GROOVE PANCREATITIS -A DIAGNOSTIC DILEMMA

2021 ◽  
pp. 55-56
Author(s):  
Aleena Elizabeth Andrews
Keyword(s):  
Surgical Intervention ◽  
Soft Tissue Mass ◽  
Pancreatic Head ◽  
Duodenal Wall ◽  
Diagnostic Dilemma ◽  
Tissue Mass ◽  
Groove Pancreatitis ◽  
Cystic Changes ◽  
The Common ◽  
Anatomical Area

Groove pancreatitis is a segmental chronic pancreatitis that affects the groove area, classically the anatomical area between the pancreatic head, the duodenum, and the common bile duct. The etiopathogenesis remains elusive till date, though association with alcohol abuse has been described in literature. Imaging feature described include soft tissue mass in the groove, thickening of medial wall of duodenum, thus closely mimicking a neoplastic aetiology and hence posing diagnostic dilemma. However classic ndings of cystic changes in the groove extending to duodenal wall and brotic component can aid the radiologist in making an accurate diagnosis and thus avoiding unnecessary surgical intervention. Groove pancreatitis is a disease that should be considered in the list of differential diagnosis of masses implicating the pancreatic head and medial duodenal wall.

scholarly journals Soft Tissue Tumor Leg - A Rare Presentation of Cutaneous Rhinosporidiosis

2020 ◽  
pp. 1-2
Author(s):  
R. Chithra ◽  
B Sai Dhandapani ◽  
R King Gandhi ◽  
R. Chithra
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Tumor ◽  
Soft Tissue Mass ◽  
Radiological Findings ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Tissue Mass ◽  
Tissue Tumor ◽  
Typical History ◽  
Polypoidal Growth

Rhinosporidiosis presents commonly as polypoidal growth in nose, but presentation in other sites including skin, genitourinary tract is documented. Cutaneous presentation is rare, which may present as pedunculated swelling or cutaneous ulceration, but presenting as soft tissue tumor is extremely rare. The multifaceted presentation of the disease causes diagnostic dilemma to an unsuspecting physician. Clinical and radiological findings may mislead, but usually typical history helps, and typical histology clinches the diagnosis. We are presenting a case of disseminated cutaneous rhinosporidiosis presented as soft tissue mass lesion in the leg causing diagnostic difficulty due to the rare presentation.

scholarly journals Symptomatic Floor-of-Mouth Swelling with Neck Extension in a 14-Year-Old Girl

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Kristin Dayton ◽  
Matthew F. Ryan
Keyword(s):  
Surgical Intervention ◽  
Soft Tissue Mass ◽  
Sublingual Gland ◽  
Management Options ◽  
Mylohyoid Muscle ◽  
Tissue Mass ◽  
Neck Extension ◽  
Incision And Drainage ◽  
Tracheal Compression ◽  
Floor Of Mouth

A plunging ranula is a soft-tissue mass stemming from a mucous extravasation cyst of the sublingual gland which can herniate through the mylohyoid muscle. We describe a case in which a 14-year-old girl presented with a rapidly expanding mass on the floor of her mouth affecting her ability to swallow and speak and causing tracheal compression. The patient was initially managed conservatively with antibiotics and steroids; however, the mass continued to expand necessitating emergent bedside incision and drainage and subsequent surgical intervention. The pathophysiology and management options for ranulas are also discussed herein.

scholarly journals Malignant peripheral nerve sheath tumour in the submandibular space

2017 ◽  
Vol 99 (5) ◽  
pp. e137-e138 ◽  
Author(s):  
JB Olivier
Keyword(s):  
Soft Tissue ◽  
Peripheral Nerve ◽  
Adjuvant Radiotherapy ◽  
Soft Tissue Mass ◽  
Tissue Mass ◽  
Complete Excision ◽  
Aggressive Form ◽  
Nerve Sheath ◽  
Anatomical Area ◽  
Peripheral Nerve Sheath Tumour

Malignant peripheral nerve sheath tumours (MPNSTs) are a rare but aggressive form of soft tissue sarcoma with few reported cases in the anatomic location seen with the case presented here. This case involves a 23-year-old man presenting with a soft tissue mass under the mandible found to be a MPNST, which was investigated and fully excised. Adjuvant radiotherapy was used postoperatively. Although uncommon, these tumours have a poor prognosis and suitable management therefore needs to be put in place as soon as possible. Complete excision with negative margins and adjuvant radiotherapy are the current methods used for treatment. This case is unusual and highlights the management of an aggressive tumour in a difficult anatomical area, prompting the consideration of MPNST as a differential diagnosis for a soft tissue mass.

