Absceso del psoas ilíaco secundario a un tumor de colon izquierdo fistulizado al retroperitoneo: caso clínico y análisis de la literatura / Iliopsoas abscess resulting from penetrating left colon cancer to the retroperitoneum: case report and literature review / Abscesso do iliopsoas secundário a tumor de cólon esquerdo fistulizado para o retroperitônio: caso clínico e análise da literatura

Los abscesos del psoas ilíaco secundarios a un tumor de colon fistulizado son excepcionales y potencialmente graves. La mayoría son adenocarcinomas de tipo mucinoso. Su tratamiento es complejo ya que, para lograr una resección oncológica pretendidamente curativa, es necesario realizar una resección ampliada con mayor morbimortalidad. Presentamos el caso de una paciente con un adenocarcinoma mucinoso de colon izquierdo fistulizado al músculo ilíaco y la pared anterolateral del abdomen en la que se realizó una resección multivisceral que incluyó el colon izquierdo, el músculo y la cresta ilíaca y parte de la pared anterolateral del abdomen.

Iliopsoas abscess secondary to perforation of colon cancer is an extremely rare and potentially life-threatening condition. Most tumors are mucinous adenocarcinomas. Its treatment its complex, as most patients need radical extended resections to achieve good oncological results, which are in turn, graved with higher morbidity and mortality. We present the case of a patient with a left colon mucinous adenocarcinoma penetrating to the iliopsoas muscle and the anterolateral abdominal wall that required a multivisceral resection including left colon, iliac muscle and crest and part of the anterolateral abdominal wall.

Abscessos do iliopsoas secundários a um tumor de cólon fistulizado são raros e potencialmente graves. A maioria são adenocarcinomas do tipo mucinoso. Seu tratamento é complexo, pois, para se obter uma ressecção oncológica supostamente curativa, é necessário realizar uma ressecção ampliada com maior morbimortalidade. Apresentamos o caso de um paciente com adenocarcinoma mucinoso de cólon esquerdo fistulizado para o músculo ilíaco e parede ântero-lateral do abdome no qual foi realizada ressecção multivisceral que incluiu cólon esquerdo, músculo e crista ilíaca e parte do a parede anterolateral do abdome.

Diverticulitis apendicular, como diagnóstico diferencial / Appendiceal diverticulitis as differential diagnosis

RESUMEN La diverticulitis apendicular (DA) es una patología poco frecuente, considerada clínicamente indistinguible de la apendicitis aguda, aunque podría presentar una sintomatología más leve. Este es el caso de un paciente masculino de 59 años, que concurre al Servicio de Urgencias presentando signos y síntomas sugestivos de una apendicitis aguda; una ecografía informa un asa tubular parcialmente compresible de 7,8 mm de diámetro y una fina banda de líquido laminar, compatible con proceso apendicular agudo. La apendicectomía se realizó de manera convencional evidenciándose un apéndice inflamado principalmente en su región distal. La histología reveló diverticulitis apendicular complicada con rotura. El paciente evolucionó favorablemente y se externó a las 24 horas. Existe una asociación de DA y neoplasia apendicular, por lo que se recomienda una colonoscopia y el seguimiento de este tipo de pacientes.

ABSTRACT Appendiceal diverticulitis (AD) is a rare condition considered clinically identical to acute appendicitis although it may present milder symptoms. We report the case of a 59-year-old male patient who visited the emergency department due to signs and symptoms suggestive of acute appendicitis. An abdominal ultrasound showed partially compressible tubular loop with a diameter of 7.8 mm and a thin band of laminar fluid, consistent with acute appendiceal process. During conventional appendectomy the appendix had signs of inflammation, mainly in the distal region. The histology revealed appendiceal diverticulitis complicated with rupture. The patient had favorable outcome and was discharged 24 hours later. As, there is a clear association between AD and appendiceal neoplasms, colonoscopy and patient monitoring is recommended.

