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PubMed1990

[Extra-abdominal spread of pelvic neoplasms. CT evaluation and radiotherapeutic implications].

Meyers and other authors have described the extra-abdominal spread of inflammatory abdominal diseases. Conversely, little attention has been paid to the extra-abdominal spread of pelvic neoplasms. The authors have detected, by means of CT, 17 cases of extra-abdominal neoplastic spread in a series of 203 patients with pelvic neoplasms. Neoplastic spread involved the inguinal region in 1 case, the buttock in 6 cases, and the ischiorectal fossa and/or perineum in 12 cases, with more than one region involved in some patients. In such cases CT showed the extension of tumoral tissue beyond the muscular walls of the pelvis. Recurrent pelvic carcinomas are the most common neoplasms spreading outside the pelvis. Surgical obliteration of the pelvic fasciae can explain such a behavior. Differential diagnosis is to be made with inflammatory pelvic diseases with extrapelvic spread. When a pelvic tumor spreads outside the pelvis it can be seen as a primitive gluteal or inguinal or perineal mass. CT demonstration of such an insidious event is mandatory for both a correct diagnosis and radiation treatment planning.

Adult↗

PubMed1989

The inferior gluteal free flap in breast reconstruction.

The inferior gluteal musculocutaneous free flap usually provides a sufficient amount of autogenous tissue for breast reconstruction when adequate tissue is not present in the lower abdomen or back. Its arteriovenous pedicle is longer than the superior gluteal musculocutaneous free-flap pedicle and permits microvascular anastomosis in the axilla, avoiding medial rib and cartilage resection. In the thin patient, there is more available donor tissue than with the superior gluteal musculocutaneous free flap. Cadaver dissections confirm the greater pedicle length and the local area of the lower gluteus maximus muscle needed to carry the skin island and have helped define a safe approach to flap elevation. We have used four flaps for breast reconstruction without vascular compromise or the need for reexploration. The low donor-site scar in the inferior buttock fold has been acceptable, especially for a bilateral reconstruction. The anatomy of the gluteal region, the surgical technique for the inferior gluteal free-flap transfer, and a 3-year patient follow-up are presented.

Breast↗

PubMedDate not supplied

[Primary neuroendocrine carcinoma of the skin: histologic, immunohistochemical and ultrastructural study of a case with highly aggressive biological behavior].

We report a histological, immunohistochemical and ultrastructural study of a case of neuroendocrine carcinoma of the skin, which occurred in a 52 years old woman in the dermal, subcutis and soft tissues of the left buttock. Clinically this neoplasm, which was related to intramuscular injections and a to a following abscess, had rapidly reached unusual dimension compared with other cases of neuroendocrine carcinoma of the skin reported in the literature. The patient died three months after presentation with distant metastases. A variable percentage of the neoplastic cells was positive for low molecular weight cytokeratins (CK), neurofilaments (NF), neuron specific enolase (NSE) and occasionally for vaso-intestinal polypeptide (VIP). Ultrastructural investigations showed two types of neoplastic cells, identified for some features of the nucleus and of the cytoplasm; these two groups of cells are, in our opinion, related to different stages of cellular development. Our results, in agreement with some observations reported in the literature, give evidence of a possible origin of neuroendocrine carcinoma of the skin from an undifferentiated cell which is capable of neuroendocrine or ectodermal differentiation.

Abscess↗

PubMed1985

Obesity as a predictor of poor antibody response to hepatitis B plasma vaccine.

Factors associated with lack of antibody response to the hepatitis B virus plasma vaccine were retrospectively evaluated by means of a logistic regression in 194 previously seronegative staff members of a community hospital. All subjects had received three doses of vaccine by intramuscular buttock injection using a 1-in, 23-gauge needle. Overall, only 55.7% of subjects developed detectable antibody to hepatitis B surface antigen in serum after immunization. The weight-height index served as a surrogate measure of obesity. Predictors of poor immunogenic response to hepatitis B vaccine included higher weight-height index, older age, and vaccine batch. Sex, race, timing of vaccine doses, and timing of postimmunization determination of antibody to hepatitis B surface antigen were not predictors of vaccine efficacy.

Adult↗

PubMed1986

Free split-thickness skin grafts. A comparative study of various donor sites into recipient sites on the foot and ankle.

