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A 40-year-old woman noted a large tumor mass in the left buttock that, on microscopic examination, proved to be a recently described, relatively uncommon spindle cell hemangioendothelioma. This particular neoplasm, which has some features of Kaposi's sarcoma, seems not to have been reported previously in a deep, intramuscular location.
Hydatid disease is an parasitic infestation due to germens from Echinococcus family, principal localizations of the disease being hepatic and pulmonary. We present two cases of disease, first localized primary on the buttock and second with multiple organ involving. We consider these cases interesting because of rarity and complexity of lesions.
Gianotti-Crosti syndrome (GCS), or papular acrodermatitis of childhood, is a distinctive self-limiting rash with symmetrically distributed papules on the face, buttocks, and extremities that has been related to several underlying viral diseases. We report a case of a boy exhibiting involutive lesions of milkers' nodules who subsequently developed a rash with the clinical features of GCS. The temporal relationship suggested the possibility of a causal association.
The author describes a new technique of fat grafting of the buttocks, GLADI (Gluteal Adipose Implant) based on Coleman procedure, associated with the lipoplasty of the gluteal-trochanteric region in order to improve harmony of the lower limbs. 132 patients were treated by this technique with very good results, no major complication, and a durable increase of the gluteal region in 125 (94.7%) of them. GLADI technique is a valid alternative to silicone implantations and offers durable improvements in gluteal shape without the need of additional surgery or the risk of implant rupture.
A 70-year-old woman developed localized livedo racemosa on the right buttock 2 months after renal transplantation. The suspected diagnosis of cholesterol embolism was confirmed by histopathological demonstration of cholesterol crystals in the wall of a small artery. The gluteal region is supplied by blood vessels that branch off the internal iliac artery distal to the usual anastomosing site of the donor kidney. Cholesterol emboli dislocated in the course of a kidney transplantation can reach the gluteal region. Cholesterol embolism after renal transplantation as well as the observation of cholesterol crystals in the histological preparation are rare findings.
A 23-year-old man presented with diffuse swelling of the left buttock with overlying skin lesions associated with seropurulent discharge. There was no past history of tuberculosis. Routine investigations were normal and smears of the discharge for bacteria, fungi, and AFB were negative. However, culture of skin biopsy showed Mycobacterium tuberculosis. Skin and lymph node biopsy showed granulomatous inflammation suggestive of tuberculosis. Administration of antitubucular therapy led to complete resolution of the lesions within 12 months.
A 47-year-old woman underwent hysteroscopy and removal of an endometrial polyp because of irregular, acyclic bleeding of 6 months' duration. The procedure was carried out under spinal anesthesia. No adverse events occurred during puncture or surgery, or in the immediate postoperative recovery period. Recovery from the sensory and motor block was normal. Twenty-four hours after surgery gluteal and lower limb pain and paresthesia developed, with no sensory or motor deficit. The symptoms suggested transient neurological syndrome. This syndrome has been defined by pain in the lower limbs, buttocks, thighs and calves after uncomplicated spinal anesthesia and full recovery from the sensorimotor block during the immediate postoperative period (first 24 hours). The condition is self-limiting and does not leave permanent neurological sequelae. Recent studies have demonstrated biochemical and anatomical changes that provide a structural basis for this clinical entity. According to this literature, transient neurological syndrome might be a mild expression of local anesthetic toxicity. Recent findings show that the initial injury to the nerve cell membrane, induced by high concentrations of local anesthetic could lead to permanent neuronal damage.
The authors have made a review of the literature about two cases of osteomyelitis of the iliac ala. They insist on rarity of the disease and how often the right diagnosis may be delayed because of misleading clinical symptoms. Any tumefaction of the buttock associated with pelvic pain and with an infectious syndrome necessarily evoke an iliac osteomyelitis. The bone scan may be negative which need not exclude the possibility. The evolution may be the formation of intra or extra or sometimes simultaneous sub-periosteal abscesses which must be drained. This is the reason why the authors advise to verify systematically the other side of the ilium by its surgical trepanning in case of a sub-periosteal abscess.
In the pelvic region three major compartments (gluteus medius-minimus, gluteus maximus and iliopsoas) can be distinguished from the smaller compartment of the tensor fasciae latae muscle. Pelvic compartment syndromes are rare. A clear history of trauma is often lacking. Association with drug and alcohol abuse is common as well as an association with the widespread use of anticoagulant therapy. From 1982 to 1988 six acute buttock compartment syndromes were treated in the Trauma Department of Hannover Medical School. In five patients fasciotomy of the gluteal compartment was performed. Two patients with a compartment syndrome secondary to necrotising fasciitis died of septic multiple organ failure. The mean follow-up of the four other patients was 29 months (7-48 months). Three of these four patients revealed a decrease of gluteal muscle volume. Ergometric tests showed a decrease in gluteal muscle strength in all patients.