Study of role of computerized tomography (CT) in evaluation of groove pancreatitis

2021 ◽  
Vol 20 (1) ◽  
pp. 15-19
Author(s):  
Swadeep Raj G ◽  
Keyword(s):  
Pancreatic Head ◽  
Final Diagnosis ◽  
Duodenal Wall ◽  
Wall Thickening ◽  
Imaging Findings ◽  
Pure Type ◽  
Groove Pancreatitis ◽  
Hyperintense Signal ◽  
Contrast Enhanced Ct ◽  
Pancreatic Duct Dilatation

Background: Groove pancreatitis is a rare form of chronic pancreatitis affecting the groove between the pancreatic head, duodenum and common bile duct. The exact cause of the disease is not known, although there are strong associations with long term alcohol abuse, functional obstruction of duct of Santorini and brunner gland hyperplasia. The purpose of this study was to describe the imaging findings of groove pancreatitis (GP) on Contrast enhanced CT Abdomen. Material and Methods: Present study was retrospective study conducted, with help of medical records of 16 patients with a final diagnosis of Groove pancreatitis. CT, MRI and MRCP findings were analysed. Statistical analysis was done using descriptive statistics. Results: In present study, two types of groove pancreatitis (GP) as pure type (50%) and segmental type (50%) were noted. Other important findings were focal duodenal wall thickening (62.5%) and cysts in the duodenal wall itself or in groove between the pancreatic head and the duodenum (37.5%), CBD dilatation and distal smooth tapering (62.5%) including all the segmental types and 2 of the pure type leading to intra- and extra-hepatic biliary system dilatation. MRI and MRCP were available in 6 patients in our study. There was a CT similarity regarding the sheet of tissues within the pancreaticoduodenal groove. These were seen expressing T1 hypo-intense and T2 slightly hyperintense signal in 3 patients with depiction of mild enhancement in the delayed phases in three of them (50%). On the MDCT examinations hypodense sheet at the PD groove was seen in 12 patients with modest enhancement identified in delayed phase seen in 6 of the them. Duodenal wall thickening was seen in 10 patients while associated cysts within the duodenal wall or in PD groove were seen in 6 patients. Pancreatic head enlargement with diffuse enhancement was seen in 8 patients. Mild pancreatic duct dilatation was seen in 8 patients while dilatation of the CBD was seen in 10 patients with distal tapering and intra-hepatic biliary dilatation. Conclusion: Groove pancreatitis (GP) is a disease that should be considered in the list of differential diagnosis of masses implicating the pancreatic head and medial duodenal wall. Imaging findings that are suggestive of GP include chronic inflammatory changes with fibrosis in the PD groove with or without implication of the nearby head of the pancreas, duodenal medial mural thickening with luminal stenosis and cysts at the PD groove or within the duodenal wall.

scholarly journals GROOVE PANCREATITIS MASQUERADING AS CARCINOMA PANCREAS : A DIAGNOSTIC DILEMMA

2020 ◽  
pp. 1-2
Author(s):  
Lohith P ◽  
Rajshekar P ◽  
Deepak Ghuliani ◽  
Ravindra K Saran
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Duodenal Obstruction ◽  
Signs And Symptoms ◽  
Duodenal Wall ◽  
Management Approach ◽  
Clinical Response Rate ◽  
Diagnostic Dilemma ◽  
Groove Pancreatitis ◽  
Whipple’S Procedure