Presented is a retrospective study in plastic surgery comparing various donor sites for split-thickness grafting in the lower extremity. Split-thickness donor grafts obtained from the buttocks, thigh, leg, and medial arch of the foot were transferred to various sites on the foot and ankle. Results indicate that medial arch donor sites provide a more functional graft and a cosmetic result which is generally more acceptable to the patient.

Adult↗

PubMed1988

[Solitary mastocytoma with generalized symptoms].

The physical examination of a 9 1/2 months old infant with repeated attacks of flushing, hypotonia and tachycardia, beginning at the age of 3 months revealed two indurated, brown coloured skin areas, each with a diameter of 2 cm, situated on the left side of the back and on the left buttock, respectively. The histological findings proved the clinically suspected diagnosis of a "solitary mastocytoma". No more generalised symptoms were observed after the surgical removal of the skin lesions during a follow up period of 24 months until today.

Buttocks↗

PubMed1985

Unusual extraperitoneal presentations of diverticulitis.

Extraperitoneal presentations of complicated diverticular disease are unusual. The initial clinical presentations of these extraperitoneal manifestations have been described in the perineum, scrotum, buttock, hip, joints, thigh, lower extremities, mediastinum, and neck. These presentations render the diagnosis difficult and may lead to the delay of the proper therapy. The purpose of this report is to call attention to these unusual extraperitoneal presentations of complicated diverticular disease to describe the routes of spread and to present a case in point. Reviewing the literature, we have concluded that these unusual presentations occur more commonly in women and the elderly, that a delayed diagnosis significantly increases the mortality rate, and that the most common site of an extraperitoneal presentation is in the area of the hip.

Abscess↗

PubMed1988

Myospherulosis in Japan. A report of two cases and an immunohistochemical investigation.

We report two cases of myospherulosis and offer review of the Japanese literature. Case 1 was a 41-year-old woman with cystic tumors under the fascia of the right major gluteal muscle. Case 2 was a 36-year-old man with subcutaneous cystic tumors in the right buttock. The characteristic saccular structures enclosing numerous small spherules were observed in the cysts. These spherules measured 5-7 micron in diameter and stained with Masson trichrome, Giemsa, Papanicolaou, and alizarin red S for hemoglobin. The myospherules also stained positively by the immunohistochemical method for hemoglobin. These findings support the contention that the spherules and parent bodies were derived from erythrocytes altered by foreign lipids or fat.

Adult↗

PubMed1988

Thermography of gluteal regions after hypogastric artery ligation.

Thermographic examination of buttocks of 7 patients after hypogastric artery ligation using non-absorbable suture has been performed. In 6 patients the possibility of eventual recanalization has been eliminated by aortography, in 1 patient by pelvic angioscintigraphy. Repeated thermographic examination of 3 patients after bilateral ligation has shown no anomalous results. In 1 among 4 patients after unilateral ligation a cooler area could be repeatedly observed on the ipsilateral side. Thermography, in combination with other methods of examination, seems to be suitable for complex study of the state of circulation after hypograstric artery ligation, performed to stop a life-threatening hemorrhage.

Adult↗

PubMed1987

Isolated hypogastric artery revascularization after previous bypass for aortoiliac occlusive disease.

Patients with recurrent buttock claudication and/or impotence occurring after aortoiliac reconstruction, whose resting and postexercise vascular laboratory values are normal, represent an uncommon and poorly recognized problem resulting from occlusion of the bypassed iliac segments and ischemia isolated to the distribution of the hypogastric artery. This paradox and its solution are exemplified by two patients reported herein. In each instance flow was reestablished after thromboendarterectomy of the proximal hypogastric artery by connecting the artery to the functioning bypass.

Aorta, Abdominal↗

PubMed1987

The permanent tissue expander.

The permanent tissue expander has many advantages over a fixed-volume implant. Chest-wall skin can be expanded, enabling safe reconstruction of an aesthetically pleasing breast without the use of flaps. Excessive pressure on compromised skin flaps is avoided, and larger breasts can be achieved postoperatively by staged expansion. It appears that early capsular contracture can be treated by overexpansion of the implant and subsequent removal of saline to decrease the pressure. A second operative procedure to change an implant that is too small is unnecessary, and greater symmetry of the breasts can be obtained by adjusting the volume of the implant postoperatively. The expander has proven to be of great benefit in augmentation mammaplasty, the creation of symmetric breasts that are of a size and shape that completely satisfies the patient's demands. This is facilitated by the use of an implant that permits the patient and surgeon to effect expansion and volume adjustments. The patient can be more confident that her conception of an acceptable physical appearance will be realized, and the surgeon can thus decrease the incidence of patient disappointment. The implant has been used to reconstruct breasts following mastectomy (secondary reconstruction), at the time of mastectomy (primary reconstruction), following subcutaneous mastectomy, in Poland's syndrome, in breast augmentation, and even in buttocks asymmetry.