A case control study was carried out to determine the exposure factors of gluteal fibrotic contracture (GFC). Sixty two school children were taken as the case group and were matched for sex, age and village of residence with 62 of their classmates constituting the control group. It was found that all 62 members of the case group had received intramuscular (IM) injections at some time prior to the onset of GFC, while only 57 of the control group had received IM injections. This difference is a statistically significant (p = 0.029). Injection sites on both buttocks were higher in the case group than among the controls. The odds ratio for the prevalence of hepatitis B virus infection (HBV) in the case group as compared to the control group was 3.0 (95% CI 1.1-7.8). A trend correlation was found between the annual frequency of IM injection, GFC and HBV infection. We concluded that IM injections played an important role in GFC and added to the risk of HBV infection, because they had been administered by improperly sterilized reusable syringes in an area where both GFC and HBV infections were prevalent and IM injection was common.
Recent advances in medical grade elastomer technology empower plastic surgeons to enhance specific body parts, thereby performing body sculpting. This article examines alloplastic implants for large body soft-tissue augmentation, namely pectoralis major enlargement, calf augmentation, and buttock enhancement.
2 cases of damage to peripheral nerves following bicycle riding are described in males aged 13 and 35 years, respectively. In 1 there was injury to the ulnar nerve at the level of the wrist, with hypesthesia of the 2 ulnar digits and paresis of intrinsic muscles. In the other case there was involvement of the pudendal nerves with numbness of the buttocks and genitalia, and with difficulty in achieving erection. After cycling was stopped for a few weeks the symptoms disappeared spontaneously, with full recovery. Once symptoms subside completely cycling can be resumed, although with certain precautions.
The authors present four cases. The first case is a diaphragmatic-mediastinal, the second one is a cervical-mediastinal one, the third case has a buttock, the last one is a case of hip-thigh. Their ages are one, eight and three years old and the fourth case is seven days old. They appear in axilla, neck, thoracic wall and fat prevertebral tissue, in below three year old children. Despite their benignity, the tumors grow very fast. The complete extirpation is fundamental to avoid relapses, which are presented approximately in a 15 for 100 of the cases. Mutilations are not necessary, since it is a benign tumor. Finally, the authors amply review the literature. They differentiate the concepts of lipoma, hibernoma and lipoblastoma.
The history of a patient with neurological deficit symptoms secondary to a spinal epidural abscess connected with psoas abscess and several fistulas on the buttocks is described. Etiology, diagnosis, and treatment are discussed. Percutaneous drainage of the spinal epidural abscess is suggested as an alternative to surgery.
Puzzling, treatment-resistant oval erosions occurred in a forty-two-year-old woman shortly after treatment with etretinate was begun for psoriasis. Appearing on the breasts, inguinal folds, and buttocks, these lesions persisted and increased in size and number during three months of hospitalization. The cause proved to be etretinate; stopping use of the drug led to complete healing within three weeks.
An 18-year-old girl had a cyst excised from the left buttock in 1988. The cyst was diagnosed to be a cutaneous ciliated cyst, since histologic examination using special stains demonstrated its lining to be similar to fallopian tube epithelium. Only 20 such cases have been published to date, and this report is probably the first case in the plastic surgical literature, to the best of our knowledge.
135 cases of alveolar soft part sarcoma (ASPS) are presented. It is the largest series of ASPS currently reported in the medical literature. Follow-up clinical data were available in 51 cases. 68 of the patients were male and 67 were female. The mean age of the patients when making the diagnosis was 35.5 years. Most of the tumors were located at the extremities (72.1%), particularly on the thigh and buttock (36.1%). The five year survival rate was 45.9%, the recurrence rate was 47.1%, and the metastatic rate was 35.3%. The most common sites of metastases were the lung, brain and liver. Microscopially, all the tumors gave a typical organoid structure. Electron microscopic study showed special crystals in the tumor cells. 33 cases of ASPS were examined immunohistochemically with 16 kinds of antibodies in order to clarify the histogenesis of alveolar soft part sarcoma. The presence of desmin, actin, myoglobin and myosin suggests the myogenic character of this tumor.
A case of recurrent metastatic Merkel cell carcinoma of the buttock is described and after a short review of the literature some clinical and therapeutic features of this rare tumor are given.