twice, it complicated the diagnosis of MCC vs. small cell carcinoma. We suspected a more likely diagnosis of MCC metastasis to the parotid gland due to multiple reported cases (Day et al. 2016). Our patient also had an identifiable Bowen’s disease borderline to the neuroendocrine carcinoma. It is well known of the coexistence of MCC and squamous cell carcinoma in a cutaneous lesion (Suaiti et al. 2019). Thus, a metastatic MCC to the parotid gland is more likely in this case. As MCC is an aggressive cancer that metastasizes quickly, accurate diagnosis is crucial. With recent literature reporting the association of CK20-negativity with VN-MCC, and the presence of UV signature mutations in CK20- negative MCC, genomic screening would be a useful diagnostic tool.

Characteristics of 18F-FDG PET/CT in patients with Kimura's disease from China.

'Kimura's disease (KD) is a rare chronic inflammatory disorder of unknown etiology and is difficult to diagnose due to poor clinical presentation and imaging features. Few studies on characteristics of 18F-FDG PET/CT of KD have been reported. This study aimed to observe the reliable characteristics and usefulness of 18F-FDG PET/CT for the evaluation of consecutive patients with KD. The clinical data and 18F-FDG PET/CT imaging findings of 8 patients with pathologically confirmed KD were reviewed retrospectively.18F-FDG PET/CT images were evaluated visually and semiquantitatively by measuring the maximum standardized uptake value (SUVmax). The correlations between clinical data and 18F-FDG PET/CT features were analyzed by simple linear regression. This study included 7 males and one female ranging in age from 17 to 79years. The longest diameter of lesions ranged from 0.8cm to 4.8cm, and regional or generalized lymphadenopathy was found in all 8 patients with eosinophilia, while subcutaneous masses and salivary gland involvement concurrently were found in 4 patients. 18F-FDG PET/CT revealed that these involved lesions had high 18F-FDG uptake with SUVmax > 2.5 (2.6 to 6.3). Moreover, the margin of the lesions was well defined in 6 cases and ill defined in 2 cases, and homogeneous density and 18F-FDG uptake were both found in all these lesions. There was negative correlation between eosinophils and SUVmax (R2 = 0.538). Kimura's disease should be considered when 18F-FDG PET/CT is characterized by homogeneous lesions of regional or generalized lymphadenopathy, accompanied with subcutaneous masses and salivary gland involvement concurrently, especially in patients with eosinophilia.

7216 Absence Of Weight Gain In C57Bl/67 Female Mice On A High-Fat Diet Protects The Skeleton From Bone Loss

Abstract Disclosure: C. McAndrews: None. C. Chlebek: None. S. Costa: None. C.J. Rosen: None. Background: Obesity is associated with both systemic metabolic changes that increase the risk of comorbidities and reduced bone quality that increases the risk of fracture. The effects of high-fat diet consumption have been well studied in preclinical models where high-fat diet-feeding induces obesity, but there have been no studies to investigate the effects of high-fat diet-feeding in animals that do not become obese. Therefore, we characterized components of systemic metabolism and bone mineral content in non-obese C57Bl/6J mice that were fed a high-fat diet. Methods: Female C57Bl/6J mice aged 8 weeks received either a high-fat (60% kcal fat, n = 31) or control (10% kcal fat, n = 17) diet for 12 weeks. Body composition, areal bone mineral density (BMD) and bone mineral composition (BMC) were assessed after the feeding period using dual energy x-ray absorptiometry (Faxitron UltraFocus-DXA). Glucose (GTT) and insulin (ITT) tolerance testing were performed at the conclusion of the study. Changes in body weight were calculated as the difference between baseline and experiment end. High-fat diet-fed animals were classified as obese (HFD-O, n = 24) if they weighed more than 25 g or had greater than 25% body fat as evaluated via DXA, and were otherwise considered non-obese (HFD-NO, n = 7). In a small subset of animals, subcutaneous inguinal fat pads were harvested and weighed (n=5-7/group). Differences between groups were assessed with one-way ANOVAs and Tukey post-hoc analyses. Results: HFD-O mice weighed more than HFD-NO and control animals, whereas the body weights of HFD-NO mice were not significantly different from control (p &amp;lt; 0.001). Fat percent was increased in HFD-O mice compared to HFD-NO and control animals (p &amp;lt; 0.001). Subcutaneous inguinal fat mass was increased in both HFD-O and HFD-NO mice compared to control (p &amp;lt; 0.001). Fasting blood glucose did not significantly differ between groups. Glucose tolerance was worsened in both HFD-O and HFD-NO mice compared to control (p &amp;lt; 0.001), but there were no significant differences in insulin tolerance between groups. BMD was decreased in HFD-O mice compared to HFD-NO and control animals (p &amp;lt; 0.001). DISCUSSION: The consumption of a high-fat diet in mice induces deleterious metabolic changes irrespective of weight gain. However, high-fat diet-induced bone loss does not occur in the absence of weight gain. These findings suggest that certain adipokines derived from larger adipose depots may drive high-fat diet-induced bone loss and warrant further investigation. Acknowledgements: This work was supported by the 2023 Endocrine Society Research Experiences for Graduate and Medical Students (REGMS) Program. Presentation: 6/1/2024