Breast↗

PubMed1979

An ultrastructural study of a juvenile melanoma.

An unusual variant of juvenile melanoma, namely a sclerosing juvenile melanoma occurring on the buttock, has been studied by light and electron microscopy. The diagnosis of a pigment tumour was confirmed by the presence of structures common to these lesions, i.e. melanosomes, intracytoplasmic fibrils and microvilli on the cell surface. The tumour consisted of two cell configurations, namely a multinucleated giant cell and a second cell made up of two separate cells lying in close apposition, the cytoplasm of one cell being dark and the other light. This tumour can be differentiated from a benign naevus by the bizarre histological appearance on light microscopy. On electron microscopy the distinction is made by the presence of the very large multinucleated giant cells, the apposition of the light and dark cells, the scanty melanosomes and the presence of intracytoplasmic lumina. The value of electron microscopy in the determination of the nature of unusual skin tumours is discussed.

Adolescent↗

PubMed1979

Pruritic urticarial papules and plaques of pregnancy.

We report an intensely pruritic cutaneous eruption that occurs in the third trimester of pregnancy. The clinical manifestations include erythematous urticarial papules and plaques that begin on the abdomen and spread to involve the thighs and occasionally the buttocks and arms. This dermatosis appears to be clinically distinct from previously described pruritic eruptions occurring in pregnancy. Biopsy specimens of the lesions show two histological patterns. We propose that this entity be termed "pruritic urticarial papules and plaques of pregnancy (PUPPP)".

Abdomen↗

PubMed1972

Sciatic injection neuropathy.

Prevention of sciatic injection neuropathy can best be accomplished by teaching that the injection should be made into the gluteal mass in the upper outer quadrant rather than the buttock, and that the needle should be introduced in a plane perpendicular to the surface of the bed when the patient is lying prone. Failing prevention, one must strive for early and correct diagnosis, especially in infants, and carry out exploration with internal and external neurolysis if there is no evidence of improvement within two to three months.

Adult↗

PubMed1983

[Reticulated pigment anomaly of the skinfolds].

We report a case of reticulate pigmented anomaly of the flexures in a 54 years-old white male patient. His lesions had developed during the last 30 years, involving neck, axillae, groins, anterior chest wall, scrotum, buttocks and thighs. The abnormality is characterized by pigmented epidermal downgrowths, with similar lesions developing around dilated pilosebaceous follicles. The condition may be compared with acanthosis nigricans. For this reason it is important to recognize this new genodermatosis in order to avoid unnecessary investigations to exclude visceral malignancy.

Acanthosis Nigricans↗

PubMed1978

Hypercalcemia in squamous cell carcinoma of the skin.

Squamous cell carcinoma of the skin is an extremely rare cause of hypercalcemia associated with malignant neoplasms. The case of a patient with extensive squamous cell carcinoma of both buttocks and thighs, with severe hypercalcemia is reported. The data presented indicate secretion of a humoral factor by the tumor, producing hypercalcemia.

Buttocks↗

PubMed1984

[Aneurysm of the gluteal artery].

A 90 year old man developed the rare lesion of an aneurysm of the gluteal artery, provoked by an injury in a patient with atheromatous multiple aneurysm disease. The inflammatory and permanent nature of the sciatic pain, the history of a recent increase in size of the buttocks, as well as signs of a deglobulization suggest the need for urgent arteriographic exploration for precise definition of the arteries supplying the aneurysm. Surgical treatment is by primary ligature of the hypogastric artery associated with a direct approach in order to perform endoaneurysmorhaphy.

Aged↗

PubMed1978

Appendico-cutaneous fistula. A case report.

Fistula formation between the appendix and adjacent organs is a rare condition. Cutaneous fistulas occur even more seldom. In this paper a case will be described where a fistula was formed between the appendix and the right buttock.

Aged↗