INTRODUCTION: Groove pancreatitis(GP) is a rare special form of chronic pancreatitis localised to pancreaticoduodenal groove, presents commonly with signs and symptoms of duodenal obstruction, mimicks pancreatic cancer radiologically and the surgeon proceeds with inadvertent whipples procedure. PRESENTATION OFCASE: A28yr old gentleman, alcoholic presented with duodenal obstruction for 3days. CECTabdomen was suggestive of exophytic lesion from second part of duodenum ?duodenal diverticulum. UGIE showed large growth with overlying abnormal mucosa causing luminal compromise in second part of duodenum. Biopsy was taken which showed normal villous pattern. Patient was managed conservatively and improved gradually. On further evaluation, EUS showed 5×5.5cm cystic space occupying lesion in close relation to second part of duodenum and head of pancreas ?origin. EUS guided FNAC showed features suggestive of adenocarcinoma. With this pathological diagnosis, patient was taken up for Whipple's procedure, intraoperatively, 3cm mass lesion was noted in the pancreaticoduodenal groove. HPE of the specimen showed a haemorraghic nodule (3×1.8×1.2cm) in the duodenal wall and changes of chronic pancreatitis in the pancreticoduodenal groove suggestive of GP. Postoperative period and follow up of 6 months was uneventful. DISCUSSION: In GP, EUS guided FNAC may reveal large gaint cells, spindle cells or hyperplasia of brunner glands depending on the area of sampling and these features mimic neoplasia as observed in our case. MRI criteria given by Kalb et al show diagnostic accuracy of 87.2% for GP and negative predictive value of 92.9% to rule out pancreatic cancer. Arvanitakis et al showed stepwise management approach is effective in GP and with combination of medical and endoscopic treatment, complete clinical response rate was observed in 80%. CONCLUSION: It is important to diagnose and differentiate GP from pancreatic cancer preoperatively and avoid morbidity from unnecessary pancreaticoduodenectomy in patients of GP.

scholarly journals Pancreas-preserving duodenal resections as a surgery of choice for the isolated form of cystic dystrophy of the duodenal wall (pure form of groove pancreatitis)

2019 ◽  
Vol 47 (6) ◽  
pp. 477-495
Author(s):  
V. I. Egorov ◽  
R. V. Petrov ◽  
A. I. Schegolev ◽  
E. A. Dubova ◽  
A. N. Vankovich ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Whipple Procedure ◽  
Pure Form ◽  
Long Term Results ◽  
Treatment Modalities ◽  
Duodenal Wall ◽  
Exocrine Insufficiency ◽  
Results Of Treatment ◽  
Groove Pancreatitis ◽  
Diagnostic Modalities

Background: Management of the isolated form of cystic dystrophy of the duodenal wall (CDDW), or pure form of groove pancreatitis, is controversial. Pancreatoduodenectomy is considered to be the most suitable procedure for CDDW. Pancreas-preserving procedures (PPDR) have been described as surgical options for the cases where only the duodenum has been involved. There are no studies comparing pancreas-preserving vs. pancreas-resecting procedures for this disease.Aim: To analyze the results and outcomes of PPDR and other treatment approaches to CDDW and to review the literature.Materials and methods: We performed a retrospective analysis of 82 patients with CDDW who received treatment from February 2004 to April 2019. We compared short-term and long-term results of treatment of 15 patients with isolated CDDW after PPDR and 42 patients with CDDW after pancreatoduodenectomy.Results: The preoperative diagnosis was correct in 81 of the cases (98.8%). The patients experienced abdominal pain (100%), weight loss (76%), vomiting (30%), and jaundice (18%). CT, MRI, and endoUS were the most useful diagnostic modalities. Twelve patients with CDDW took conservative treatment due to rejection of the operation. The other patients underwent cystoenterostomies (8), duodenum-preserving pancreatic head (DPPH) resections (6), pancreatoduodenectomy (42) and PPDR (15) with zero mortality. Full pain control was achieved after PPDR in 93%, after pancreatoduodenectomy in 83%, and after draining procedures in 18% of the cases. Newly onset diabetes mellitus (7) and severe exocrine insufficiency (5) were common after pancreatoduodenectomy and never occurred after DPPH resections and PPDR. Weight gain was significantly higher after pancreatoduodenectomy and PPDR, compared to other treatment modalities.Conclusion: PPDR is the optimal surgical procedure for the isolated form of CDDW. Early detection of CDDW allows for preservation of the pancreas. The pure form of groove pancreatitis is a disease of the duodenum, and the Whipple procedure should be considered excessive for this disease.

scholarly journals Thymoma in an aged backyard Leghorn chicken, with reviews of a database and literature

2021 ◽  
Vol 33 (2) ◽  
pp. 336-339
Author(s):  
Julia Blakey ◽  
Carmen Jerry ◽  
Ana da Silva ◽  
Simone Stoute
Keyword(s):  
Soft Tissue Mass ◽  
Animal Health ◽  
Postmortem Examination ◽  
Cervical Region ◽  
Laboratory System ◽  
Unexpected Death ◽  
Tissue Mass ◽  
Microscopic Features ◽  
History Of ◽  
Backyard Chickens

