Tender Mass Research Articles

Wandering spleen

A 25-year-old female presented to our hospital with severe abdominal pain of two days’ duration. A routine obstetric ultrasound several years prior had revealed an enlarged spleen, but she was otherwise healthy and had carried two uneventful pregnancies to term. Physical exam on arrival in the emergency room was notable for a tender mass in the subumbilical region. A CT scan revealed an enlarged and ectopic spleen (A, B) with twisting of its vascular pedicle and numerous venous collaterals adjacent to the splenic vein (A, C – arrows). The patient was admitted to the general surgery department but declined any surgical intervention following symptomatic improvement and was discharged. A so-called wandering spleen is a rare condition thought to be due to laxity of the splenic ligaments. Our patient’s acute presentation was likely due to a self-resolving episode of splenic vessel torsion, with previous episodes likely resulting in congestive splenomegaly

Incisional hernia appendicitis: A unique case report.

Introduction and importanceIncisional hernia appendicitis is very rare. Very few papers have been published reporting about Pfannenstiel incision hernia with appendicitis. Here we report one such case of Pfannenstiel hernia with appendicitis.Case presentationA 20 years old lady presented with a tender mass in the right iliac fossa after Pfannenstiel incision. Ultra-sonography showed an incisional hernia with a 12.1 mm defect at the site of the incision. A provisional diagnosis of strangulated hernia was made. Acute appendicitis was diagnosed intra-operatively. Appendectomy followed by primary repair of the hernia was done. The patient had an uneventful recovery postoperatively and was discharged on the third day without any complications. Histopathology confirmed appendicitis.Clinical discussionAmyand originally documented the presence of appendix within external hernias. The presence of appendicitis within an incisional hernia is even rarer. Hypermobility of the cecum, inflammatory adhesions from surgery and defects created during surgery have been considered as the pathological basis of such incisional hernias. A classic presentation of appendicitis may be absent in cases of incisional hernia appendicitis. Deviation from usual clinical symptoms often deviates from treating surgeons to assume it as strangulated/incarcerated hernia. Incisional hernia appendicitis management consists of appendectomy followed by subsequent primary hernia repair. The use of mesh for repair is not preferred.ConclusionIncisional hernia appendicitis diagnosis is almost always intraoperative. As the incidence of incisional hernia appendicitis is low, awareness about the possibility of its occurrence is essential to formulate a well-planned intra-operative strategy.

Bartholin’s Abscess with Bacterial Vaginosis Coinfection Successfully Treated with a Modified Word Catheter and Combined Antibiotics

BACKGROUND: Bartholin’s abscess is an infection of the Bartholin gland that often occurs in women of childbearing age. The prevalence of Bartholin’s abscess is 2% in the female population worldwide. Patients often complain dyspareunia with a high recurrence rate. Bacterial Vaginosis (BV) is a syndrome of changes in the vaginal ecosystem that occurs spontaneously in sexually active women. BV can contribute to the development of a Bartholin’s gland abscess. CASE REPORT: A 30-year-old woman came with the chief complaint of a 5 cm × 5 cm erythematous, tender, and mobile mass on the right side of the labia majora. In addition, the patient also experienced recurrent vaginal discharge. The patient was diagnosed with Bartholin’s abscess with BV coinfection that was successfully treated with a modified word catheter and combination of antibiotics that showed no recurrence. CONCLUSION: Combination of modified word catheter and antibiotics can be a simple yet effective way in treating Bartholin’s abscess.

Aneurysmal Bone Cysts of the Craniofacial Origin: A Systematic Review.

ObjectiveAneurysmal bone cysts (ABCs) are blood-filled, locally destructive, benign bone tumors. Our objective was to conduct a systematic review outlining patient demographics, clinical characteristics, management, and outcomes of those with ABCs of the craniofacial bones.Data SourcesUsing PubMed, Cochrane, and Embase databases, 116 studies were included.Review MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic review was conducted. Data including patient demographics, clinical characteristics, treatment strategies, and patient outcomes were collected.ResultsA total of 127 patients from 116 studies were identified. Age ranged from 8 months to 90 years, with a mean age of 19.0 years. The most commonly affected craniofacial locations were the mandible (n = 31, 24.4%), temporal bone (n = 21, 16.5%), and occipital bone (n = 14, 11.0%). The most common presenting symptoms included a nontender mass (n = 51, 40.2%), a tender mass (n = 31, 24.4%), and generalized headache (n = 30, 23.6%). Imaging modalities included computed tomography (CT) and magnetic resonance imaging (MRI) (n = 77, 60.6%), CT alone (n = 31, 24.4%), and MRI alone (n = 8, 6.2%). All patients underwent surgical resection, with 1 patient requiring adjuvant radiation in addition to surgery. In total, 121 patients were disease-free and symptom-free without evidence of recurrence (17.4-month mean follow-up, 5.4 months average time to first recurrence).ConclusionThe current literature’s characterization of ABCs in craniofacial bones is limited to case reports and case series. Given the rarity of these tumors, head and neck surgeons may rely on systematic reviews such as the present analysis to guide management.

