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Autops. Case Rep ; 11: e2020239, 2021. graf
Article in English | LILACS | ID: biblio-1153181


The gluteal region contains important neurovascular and muscular structures with diverse clinical and surgical implications. This paper aims to describe and discuss the clinical importance of a unique variation involving not only the piriformis, gluteus medius, gluteus minimus, obturator internus, and superior gemellus muscles, but also the superior gluteal neurovascular bundle, and sciatic nerve. A routine dissection of a right hemipelvis and its gluteal region of a male cadaver fixed in 10% formalin was performed. During dissection, it was observed a rare presentation of the absence of the piriformis muscle, associated with a tendon fusion between gluteus and obturator internus, and a fusion between gluteus minimus and superior gemellus muscles, along with an unusual topography with the sciatic nerve, which passed through these group of fused muscles. This rare variation stands out with clinical manifestations that are not fully established. Knowing this anatomy is essential to avoid surgical iatrogeny.

Humans , Male , Adult , Buttocks/pathology , Piriformis Muscle Syndrome/complications , Anatomic Variation , Sciatic Nerve , Tendons , Dissection , Muscles/abnormalities
An. bras. dermatol ; 92(4): 546-549, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-886990


Abstract: Liposarcomas correspond to the most common histological subtype of soft tissue sarcomas. They can be subdivided into: well differentiated or atypical lipoma, undifferentiated, myxoid, round, and pleomorphic cells. Atypical lipomas are the most prevalent and usually appear as asymptomatic softened tumors. They are locally aggressive but rarely lead to distant metastases. The diagnosis of this tumor is based on the imaging and histopathologic findings. Treatment consists of excision surgery with complete tumor removal. It has a good prognosis due to the low percentage of distant metastases. We report a rare case of giant atypical lipoma as well as the adopted therapy and evolution.

Humans , Male , Adult , Soft Tissue Neoplasms/pathology , Lipoma/pathology , Liposarcoma/pathology , Soft Tissue Neoplasms/surgery , Soft Tissue Neoplasms/diagnosis , Biopsy , Buttocks/pathology , Diagnosis, Differential , Lipoma/surgery , Lipoma/diagnosis , Liposarcoma/surgery , Liposarcoma/diagnosis
An. bras. dermatol ; 91(5,supl.1): 134-136, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837928


Abstract Porokeratosis is a skin disorder clinically characterized by annular plaques with keratotic borders resembling the Great Wall of China and histopathologically by cornoid lamellae. The disease has several clinical variants. Porokeratosis ptychotropica, which has recently become part of these variants, is quite rare and little known. The entity is characterized by verrucous plaques – which may resemble a psoriasis plaque – that affect the regions of the buttocks, most commonly the gluteal cleft, with or without extremity involvement. Itching is often present. We report a rare case of porokeratosis ptychotropica and highlight its unusual manifestation (single plaque), the first case reported in the Brazilian literature.

Humans , Male , Young Adult , Skin/pathology , Porokeratosis/pathology , Pruritus , Biopsy , Brazil , Buttocks/pathology , Erythema/pathology
An. bras. dermatol ; 91(4): 496-498, July-Aug. 2016. graf
Article in English | LILACS | ID: lil-792442


Abstract: Porokeratosis is a disorder of epidermal keratinization characterized clinically by a distinctive ridge-like border, and histologically by cornoid lamellae. The known clinical variants of porokeratosis are: classic porokeratosis of Mibelli, disseminated superficial (actinic) porokeratosis (DSAP), porokeratosis palmaris et plantaris disseminata, linear porokeratosis and punctate porokeratosis. In 1995, a seventh form was described as porokeratosis ptychotropica: a verrucous form resembling psoriasis involving the gluteal cleft presenting on the histological exam multiple cornoid lamellae. There are very few reports in the literature of this clinical variant. The present study describes the case of a healthy male presenting gluteal hyperkeratotic plaques for 22 years. He had been to several dermatologists, none of them had achieved a definitive diagnosis. We present a typical clinical presentation and its dermoscopy findings, in addition to histological examination that confirmed the diagnosis.