Nutrition, Growth, and Age at Puberty in Heifers

Puberty onset and age at first calving have a critical impact on livestock production for good reproductive efficiency of the herd and to reduce the duration of the non-productive stage of the growing heifer. Besides genetic factors, sexual maturation is also affected by environmental factors, such as nutrition, which can account for up to 20% of the observed variability. The rate of body weight gain during growth is considered the main variable influencing the age at puberty, dependent on planes of nutrition in growing animals during the prepubertal-to-pregnancy stage. This paper reviews current knowledge concerning nutrition management and attainment of puberty in heifers, considering the relevance of some indicators such as body measurements and hormones strictly linked to the growth and puberty process. Puberty onset is dependent on the acquisition of adequate subcutaneous adipose tissue mass, as it is the main source of the hormone leptin. Until a certain level, body condition score and age at puberty are negatively correlated, but beyond that, for fatter animals, such correlation is gradually lost. Age at puberty in heifers was reported to be negatively related to IGF-1. Future research should be planned considering the need to standardize the experimental animals and conditions.

Comparable glucagon-stimulated amino acid suppression in individuals with and without hepatic steatosis or steatohepatitis.

Hepatic amino acid (AA) metabolism and glucagon secretion are linked in a feedback cycle in which circulating AAs stimulate glucagon secretion, while glucagon stimulates hepatic AA catabolism. It has been proposed that metabolic dysfunction-associated steatotic liver disease (MASLD) leads to hepatic glucagon resistance, which may result in hyperaminoacidemia and hyperglucagonemia. We tested the glucagon effect on AA metabolism in subjects with obesity; 11 with steatohepatitis (MASH), 10 with steatosis (MAS), and seven subjects (CON) without steatosis. We performed a somatostatin clamp with infusions of insulin and low-dose followed by high-dose glucagon. We measured plasma levels of 17 AAs and assessed hepatic fat content (FF%) and body fat distribution (visceral and subcutaneous adipose tissue mass) by MRI. HighGlucagon suppressed plasma total AA equally in all groups; MASH 13% (SD 9%), MAS 14% (7%), CON 11% (5%), respectively. In univariate regression analyses visceral adipose tissue mass (β = 0.471, P = 0.011) and AA concentration at LowGlucagon (β = ─0.524, P = 0.004), but not FF% (β = ─0.243, P = 0.213), were significant predictors of AA reduction. Using a stepwise backward multiple regression approach revealed similar results. Total and specific AA levels (glutamic acid, tyrosine) were higher in both MASLD groups during the study and FF% was positively correlated to a number of individual AAs. Though finding elevated AA concentrations in subjects with MASLD, we conclude that in MASLD patients that do not have elevated glucagon at baseline, glucagon suppresses circulating AA levels equally in subjects with and without MASLD. NCT04042142.