Xanthogranulomatous Breast Mass: An Unusual Presentation

Xanthogranulomatous inflammatory reactions are benign inflammatory processes characterized by aggregating lipid-laden foamy macrophages. Although cases have been reported in different organ systems, these rare reactions predominantly occur in the kidney and gallbladder. We present a 92-year-old female who noticed a palpable, tender mass in the lower inner quadrant of her right breast with no skin changes. She was referred to surgery by her primary care physician on suspicion of malignancy and further evaluation. Ultrasound-guided biopsy, ordered by the primary care provider, revealed a suspicious high-grade malignant neoplasm of uncertain origin. Pathological findings include the presence of an unusual population of malignant epithelioid cells with a striking xanthogranulomatous reaction, along with numerous Touton-like histiocytes. These findings are comparable in morphology to a recently reported xanthogranulomatous epithelial tumor. Given the lack of history of breast carcinoma in this patient as well as the lack of immunohistochemical studies suggesting breast carcinoma, treatment involved continuing standard of care for an unusual high-grade sarcoma via lumpectomy. A positron emission tomography (PET) scan was ordered to ensure there was no spread or alternate origins of the cancer tissue. This case report brings to light the findings of a probable xanthogranulomatous tumor in breast tissue, an exceptionally rare phenomenon in breast cancer, especially in the elderly population. Due to the rarity of xanthogranulomatous tumors in the breast, prognosis and standardized treatment have yet to be established.

A Woman with Painful Neck after COVID-19 Vaccination

A 31-year-old woman presented to the emergency department with progressive onset of left-side neck pain for 2 days. She had received the first dose of the Oxford-AstraZeneca (ChAdOx1 nCoV-19) COVID-19 vaccine in her left arm 1 week before. On physical examination, she was afebrile with normal vitals. Neck examination was remarkable for multiple palpable, mobile, tender masses. Point-of-care ultrasound of the left side of the neck was performed (Figure, Video E1 [available at http://www.annemergmed.com]).

Rectus Sheath Hematoma Secondary to Domestic Violence

Rectus sheath hematoma (RSH) is an infrequent condition that occurs when epigastric arteries bleed into the rectus sheath and sometimes acts like an acute abdomen. In view of the fact that it is a rare case without specific clinic signs, misdiagnosis and use of invasive manipulations for patients are possible. A 27-year-old woman applied to our clinic with abdominal pain, weakness, and nausea. Acute abdominal pain was in the periumbilical region and physical examination revealed tenderness, rebound phenomenon, and local mass in the right periumbilical region. Rectus sheath hematoma was identified by magnetic resonance imaging. The cause in this case was abdominal trauma due to domestic violence. After the legal procedures, symptomatic treatment was prescribed to the patient. Interestingly in this case, we did not get to the diagnosis through history, we reached the history after diagnosis. Besides the treatment of the patient, maybe our team prevented further violence against a woman.

Secretory carcinoma of salivary gland: a clinicopathological and prognostic analysis of twelve cases

Objective: To study the clinical manifestations, pathological features, molecular features, differential diagnosis and prognosis of secretory carcinoma of salivary gland (SCSG). Methods: Twelve cases of SCSG diagnosed in the Department of Pathology, the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019 were collected and analyzed in terms of histological morphology, immunohistochemistry (Envision method) and molecular detection. Results: Among the 12 patients, there were 6 males and 6 females, aged 12-67 years old, with a median age of 41.5 years. The lesions in 11 patients were located in the parotid gland. The maximum diameter of the tumors ranged from 0.8 to 5.5 cm. Clinically, slow-growing painless or tender mass was the first symptom, and all patients underwent surgical resection, among which 5 patients received postoperative radiotherapy and chemotherapy, and 1 patient developed local recurrence. Histopathologically, the tumor is characterized by microcystic, solid or tubular structures with unique intravitary homogeneous secretions. Immunohistochemistry showed diffuse expression of CK7, mammaglobin, GATA-3 and S-100 in all cases, and pan-Trk in 10 of the 12 cases. Sox-10 was expressed focally in 9 cases, and Ki-67 index was 5%-20%. In molecular detection, 11 cases had ETV6 gene break/fusion. Conclusions: SCSG is a relatively rare low-grade malignant salivary gland tumor, with typical histological morphology and immunophenotype, Pan-Trk immunohistochemistry may be related to NTRK fusion, ETV6-NTRK3 gene rearrangement is not only of diagnostic significance, but also Trk-targeted therapy is expected to play a greater role in clinical treatment.