A 7-y-old backyard Leghorn chicken ( Gallus domesticus) was submitted to the California Animal Health and Food Safety Laboratory System (CAHFS)–Turlock branch for postmortem examination, with a history of unexpected death. At postmortem examination, a hemorrhagic soft tissue mass was observed in the cervical region. Microscopically, a densely cellular neoplasm of polygonal epithelial cells and small lymphocytes was observed. The microscopic features of the neoplasm in combination with positive immunohistochemistry for pancytokeratin and CD3 were used to classify the lesion as a thymoma. Thymoma was diagnosed in only 5 birds submitted to CAHFS from 1990 to 2019. Thymoma has been described only rarely in birds, and is an unusual diagnosis in backyard chickens.

Fibroadenoma of Ectopic Breast Tissue in the Groin – A Rare Disease Entity

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S47-S48
Author(s):  
D Emechebe ◽  
M Alshal ◽  
T Rana ◽  
M Agaronov
Keyword(s):  
Breast Tissue ◽  
Tissue Mass ◽  
Ectopic Breast Tissue ◽  
The Common ◽  
Painless Mass ◽  
The Right ◽  
Ectopic Breast ◽  
Urogenital Anomalies ◽  
Superficial Soft Tissue

Abstract Introduction/Objective Ectopic breast tissue (EBT) is a well-documented anomaly of the breast and commonly presents along the embryonic milk line extending between the axilla and groin. Reported incidence of accessory breast is 0.4–6% in females. Pathologies developing in an EBT are reported as a rare entity in the literature. Carcinoma is reported as the common pathology followed by inflammation and fibroadenoma Methods We present a case of 43-year- old female who presented with a painless mass in her right groin for the past year which gradually increased in size. CT abdomen pelvis with contrast showed a 2.2 x 3.0 x 4.4 cm superficial soft tissue mass in the right groin which was suspected to be a lymph node. Further investigation and histopathological report of biopsy showed ectopic breast tissue with admixed chronic inflammation and reactive changes.However, excision of the mass three months later showed showed proloferation of both glandular and stromal elements. Results The tissue from the biopsy was positive for GATA 3, mammoglobin, GCDFP and CD 10 and the histological features on excision was confirmatory of fibroadenoma. Conclusion In conclusion, when tumors or nodules are found along the mammary line, the presence of breast tissue should be considered during the investigation. It is clinically wise to evaluate and screen carefully cases of supernumerary breast for any pathology and for any associated urogenital anomalies such as supernumerary kidneys, polycystic kidneys and renal cell adenocaricnoma. In our case, patient had no associated urogenital anomalies and she is on follow up.

scholarly journals Extradural Peripheral Nerve Sheath Tumour at T7 Level in a 2-Year-Old Dog

VCOT Open ◽  
2021 ◽  
Vol 04 (01) ◽  
pp. e41-e46
Author(s):  
Federica Aragosa ◽  
Chiara Caterino ◽  
Giovanni Della Valle ◽  
Ilaria D'Aquino ◽  
Dario Costanza ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Soft Tissue Mass ◽  
Resonance Imaging ◽  
Tissue Mass ◽  
Nerve Sheath Tumour ◽  
Free Interval ◽  
Nerve Sheath ◽  
Dorsal Laminectomy ◽  
Intervertebral Foramina ◽  
Peripheral Nerve Sheath Tumour

AbstractThe aim of this report is to describe an unusual localization of nerve sheath tumour (NST), clinical presentation, imaging, surgical management, and outcome in a 2-year-old dog. A 2-year-old female American Staffordshire Terrier presented with nonambulatory paraparesis, thoracolumbar hyperaesthesia, hindlimb hyperreflexia, and mild muscle atrophy. Computed tomography and magnetic resonance imaging revealed an extradural mass at T7-T8, without vertebral lesions. Surgical treatment consisted in resection of the soft tissue mass through dorsal laminectomy. The dog was ambulatory within 24 hours and free of recurrence at 18 months postoperatively. Histopathologic and features of immunohistochemistry were consistent with NST. The NST of this report was similar to those described before, but exhibited unusual characteristics, such as being extradural, without extension into intervertebral foramina, and being located in an atypical region (T7-T8). Moreover, survival time and relapse-free interval are greater than previously reported for similar cases.

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