Humans , Male , Adult , Buttocks/pathology , Porokeratosis/pathology , Biopsy , Dermoscopy/methods
Article in English | IMSEAR | ID: sea-159394


Pleomorphic hyalinizing angiectatic tumor (PHAT) is relatively a new entity that was described first in 1996. Although it is often confused with neurilemmoma and low grade malignant fibrous histiocytoma, it is considered to be a distinctive neoplasm because of certain unique microscopic and immunohistochemical findings. It is a low grade, slowly growing tumor that recurs after surgical removal in about a third of all cases. It is not known to metastasize. In this review, we have immunohistochemically analyzed a case of gluteal soft tissue tumor in a 22-year-old woman using CD 34, CD 68, CD 99, S100 and desmin. Classical histological features and positivity for only CD 34 helped in establishing the diagnosis as PHAT. We have reviewed the available literature.

Antigens, CD34/analysis , Buttocks/pathology , Female , Humans , Hyalin/pathology , Immunohistochemistry/methods , Review Literature as Topic , Soft Tissue Neoplasms/chemistry , Soft Tissue Neoplasms/immunology , Biomarkers, Tumor/metabolism , Young Adult
Rev. bras. cir. plást ; 29(2): 303-308, apr.-jun. 2014. ilus
Article in English, Portuguese | LILACS | ID: biblio-601


Introdução: As nádegas são constituídas por músculos responsáveis por movimentos das pernas, assumindo o músculo glúteo máximo o volume principal. Possuem uma função secundária, de cunho sexual, como zona erógena. O maior volume de nádegas desperta maior atenção e desejo sexual, o que tem levado a um aumento da procura pela cirurgia de gluteoplastia de aumento com utilização de implantes de silicone. Os implantes glúteos proporcionam uma remodelagem e aumento efetivo das nádegas que nem sempre são obtidos por outros métodos. Existem quatro planos para a colocação dos implantes glúteos: subcutâneo, subfascial, intramuscular e submuscular. Atualmente, há uma discussão sobre a posição ideal dos implantes glúteos, com defensores tanto do plano subfascial quanto intramuscular. O objetivo deste estudo foi apresentar as técnicas publicadas de gluetoplastia de aumento, que utilizam o plano intramuscular para acomodação dos implantes, e avaliar a satisfação com os resultados, assim como a segurança, a aplicabilidade e a reprodutibilidade dos procedimentos. Métodos: Este estudo constitui-se de uma revisão de literatura, elaborada através de uma pesquisa eletrônica de literatura, em novembro de 2011, através dos bancos de dados MEDLINE. As complicações imediatas mais frequentes são dor, deiscência da ferida, seroma e infecção. Resultados: Houve grande satisfação dos pacientes. A técnica XYZ, através da marcação de pontos de referências anatômicas para guiar a dissecção intramuscular no plano correto, permite uma compreensão necessária para reproduzi-las e evitar complicações como implantes visíveis e palpáveis. Conclusão: Este procedimento tem se mostrado um método que produz resultados muito naturais e de longa duração, com baixas taxas de complicações.

Introduction: The buttocks are composed of muscles that control leg movement, with the gluteus maximus muscle playing an important role. In addition, as an erogenous zone, they are associated with sex-related function. Voluminous buttocks incite greater scrutiny and sexual desire, which has increased the demand for augmentation gluteoplasty with the use of silicone implants. Gluteal implants allow for effective reshaping and augmentation of the buttocks, in sharp contrast with the results obtained with other techniques. The implant pockets can be inserted in four different planes, namely the subcutaneous, subfascial, intramuscular, and submuscular planes. The ideal location of the gluteal implant is currently controversial, with arguments in favor of both the subfascial and intramuscular planes. The aims of this study were to introduce gluteoplasty techniques described in the literature that use the intramuscular plane as the implant insertion route and to determine the degree of patient satisfaction with results, as well the safety, applicability, and reproducibility of the technical procedures. Methods: This literature review is based on online electronic searches on the MEDLINE database in November 2011. The most frequently described immediate adverse effects of the technique include pain, wound dehiscence, seroma, and infection. Results: The patients were greatly satisfied. The XYZ procedure, which includes marking anatomical reference points to guide the intramuscular dissection, provides technical insight that ensures reproducible results and prevents complications such as palpable or perceptible implants. Conclusion: This procedure has been demonstrated to produce natural and satisfactory results, with low complication rates.