Spontaneous giant rectus sheath hematoma in patients with COVID-19: two case reports and literature review

IntroductionCoronavirus disease 2019, COVID-19, as a global public health emergency, has come with a broad spectrum of clinical manifestations and complications. In this study, we present a unique complication of this disease.Presentation of cases(A) A 65-year-old woman with a known case of COVID-19; on the second day of admission, the patient presented sudden tachycardia and hypogastric pain; on abdomen physical examination, a huge lower abdominal tender mass was noticed. (B) A 50-year-old woman with COVID-19, 4 days after admission, started complaining of tachycardia, pain, and mass in the lower abdomen. On abdomen physical examination, a huge lower abdominal tender mass was noticed. Both of the patients underwent an abdomen CT scan which confirmed a huge rectus sheath hematoma (RSH). Both of the patients underwent angioembolization of the inferior epigastric artery. The patient recovered completely and no evidence of further expansion was seen after 2 weeks of follow-up.DiscussionHemorrhagic issues in COVID-19 patients remain poorly understood. Physicians should discuss risks of RSH in patients where continuous anticoagulation therapy will be reinstated. With increased clinician awareness of the need for RSH screening in COVID-19 patients with acute abdominal pain, the interprofessional team of healthcare providers can maximize patient safety and reduce hospitalization time, especially in high-risk patients at risk for unnecessary surgery.ConclusionsThese two reports and literature review demonstrate the need of active surveillance for possible hemorrhagic complications in patients with COVID-19 infection.

Rare cause of painless lower gastrointestinal bleeding: A case report.

Introduction and importanceEndometriosis is a complex disease in which an abnormal uterine lining-like estrogen-dependent cells settle outside the uterine cavity. Gastrointestinal tract is the commonly affected region in extragenital endometriosis.Case presentationA 44-year-old female patient suffering from intermittent hematochezia for the past three months was presented with no medical history or any other symptoms correlating with current complaints. Clinical examination showed the patient in good condition with soft abdomen without evidence of tenderness or palpable mass or any sign of haemorrhoids or fissures. Initial abdominal sonography revealed a 20 × 25 mm hypoechoic change in caecal region. Colonoscopic biopsies and histopathological examination revealed only colon mucosa with mucosal oedema and an unspecific inflammatory reactive regenerative polypoid with no evidence of tumor tissue adenoma. Intermittent hematochezia of the patient got worse in the following months without any other concurrent symptom. Laparoscopically assisted ileocecal resection with a sutured side-to-side ileoascendostomy was then performed. The patient was kept on enhanced recovery program and was discharged on the fourth post-operative day with analgesics.Clinical discussionPatients who present with diagnostic challenges or fails to respond to initial treatments for alternative gastrointestinal diagnoses (e.g., IBS), should be analyzed for endometriosis especially in patients with a history or risk factors including nulliparity, early menarche, haematocolpos, retrograde menstruation or even positive family history.ConclusionEndometriosis must be considered as a gastrointestinal pathology as much as gynecological one, and the gastrointestinal surgeons and physicians should be aware of its symptoms or presentation.

Neck Swelling and Fussiness in an 8-week-old Infant.