Periorbital Intravenous Lobular Pyogenic Granulomas: A Case Report and Literature Review of This Peculiar Pathology.

Intravenous lobular pyogenic granuloma (ILPG) is a seldom-documented pathology in oculoplastic and orbital literature. This study aims to elucidate the clinical presentation and histopathologic findings surrounding periorbital ILPG through a case presentation and literature review. We describe a 42-year-old male with a palpable periorbital subcutaneous nodule that was subsequently diagnosed as ILPG on immunohistochemistry. A literature review was performed by searching articles in the PubMed/MEDLINE database using the keywords "periorbital intravenous lobular pyogenic granuloma," "periorbital intravenous pyogenic granuloma," or "periorbital intravenous capillary hemangioma." The literature review identified 6 patients presenting with similar subcutaneous nodules that were diagnosed as periorbital ILPGs. All patients, including the one in this study, were treated with local excision. Only 1 patient (1/7; 14.3%) noted pain while 5 experienced swelling or fluctuance (5/7; 71.4%). In patients with documented pathology reports, all ILPGs involved the angular vein (6/6; 100%). Of the 3 patients who had follow-ups at 2 to 7 years postexcision, none had recurrence. Histopathologic findings demonstrate an intravascular lobular tumor composed of capillaries with endothelial cells and pericytes. Marked reactivity to anti-Wilms tumor type 1 (WT-1) and anti-Smooth muscle actin was noted in the capillary structure. ILPG can be included on the differential for well-circumscribed, subcutaneous periocular masses. While the etiology of periorbital ILPG is unknown, most cases are managed with surgical excision, and recurrence appears to be uncommon. In sharing these cases and histopathologic underpinnings of periorbital ILPG, we endeavor to describe this peculiar pathology for oculoplastic and reconstructive surgeons.

Chest wall subcutaneous mass leading to the diagnosis of pericostal tuberculosis

AbstractWhen diagnosing a chest wall mass, even in the absence of pulmonary lesions, it is crucial to consider pericostal tuberculosis as a differential diagnosis. Attention must be paid to the characteristic findings on contrast‐enhanced computed tomography, such as central low attenuation, peripheral rim enhancement of soft tissue, and pleural involvement.

Rare Metastasis of Cutaneous Leiomyosarcoma to the Inguinal Region: Case report and Literature review

Introduction: Cutaneous leiomyosarcoma (CLM) is a rare malignancy arising from smooth muscle cells in the skin. It constitutes 2%-3% of all cutaneous soft tissue sarcomas and is known for its propensity for local recurrence and distant metastasis. Common metastatic sites include the lungs, liver, and brain. Diagnosis involves clinical examination and histopathological analysis, while management typically involves surgical excision, with adjunctive therapies like radiation and chemotherapy often considered due to its aggressive nature. Metastasis rates are reported as 12% for dermal and 51% for subcutaneous CLM. Case Report: A 40-year-old female with a history of excised leiomyosarcoma on the right buttock presented with a large, painful mass in the right inguinal region. Imaging revealed a substantial subcutaneous mass with significant local invasion and inguinal lymphadenopathy. Histopathological examination confirmed metastatic leiomyosarcoma. The patient showed anemia and elevated white blood cell count. Literature Review: Various cases reveal that CLM typically presents as nodular masses, primarily managed by surgical excision. Metastasis is rare but can occur, particularly in subcutaneous tumors. Inguinal region metastasis is highly unusual, with most cases showing spread to distant organs or regional lymph nodes. Imaging and histopathological findings are crucial for diagnosis. Discussion: CLM, while less metastatic compared to other sarcomas, requires vigilant monitoring due to its potential for local recurrence and distant spread. Metastasis to the inguinal region is exceptionally rare, highlighting the need for ongoing research to better understand such anomalies. Conclusion: CLM generally has a better prognosis than other sarcomas, but early detection of recurrence and metastasis is crucial. The rare occurrence of inguinal region metastasis emphasizes the importance of comprehensive surveillance and further research to understand this phenomenon better.