Humans , Female , History, 21st Century , Postoperative Complications , Prostheses and Implants , Surgery, Plastic , Buttocks , Review Literature as Topic , Retrospective Studies , Tissue Transplantation , Evaluation Study , Postoperative Complications/surgery , Prostheses and Implants/standards , Surgery, Plastic/methods , Buttocks/surgery , Buttocks/pathology , Tissue Transplantation/methods
Rev. chil. neurocir ; 40(2): 117-118, 2014. ilus
Article in English | LILACS | ID: biblio-997453


Sciatic pain is a disabling pathology that can have various etiologies, but is rarely described as caused by an intermuscular gluteal lipoma. The authors describe a patient with a progressively worsening right sciatic pain for 6 months and with walking difficulty for 3 months. Magnetic resonance imaging (MRI) showed an expansive process compatible with lipoma between the gluteus maximus and medius, which was completely removed without sciatic nerve injury. After surgery, the patient is asymptomatic. This is an unusual case and represents an important differential diagnosis that should be considered in sciatic pain patients

El dolor ciático es una patología inhabilitante que puede tener diversas etiologías, pero rara vez se describe como causada por un lipoma glúteo intermuscular. Los autores describen a un paciente con un dolor ciática derecha que empeora progresivamente durante 6 meses y con dificultad para caminar durante 3 meses. La resonancia magnética (RM) mostró un proceso expansivo compatible con lipoma entre el gluteo máximo, y el glúteo medio. El lipoma fue retirado por completo y sin lesión del nervio ciático. Después de la cirugía, el paciente está asintomático. Este es un caso inusual y representa un importante diagnóstico diferencial que debe ser considerado en los pacientes con ciática

Humans , Sciatica/diagnosis , Sciatica/etiology , Low Back Pain , Intervertebral Disc Displacement , Lipoma/surgery , Lipoma/diagnosis , Buttocks/pathology , Magnetic Resonance Spectroscopy , Electromyography
An. bras. dermatol ; 88(5): 820-822, out. 2013. graf
Article in English | LILACS | ID: lil-689717


The authors report a case of ectopic cutaneous schistosomiasis in a 35 year-old female who presented clustered reddish macules and papules on the left buttock. The diagnosis was not suspected during clinical evaluation and required visualization of Schistosoma mansoni eggs on sections of tissue.

Os autores relatam um caso de esquistossomose cutânea ectópica em uma paciente de 35 anos que apresentou máculas e pápulas eritematosas agrupadas na nádega esquerda. O diagnostico não foi suspeitado durante a avaliação clínica, tendo sido obtido através da visualização dos ovos no exame histopatológico.

Adult , Female , Humans , Schistosomiasis/pathology , Skin Diseases, Parasitic/pathology , Buttocks/pathology , Parasite Egg Count
An. bras. dermatol ; 88(3): 438-440, jun. 2013. graf
Article in English | LILACS | ID: lil-676229


We report the case of a patient diagnosed with genitogluteal porokeratosis, a disorder of epidermal keratinization. The location described is extremely rare and very often late diagnosed or even misdiagnosed. Histopathology showed a typical cornoid lamella of great value to support this diagnosis. The importance of awareness of this entity by the specialist is emphasized as a differential diagnosis among genital diseases of chronic evolution and difficult treatment.

Relata-se o caso de um paciente com diagnóstico de poroqueratose genitoglútea, uma desordem da queratinização epidérmica, cuja localização exclusiva é extremamente rara, sendo muitas vezes tardia ou erroneamente diagnosticada. A histopatologia demonstra a clássica lamela cornóide, de grande valia para elucidação diagnóstica. Ressalta-se a importância do conhecimento desta entidade pelo especialista como diagnóstico diferencial entre as afecções genitais de evolução arrastada e de difícil tratamento.

Adult , Humans , Male , Porokeratosis/pathology , Buttocks/pathology , Diagnosis, Differential , Groin/pathology , Scrotum/pathology
An. bras. dermatol ; 86(4,supl.1): 190-192, jul,-ago. 2011. ilus
Article in Portuguese | LILACS | ID: lil-604156


Tumor triquilemal proliferante é uma neoplasia incomum que surge do istmo folicular, cuja característica histológica é a presença de ceratinização triquilemal. Apresenta-se usualmente como nódulo solitário no couro cabeludo de mulheres idosas. Descreve-se um caso de tumor triquilemal proliferante que se apresenta como lesão tumoral nodular na região glútea de uma jovem de 16 anos de idade.

Proliferating trichilemmal tumor (PTT) is an uncommon neoplasm arising from the follicular isthmus. Its histological characteristic is the presence of trichilemmal keratinization. PTT usually presents as a solitary nodule on the scalp of elderly women. We describe a case of a PTT on the gluteal region (buttocks) of a 16-year-old female, presenting as a solitary nodule.