1. David S. Kim, MD* 2. Abiara V. Agwu, MD* 3. Carol J. Baker, MD* 1. *Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX An 8-week-old male infant presents to the emergency department with 5 days of constipation and recent onset of fussiness, decreased feeding, and a swelling in the right neck. No temperature abnormalities are reported. The medical history is significant for preterm birth at 30 5/7 weeks’ gestation (weight, 930 g) via cesarean delivery due to preeclampsia and partial placental abruption to a 33-year-old mother with an unknown group B Streptococcus (GBS) status. During his neonatal admission he received antibiotics for 48 hours after delivery for a sepsis evaluation and topical ciprofloxacin, which resolved an episode of undefined otorrhea. After an otherwise uneventful hospital course, he was discharged at age 6 weeks. On examination in the emergency department, the vital signs are as follows: temperature, 97°F (36.1°C); heart rate, 172 beats/min; respirations, 40 breaths/min; blood pressure, 94/58 mm Hg; oxygen saturation, 100%; and weight, 2,400 g. The infant is in mild distress. An approximately 1-cm tender mass is palpable in the right submandibular region without overlying erythema. The remainder of the physical examination findings are normal. He has a total leukocyte count of 10,100/µL (10.1×109/L) with 20% bands. The basic metabolic panel and urinalysis findings are normal. Ultrasonography of the neck demonstrates symmetrical enlargement of numerous lymph nodes bilaterally, measuring up to 7 mm in the short axis, and without a drainable fluid collection (Fig). An abdominal radiograph is normal. Fig. Ultrasonography of the neck performed at presentation highlighting two of the numerous enlarged lymph nodes that were present bilaterally. The size and number of lymph nodes were increased for age. A fluid bolus improves the heart rate and capillary refill. A single dose of clindamycin is administered for a presumptive diagnosis of bacterial lymphadenitis. Because the infant now appears well, clindamycin is discontinued. Sixteen hours later, the infant has increasing …

Treatment-Resistant Bacterial Lymphadenitis in an Otherwise Healthy Girl.

1. Oze Henig, MD*,† 2. Soma Jyonouchi, MD‡,§ 3. Torsten Joerger, MD¶ 4. Katie Kennedy, MD‡ 1. *Division of General Pediatrics 2. ‡Division of Allergy and Immunology, and 3. ¶Department of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia, PA 4. †Children’s Hospital of Philadelphia Inpatient Pediatrics at Virtua, Voorhees, NJ 5. §Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA A previously healthy 5-year-old girl presents to the pediatric emergency department of a community hospital with 3 days of fever and neck swelling. She reports pain when moving the neck upward and to the right, but there is no neck stiffness. On physical examination she has a temperature of 102.2°F (39°C) but is well appearing. She has a 2-cm, left-sided, mobile, tender mass along the anterior cervical chain and shotty lymphadenopathy of the right anterior cervical chain. She is diagnosed as having lymphadenitis and is discharged with a prescription for clindamycin. Despite consistently taking the antibiotic, she returns 3 days later with persistent fever and worsening swelling. On physical examination her left-sided swelling has increased to 3 cm, but she continues to have normal range of motion of her neck. A complete blood cell count reveals a white blood cell count of 11,000/µL (11×109/L); hemoglobin concentration, 9.0 g/dL (90 g/L); and platelet count, 424×103/µL (424×109/L). The differential cell count includes 63% neutrophils, 24% lymphocytes, 12% monocytes, and 1% eosinophils. Ultrasonography is performed and demonstrates 2 lymph nodes in the left cervical chain that seem reactive in nature and with no abscess formation. The patient is admitted on intravenous (IV) ampicillin-sulbactam for presumed outpatient treatment failure of acute lymphadenitis. However, her symptoms persist, and further testing is needed to reveal the etiology of her infection. While receiving IV ampicillin-sulbactam, the patient continued to have persistent fever. Serologic tests for Epstein-Barr virus, cytomegalovirus, and Bartonella henselae as well as a tuberculin skin test and rapid human immunodeficiency virus testing were negative. A chest radiograph showed no abnormality. After 10 days of fever with stable physical examination findings, otolaryngology performed an excisional biopsy, with resultant …

Thyroid Abscess Initially Presenting as Destructive Thyroiditis With Subsequent Hypothyroidism