Neoplasia Mucinosa de apéndice. Abordaje laparoscópico. Reporte de caso / Neoplastic appendiceal mucinous lesion. Laparoscopic approach. Case report

El mucocele apendicular es la dilatación quística del apéndice con acumulación de material mucinoso. Su forma de presentación más frecuente es dolor en fosa ilíaca derecha, sin embargo, la mitad de los casos son asintomáticos. En el presente trabajo se presenta caso de un paciente con diagnóstico incidental de mucocele apendicular, al cual se le realizó apendicectomía laparoscópica como tratamiento definitivo. Caso clínico: Paciente masculino de 44 años sin antecedentes patológicos conocidos, quien se realiza ultrasonido abdominal que informa tumor quístico en fosa ilíaca derecha. Se decide resolución quirúrgica laparoscópica. Informe histológico: mucocele apendicular sin evidencia de malignidad y recuperación satisfactoria del paciente. Conclusión: La neoplasia mucinosa del apéndice es una patología poco frecuente, puede presentarse con una variedad de manifestaciones clínicas hasta un hallazgo incidental. El tratamiento es fundamentalmente quirúrgico y el abordaje laparoscópico es de elección en pacientes sin evidencia de ruptura y diseminación de la enfermedad(AU)

The appendicular mucocele is a cystic dilation of the appendix with accumulation of mucinous material. The most frequent form of presentation is pain in the right iliac fossa; however, half of the cases are asymptomatic patients. In the present work we present a case of a patient with an incidentally diagnosis of appendicular mucocele who underwent laparoscopic appendectomy as definitive treatment. Clinical case: A 44-year-old male patient with no known pathological history, who underwent an abdominal ultrasound that reported a cystic tumor in the right iliac fossa. Laparoscopic surgical resolution was decided, the histological examination revealed appendicular mucocele without evidence of malignancy and satisfactory recovery of the patient. Conclusion: Mucinous neoplasia of the appendix is an uncommon pathology, patients are often asymptomatic or have nonspecific symptoms, and the diagnosis is made incidentally in the course of other examination. Treatment is primarily surgical and the laparoscopic approach is the choice in patients without evidence of rupture and dissemination of the disease(AU)

Proximal type of epithelioid sarcoma: a rare aggressive tumor presenting simultaneously in spine and pelvis

A 40-year-old female presented with bilateral lower limb weakness with bladder and bowel incontinence. MRI study revealed a destructive lesion involving the D7 vertebral body and a large tumor in the gluteal muscles invading the right iliac blade. A histological examination demonstrated a tumor comprising of rounded to ovoid pleomorphic epithelioid cells with marked cytological atypia. Tumor cells expressed CD 34, vimentin and focally pancytokeratin but were negative for CD31, EMA, SMA, WT1 and LCA. A D6-7 laminectomy with posterior decompression was done. Postoperatively, external beam radiotherapy was given. However, the patient deteriorated rapidly with no neurological improvement. Epitheiliod sarcomas and their recently described proximal variant, by virtue of being an exceedingly unusual tumor are often misdiagnosed or diagnosed late beyond the stage of salvage. This report highlights the histopathology and that need to be analyzed to correctly diagnose this entity

Primary hydatid disease of the ilium: a case report

Bone hydatid disease is endemic in several regions worldwide and lacks a typical clinical appearance and image characteristics; therefore, its diagnosis is very difficult. A 49-year-old rural woman was referred with purulent discharge from sinus tract in the left ilium. X-ray and CT scan showed multiple lytic lesions with cortical destruction. She was scheduled for sequestrectomy with impression of chronic osteomyelitis but destroyed hydatid cysts were detected intraoperatively. Iliac wing excision from the iliac crest to the sacroiliac joint and supraacetabulum area was performed. Pathologic findings were in favor of bone hydatidosis. Postoperatively, albendazole and antibiotics were prescribed

Large iliac aneurysmal bone cyst

Aneurysmal bone cyst is a tumour occurring in the younger age group. Here we report a case of an aneurysmal bone cyst in the ilium in a middle aged male patient. This is the first reported case in English literature of aneurysmal bone cyst of the ilium in a middle-aged male. Review of literature and the problems in the management of such a large tumour of the ilium are discussed

Sacro-iliac tuberculosis presenting as cauda equina syndrome

Tuberculosis affecting the bone and spine has been a common problem in the developing countries for quite some time. Though the incidence has decreased dramatically, it still continues to be an important differential diagnosis in certain clinical situations. We hereby describe a patient who presented with features of cauda equine syndrome; the diagnosis was ultimately tuberculosis primarily involving the sacroiliac joint extending through the neural foramen and causing extradural compression

[Iliac chondroma: a case report]

Chondroma Is a benign bone tumour that usually occurs in the in carpal and phalangeal bones. The iliac involvement is very rare and should be differentiated from Chondrosarcoma The authors report a case of Iliac chondroma revealed by an acetabular lytic area in a l3-year-old girl. The diagnosis of chondroma was confirmed after surgical biopsy

Alterações ilíacas que influenciam na condromalácia patelar / Iliac alterations that influence on chondromalacia of the patella

As alterações na cintura pélvica em especial no ilíaco tem sido amplamene relacionadas com as compressões patelares. Deste modo, a finalidade deste estudo é fazer uma revisão sobre os efeitos da anterioridade,posterioridade, abertura e fechamento do ilíaco e suas consequências sobre a articulação patelofemural, tal como as compressões. Observou-se que estando o ilíaco em alteração por um tempo relativamente grande levará a disfunções biomecânicas da patela, tendo como uma de suas consequências, a condromalácia patelar.