Adolescent , Female , Humans , Epidermal Cyst/pathology , Skin Neoplasms/pathology , Buttocks/pathology , Epidermal Cyst/surgery , Skin Neoplasms/surgery
Indian J Pathol Microbiol ; 2011 Apr-Jun 54(2): 391-393
Article in English | IMSEAR | ID: sea-142006


A 40-year-old woman presented with a 1 year history of a painless, subcutaneous lump on the right buttock. Clinical examination showed an approximately 6 cm large subcutaneous mass covered by apparently normal-looking skin. No inguinal lymphadenopathy was found. The mass was excised with the clinical diagnosis of fibroma. Histologically, the lesion was consistent with mammary-type myofibroblastoma of soft tissue, a very rare, benign mesenchymal neoplasm with myofibroblastic differentiation. After surgical excision she was free of recurrence over a period of 8 months. This article also challenges the theory that suggests the origin of this tumor to be from the embryonic mammary tissue, adding another case of a site other than the milk lines.

Adult , Buttocks/pathology , Buttocks/surgery , Female , Histocytochemistry , Humans , Immunohistochemistry , Microscopy , Neoplasms, Muscle Tissue/diagnosis , Neoplasms, Muscle Tissue/pathology , Neoplasms, Muscle Tissue/surgery , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/pathology , Soft Tissue Neoplasms/surgery , Treatment Outcome
JPAD-Journal of Pakistan Association of Dermatologists. 2011; 21 (4): 295-297
in English | IMEMR | ID: emr-118218


Lupus vulgaris is the most common form of cutaneous tuberculosis which usually occurs in patients previously sensitized to mycobacterium tuberculosis. It is often clinically and histopathologically confused with various cutaneous disorders. Here, we present a 28-year-old man attended in our medical college with slowly progressive, asymptomatic, annular erythematous skin lesions on the buttocks for 8 years. He consulted with many physicians and was improperly treated with an oral antifungal agent for several months under the diagnosis of tinea corporis, but no cure was observed. A diagnosis of lupus vulgaris was made based on the histopathological examination and the polymerase chain reaction. Anti-tuberculosis therapy was administered and the lesions started to regress

Humans , Male , Adult , Lupus Vulgaris/pathology , Tinea/diagnosis , Buttocks/pathology , Polymerase Chain Reaction , Antitubercular Agents
Dermatol. pediatr. latinoam. (Impr.) ; 8(3): 64-67, sept.-dic. 2010. ilus
Article in Spanish | LILACS | ID: lil-600308


El nevo lipomatoso cutáneo superficial (NLCS) es una anomalía del desarrollo infrecuente, caracterizada por la presencia de tejido adiposo maduro ectópico en la dermis. Puede estar presente al nacer o aparecer en la infancia o adolescencia. Describimos dos casos de NLCS: el primero, un niño de 4 años con una placa hipertricótica en la nalga izquierda, presente desde el nacimiento y el segundo, una niña de 9 años con una placa de aspecto esclerodermiforme en el muslo izquierdo, de aparición en etapa preescolar.

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare developmental anomally characterized by the presence of ectopic mature adipose tissue in the dermis. It may be present at birth, or appear at chilhood or adolescence. We describe two cases of NLCS: the firs one, a 4-year-old child that presented with an hypertrychotic plaque on his left buttock, present from birth and, the second one, a 9-year-old girl with a plaque of sclerodermiform appearance on her left leg, that arise before school time.

Humans , Male , Female , Child, Preschool , Child , Hamartoma , Nevus, Intradermal , Diagnosis, Differential , Lipoma , Thigh/abnormalities , Buttocks/pathology
GJO-Gulf Journal of Oncology [The]. 2010; (8): 52-54
in English | IMEMR | ID: emr-123698


Fibrous hamartoma of infancy is an uncommon fibroproliferative lesion that occurs only in infancy and childhood. It predominantly affects healthy boys and can be found in almost any subcutaneous tissue. The tumor is most frequently found in the axilla, followed by shoulder, inguinal area, and chest wall. This tumor can cause much concern about malignancy because it is firm and may be fixed to underlying tissues. Despite the occasional local recurrence, the clinical course is benign and the prognosis is excellent. Treatment is by local excision. The diagnosis is made by the characteristic histologic features. In order to avoid the misdiagnosis of malignancy and unnecessary radical therapy, both surgeon and pathologist must be familiar with this entity. We report a case of fibrous hamartoma of infancy in a 4-year-old boy in gluteal region