Introduction: Due to its rich vascular supply and high iodine content infection of the thyroid gland is rare and is uncommonly associated with hyperthyroidism. We report a case of a thyroid abscess presenting with hyperthyroidism with subsequent hypothyroidism in an immunocompetent patient. Clinical Case: A 34-year old female with no past medical history presented with an enlarging neck mass associated with worsening, non-radiating throat pain of three-week duration associated with dysphagia. She reports 15-lb weight loss and palpitations. On presentation vital signs were within normal range. Physical examination revealed a diffusely tender anterior neck mass. Her thyroid function tests revealed TSH 0.01 uIU/mL (0.358-3.74), FT4 2.4 ng/dL (0.76-1.46), TSI <0.10 IU/L (0.00-0.55), TPO 12 IU/mL (0-34). Laboratory workup was also significant for leukocytosis, thrombocytosis, and hyponatremia. Thyroid ultrasound revealed a large, irregularly shaped, multiloculated fluid collection involving both lobes measuring 6.4 x 4.8 x 2.0 cm. She was started on Vancomycin and Ampicillin/Sulbactam, Metoprolol, and Methimazole. Needle aspiration of 30 cc of purulent material was performed with culture showing a heavy growth of streptococcus constellatus sensitive to penicillin. After a 4-day inpatient stay, she was discharged with Amoxicillin/Clauvanate as well as Methimazole 10mg BID. Ten days after being discharged, the patient again presented to the emergency department with complaint that the neck mass had increased in size. CT neck showed a 5.1 x 2.8 x 0.8 cm lobulated fluid collection. CT-guided drainage was performed, cytology and wound culture were found to be unremarkable. Thyroid function tests revealed she was hypothyroid with TSH 31.157 uIU/mL and FT4 of 0.72 ng/dL. Upon discharge, Methimazole was discontinued and she was started on Levothyroxine 75 mcg daily. Due to failure of prior antibiotics, she received a 14-day course of IV Ceftriaxone. Outpatient follow-up eight weeks later showed she was euthyroid on Levothyroxine 75 mcg with ultrasound revealing small thyroid gland with resolution of the abscess. Conclusion: Hyperthyroidism in the setting thyroid abscess is secondary to destructive thyroiditis. As there is no increase in thyroid hormone synthesis, there is no role for treatment with antithyroid medication. Symptomatic control with beta-blocker, surgical drainage, and IV antibiotics are recommended for cases of thyroid abscesses. If infection persists or extensive necrosis develops, thyroidectomy may be indicated. Hypothyroidism can be a consequence of destructive thyroiditis as was seen in this patient.

DIAGNOSTIC DILEMMA AND TREATMENT CHALLENGES IN IDIOPATHIC GRANULOMATOUS MASTITIS

Objective: To outline diagnostic difficulties and problems in the treatment of Idiopathic Granulomatous Mastitis&#x0D; Study Design: Prospective observational study.&#x0D; Place and Duration of Study: Breast clinic, Combined Military Hospital Rawalpindi, from Aug 2019 to Jul 2020.&#x0D; Methodology: Patients with tender mass with or without signs of inflammation, mass with abscess, sinus formation, and with recurrent abscesses were included. Those cases were labelled as IGM whose histopathology showed granulomatous mastitis with no evidence of malignancy and tissue cultures were negative. Patients with mild to moderate symptoms were treated with reassurance, analgesia and multivitamins. Abscesses were treated with incision &amp; drainage and empirical antibiotics for 1-2 weeks. All these patients were followed at 1, 3, 6 and 12 months.&#x0D; Results: A total of 35 patients fulfilled the criteria for Idiopathic Granulomatous Mastitis and were included in the study. Two patients had lactational abscess, 3 had bilateral disease and 1 patient was with diabetes 0% patients were having mass with abscess; spontaneous resolution was observed in majority of them with a few requiring incision and drainage. Of 31.4% presented with tender mass only; majority of them resolved with observation, except mass excision in two patients, 19.7% presented with discharging sinuses with underlying mass; among them 71% responded to conservative treatment while 29% were treated with anti-tuberculous therapy for recurrent sinuses. 8.5% presented with spontaneously ruptured abscesses with sinuses; they were managed conservatively.&#x0D; Conclusion: We concluded that Idiopathic Granulomatous Mastitisis a benign self-limiting disease which can be effectively managed with conservative treatment.

Man With Abdominal Pain

A 40-year-old man with a history of hypertension presented to the emergency department (ED) with sudden-onset central abdominal pain and a new supraumbilical bulge. Vital signs were normal other than a blood pressure of 182/115 mm Hg. Abdominal examination revealed a firm, tender mass, but was otherwise benign. Laboratory studies revealed a normal leukocyte count of 6,000 cells/μL and lactate level of 1.7 mmol/L. Point-of-care ultrasonography showed a bowel loop in the subcutaneous tissue, protruding through a fascial defect (Figure 1).

Extrahepatic hepatoblastoma- an extremely rare occurrence

Abstract 6 year old presented with hard non tender mass in epigastric region. On radiological examination a well defined mass was seen in the lesser sac without the liver involvement. On histopathological evaluation by trucut biopsy, diagnosis of extrahepatic hepatoblastoma was made. The boy underwent 4 cycles of neoadjuvant chemotherapy which caused the tumor to shrink by 40%. The patient underwent resection of tumor without any complications. The post-operative histopathology also revealed Hepatoblastoma (Fetal type). The patient underwent post operative chemotherapy and has an event free survival of 6 months till now. We present this case, as to the best of our knowledge; this is a rare case of isolated hepatoblastoma arising from extrahepatic tissue.