Osteíte condensante de ílio ou sacroiliite? Relato de dois casos / Osteitis condensans ilii or sacroiliitis? Report on two cases

Os autores relatam dois casos clínicos de osteíte condensante de ílio com confirmação diagnóstica por tomografia computadorizada de articulação sacroilíaca. O quadro clínico dos dois pacientes sugeria sacroiliite, mas a investigação diagnóstica demonstrou a presença de osteíte condensante de ílio. São discutidos os aspectos clínicos e radiológicos que envolvem o diagnóstico diferencial desta entidade, com a demonstração dos achados da radiografia simples e da tomografia computadorizada das articulações sacroilíacas

Herniation through iliac crest bone graft donor site: case reports

Herniation through Iliac crest bone graft donor site is one of the rare acquired hernias. Only few hundred individual case reports have been published world wide. Left over rigid bony rim of remaining ala of ilium has been labelled as the main factor in development of the hernia. We are reporting our experience employing synthetic mesh for repair in two cases of herniation through large defects in iliac bone produced after use of a full thickness bone graft from that site. Creation of diaphragm by Merseline mesh and soft tissue imbrication over that resulted in satisfactory repair. No recurrence is seen during the two years followup

Osteoma osteóide no osso ilíaco: relato de caso / Osteoid osteoma in the iliac bone: a case report

Osteoma osteóide envolvendo o osso ilíaco é freqüente. Os autores relatam o caso de um paciente masculino, 21 anos, com diagnóstico de osteoma osteóide localizado no osso ilíaco à direita com queixa de dor local, mais intensa à noite, que era aliviada por repouso e analgésicos, quadro durando dois anos até o diagnóstico final. No exame radiográfico notou-se lesäo de 2cm de diâmetro, cercada por uma esclerose óssea junto à articulaçäo sacroilíaca direita. O paciente foi tratado cirurgicamente com exicisäo do nidus. Os resultados histopatológicos confirmaram a doença. Três anos após a cirurgia o paciente está assintomático. Os autores analisam as dificuldades diagnósticas da lesäo devido à localizaçäo inusual no osso ilíaco, comparando com a literatura e destacando os diagnósticos diferenciais relacionados a dores em pacientes jovens.

Total innominatectomy for chondrosarcoma innominate.

Internal hemipelvectomy or innominatectomy is a preferred alternative to hindquarter amputation for malignant tumours of the pelvis. Various segments of the pelvis have been removed surgically leaving the lower limb with residual segments of the pelvis in treatment of such tumours. We herewith present a case of total innominatectomy, i.e. dis-articulation at the pubic symphysis and sacroiliac joint for surgical clearance and treatment of a chondrosarcoma of the Innominate bone. The tumour extended from just in front of the sacroiliac joint to the ischium and warranted such a complete resection.

Bilateral proptosis due to metastatic Ewing's sarcoma of the orbit: fine needle aspiration cytology (FNAC) and histopathology of a case.

Bilateral proptosis due to metastatic Ewing's sarcoma is an extremely rare presentation and thus merits reporting. The role of fine needle aspiration cytology in the diagnosis is highlighted.

Giant cell tumour of ilium.

Most common tumours of ilium are chondrosarcoma and reticulum cell sarcoma. Giant cell tumour commonly presents at the ends of long bones. It is quite uncommon to find osteoclastoma in flat bones, especially ilium. This is the only case of osteoclastoma of ilium seen during the last 7 years in this institution and is reported for its rarity.

Dual Fluid Levels in an Aneurysmal Bone Cyst: Sonographic Featuers

Although ultrasound has not been used to clarify bone lesions because of their high acoustic impendence and attenuation coefficient, aneurysmal bone cyst of the pelvis was imaged with ultrasound. Dual fluid levels and multiple loculations were discovered by ultrasound imaging through thin cortical bone. Ultrasonography is a simple, non-invasive method which can be utilized to detect bony lesions of an expansile nature and reveal characteric findings in an aneurysmal bone cyst.