Humans , Male , Buttocks/pathology , Infant , Myofibroma , Myofibroblasts
Indian J Pathol Microbiol ; 2009 Jan-Mar; 52(1): 100-2
Article in English | IMSEAR | ID: sea-73522


Myoepitheliomas and mixed tumors involving deep subcutaneous and subfascial soft tissues of limb or limb girdle are rare lesions as against salivary lesions that are well established conditions. Here, we report a 22-year-old female who presented with painful hard swelling in the left gluteal region of 1(1/2) year duration. MRI showed a large ill-defined heterogeneous mass lesion measuring about 7-8 cm. in the left sacral region eroding the left sacroiliac region and left sacroiliac joint. With a clinical diagnosis of chondrosarcoma, the tumor with the surrounding tissue was resected in segments at surgery. Histomorphology revealed nests, sheets and cords of round to spindled cells with extensive squamous metaplasia in a myxoid to fibrous stroma. These cells extensively infiltrated muscle and bone. The tumor cells expressed immunoreactivity for cytokeratin (AE1/AE3) and S-100.

Adult , Buttocks/pathology , Female , Humans , Keratins/analysis , Magnetic Resonance Imaging , Myoepithelioma/diagnosis , Sacroiliac Joint/pathology , Skin Neoplasms/diagnosis
Tunisie Medicale [La]. 2009; 87 (9): 627-629
in English | IMEMR | ID: emr-134798


The tumor of buschke lowenstein or giant condyloma acuminata is a pseudo-epitheliomatous profileration bilonging to verrucous carcinoma group due to their aggressive local evolution.A malignant change as mic invasive carcinoma or epidermoiz keratinizing carcinoma well-differentiated was reported.Diagnosis and surgical treatment represents an efficient alternative at the moment that must be precocius and large due to the frequencies of local recurrences and malignant change. We present in this stady an observation of an unusual localization of buschke Lowenstein tumor with review of literature 50 year-old men presented with bilateral tumours it the battock area whose diagnosis of buschke Lowenstein tumour h been clinically suspected and confirmed by biopsy and histopathologic study .The cover has been achieved by VY fasciocutaneous flaps of the muscle gluteus maximus

Humans , Male , Penile Neoplasms , Buttocks/pathology , Surgical Flaps , Carcinoma, Verrucous/surgery , Scrotum , Neoplasms, Multiple Primary
Indian J Pathol Microbiol ; 2008 Jan-Mar; 51(1): 39-41
Article in English | IMSEAR | ID: sea-75176


We present here a case of malignant hemangiopericytoma in a 40-year-old female who presented with a history of slowly growing mass in left gluteal region for about 1.5 years. She was evaluated and a mass of 10 x 7.5 x 5.5 cm 3 was found on computed tomography. The tumor was resected and was sent for histopathological evaluation. Grossly the tumor was encapsulated and on cut section it was nodular. Microscopy showed spindle cells forming cords and sheets separated by thin delicate stroma consisting largely of thin-walled vessels revealed by reticulin stain. Pleomorphism and mitotic figures were seen. It was diagnosed as a case of malignant hemangiopericytoma of gluteal region. The patient underwent radiotherapy and did apparently well. She is on regular follow-up because long-term follow-up is essential in all cases as recurrence can occur several years after treatment.

Adult , Buttocks/pathology , Female , Hemangiopericytoma/diagnosis , Humans , Tomography, X-Ray Computed
Medical Principles and Practice. 2008; 17 (4): 340-342
in English | IMEMR | ID: emr-88998


To report a rare case of ossifying fibromyxoid tumor of soft tissue in Kuwait. A 60-year-old woman presented with a painless tumor, increasing in size and located in the left buttock, which had been present for an uncertain duration. The patient underwent an excisional biopsy. Pathological examination revealed a 7.5-cm well-circumscribed mass with a lobulated cut surface. Histologically, the tumor was encapsulated by an incomplete shell of lamellar bone. The tumor had variable cellularity, and, in areas, contained myxoid stroma. The tumor cells had eosinophilic cytoplasm with vesicular round-to-oval nuclei. Sparse mitoses were noted. Immunohistochemical stains demonstrated that the tumor cells expressed vimentin, S100 and neuron-specific enolase, with the latter expressed focally. To the best of our knowledge, this is the first case of ossifying fibromyxoid tumor of soft parts to be reported in Kuwait. Therefore, pathologists and clinicians should be aware of this tumor

Humans , Female , Bone Neoplasms , Fibroma, Ossifying , Buttocks/pathology