De Garengeot Hernia: Case Report and Review of the Literature of a Rare Femoral Hernia

De Garengeot hernia is a rare femoral hernia defined as the presence of the appendix within the femoral hernia sac. The incidence of appendicitis in this type of hernia is a rare condition that accounts for 0.08–0.13% of all De Garengeot hernias. We describe the case of a 61-year-old woman that presented at the emergency department with a tender mass (diameter 10 × 8 cm) in the right groin region for 5 days associated with pain in lower right abdomen and accompanied by fever (38 °C). Computed tomography (CT) of the abdomen revealed the presence of a complex fluid collection with small foci of air in the right inguinal region, measuring 9 × 7 × 10 cm in the 3 orthogonal dimensions and a blind ending tubular structure extending from the caecal base into the groin mass through a narrowed neck defect, medial to the common femoral vessels. The CT scan demonstrated the suspected diagnosis of De Garengeot hernia complicated by acute appendicitis. The intra-operative findings confirmed the diagnosis. The patient was successfully managed operatively. The surgical strategy took into account the need to significantly reduce the diffusion of the infection inside the abdominal cavity. The patient was discharged on the fifth postoperative day without peri-/postoperative complications.

A Rare Case Report of Adenolipoma of the Breast

We report a 40-year-old woman with a mobile, non tender and firm mass, 12 × 8 cm, in the lower outer quadrant of the right breast of 5 years duration. Mammography images demonstrated a well-defined mass with mixed granular and fat density. Histopathology of the excised mass revealed well-circumscribed lobules of ducts and glandular structures haphazardly embedded in mature fatty tissue. Breast hamartoma should be differentiated from other benign lesions of the breast. Awareness among radiologists and pathologists of this benign lesion would help avoid an incorrect diagnosis and unnecessary intervention.

Young Woman With Neck Pain

A 20-year-old woman with no past medical history presented with 15 days of right-sided neck swelling and pain. She denied any trauma and had received a diagnosis of cervical strain 12 days earlier. Of note, she started taking oral contraceptives 3 months ago. Her vital signs were normal. On examination, there was a tender mass on the right anterolateral neck without erythema, fluctuance, soft tissue swelling, or facial plethora. Examination of the upper extremities and cardiopulmonary systems was normal.

A Rare Presentation of Partial Segmental Thrombosis of the Corpus Cavernosum Secondary to Sickle Cell Anemia

Background: Partial segmental thrombosis of the corpus cavernosum, known as partial priapism, is an uncommon urological condition which predominantly affects young men in which the proximal part of one corpus cavernosum is thrombosed. Many risk factors have been described in the literature, however, the exact etiology of penile thrombosis and its pathogenesis remains unclear. Several treatment options are available ranging from conservative medical treatment, surgical intervention, or simple follow-up observation without treatment. Aim: In this study, we describe a patient with sickle cell anemia who presented with pain and a perineal swelling that was eventually diagnosed as partial priapism utilizing MRI scan and was treated conservatively with a successful outcome. We then performed a literature search of similar cases highlighting incidence, risk factors and management of this rare presentation. Case Presentation: A 23-year-old male who is known with sickle cell anemia presented to casualty with a 1-day history of perineal pain of a sudden onset associated with perineal swelling and vomiting. Genitourinary exam findings confirmed the absence of classic priapism. Careful examination of his perineal area revealed the presence of a fixed, hard, and tender mass at the proximal part of the penis. It was not attached to the overlying skin and no enlarged pelvic lymph nodes were felt. Once stabilized, MRI of the pelvis was performed showing right intra-tunical corpus cavernosum features suggestive of hematoma in keeping with partial segmental thrombosis of the corpus cavernosum. Conservative treatment was initiated, and the patient was managed expectantly in which he improved gradually with eventual disappearance of the perineal mass. Conclusion: Partial segmental thrombosis of the corpus cavernosum is a rare urological condition. Pathogenesis and etiologies are poorly understood but risk factors have been advocated of which sickle cell anemia is one of them. MRI has a crucial role in the diagnosis under this condition. Conservative treatment appears to be a reliable initial therapeutic option.