Chondroid Syringoma of scalp- A Case Misdiagnosed Clinicoradiologically as Dermoid Cyst

Chondroid syringoma (CS) is a rare tumor of the apocrine or eccrine glands. CS of the scalp is rare, and its clinical manifestations are similar to those of dermoid cyst, which is a common misdiagnosis for this disease. A 26-year-old woman presented with a 2-month history of an asymptomatic subcutaneous mass on the scalp. The lesions increased progressively over time. Dermatological examination showed that there was a subcutaneous mass, ranging from 2x2 cm in diameter, with a clear boundary. The surface of the skin was smooth without ulceration or scaling. Histopathologic examination was consistent with the diagnosis of CS. CS is a rare tumor of the apocrine or eccrine glands. It usually presents as a wellcircumscribed and single subcutaneous masses. Histopathology showed the tumor was located in the dermis, with nests, sheets, and cords of basal-like cells, mucin deposition, and chondroid structures. We herein report a case of CS located in the scalp. CS of the scalp is rare, and its clinical manifestations are similar to those of dermoid cyst, for which it is commonly misdiagnosed.

True Aneurysm of Superficial Temporal Artery Presenting as Subcutaneous Scalp Swelling: A Diagnostic Conundrum in Two Cases

AbstractTrue aneurysms of the superficial temporal artery (STA) are very rarely encountered in clinical practice. Unlike pseudoaneurysms neither they have any preceding history of trauma nor are they associated with atherosclerosis or any other comorbid conditions. We hereby report two such cases, which according to our literature search are exceedingly rare. Two young patients presented with subcutaneous swelling of short duration in the scalp. They did not have any prior history of trauma or associated comorbidities. The only presenting symptom was headache with a pulsatile subcutaneous mass. Diagnostic workup revealed STA aneurysm in both the cases and they were managed with surgical excision of the aneurysm. Histopathology of the aneurysm wall revealed true aneurysm in both cases. True aneurysms of STA should be considered a differential diagnosis in patients with a scalp swelling along the course of the artery. Younger patients should be investigated further to look for any congenital predisposition or coexistent vascular lesion. Considering that it is a rare entity, a proper investigating protocol and surgery remains the key to their successful management.

Large Spontaneous Subcutaneous Abscess Formation due to Finegoldia magna in a Diabetic Patient: A Case Report.

Finegoldia magna is a member of the Gram-positive anaerobic cocci group and constitutes the flora of the skin and other parts of the body. It sometimes colonizes diabetic foot and rarely infects skin or soft tissue of non-immunocompromised patients. Here, we report the case of a severe subcutaneous abscess on the back caused by F. magna involving an immunocompromised patient with poorly controlled diabetes. A 48-year-old woman with diabetes mellitus and anemia associated with uterine fibroids was referred to us with a 1-month history of a skin manifestation on her back, with a body temperature of 35.9°C and blood pressure of 115/73 mm Hg. The manifestation involved a subcutaneous mass of 36 × 45 cm with a foul odor, partly covered with necrotic tissue, which had the appearance of a tortoiseshell-like pattern. Blood examination revealed C-reactive protein of 21.4 mg/dL and hemoglobin A1c of 9.1%. Contrast-enhanced computed tomography showed a subcutaneous abscess with internal emphysema. Emergency debridement was performed, resulting in drainage of foul-smelling gray-green pus. F. magna was detected in the pus and skin tissue. Skin and soft tissue infectious disease caused by F. magna is extremely rare, but the disease tends to become severe once developing in an immunocompromised patient, such as a patient with poorly controlled diabetes. Therefore, physicians should consider F. magna as a causative agent when poorly controlled diabetic patients suffer from severe infectious cutaneous manifestations.