1/10. Perianal mass and recurrent cellulitis due to enterobius vermicularis.A unique case of enterobiasis presenting as recurrent cellulitis and a perianal mass in a six-year-old girl is reported. Complicated perianal lesions due to enterobius are unusual. Only 10 previous cases are known, with unclear pathogenesis in most of them, although mucosal breaches and perianal crypt or gland entry have been postulated. The association of the mass in this case with a deep crypt, and the histopathologic finding of squamous epithelium focally surrounding the granulomatous reaction to the enterobius eggs suggest that the worm entered the perianal tissues via a crypt. Local secondary bacterial infection can cause significant morbidity. Surgical excision of such granulomatous mass lesions is necessary in symptomatic or complicated cases.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/10. Perianal actinomycosis: diagnostic and management considerations: a review of six cases.INTRODUCTION: Primary anal actinomycosis of cryptoglandular origin, mainly due to actinomyces israelii, a specific and rare cause of anal suppurative disease, needs to be recognized because it can be cured using specific treatments. METHOD: Data were reviewed from 6 patients with actinomycotic anal abscesses of obvious cryptoglandular origin observed in a single proctology unit between 1983 and 2000. Therapeutic management included conventional surgical treatment of anal sepsis followed by a specific oral antibiotic therapy maintained until the surgical wound had completely healed. RESULTS: All but one of the patients were men (median age, 53 years). All abscesses, except one, were indolent. No patient presented macroscopic "sulphur granules" in the pus, but one presented "watery pus". The diagnosis was established by histological study of the surgically excised tissue or by anaerobic culture of the pus. In the one hiv-positive patient, an uncommon organism was isolated: actinomyces meyeri. Two cases of recurrence were observed without evidence of actinomyces infection. CONCLUSION: actinomycosis should be suspected particularly in indolent anal suppuration. The absence of macroscopic "sulphur granules" does not mean this diagnosis can be ruled out. Careful histological examination of the excised tissue and appropriate anaerobic cultures of pus should be carried out to achieve complete eradication of this rare, but easily curable disease.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
3/10. Perianal mucinous adenocarcinoma: a clue to its pathogenesis.The case of a 49 year old male patient who presented with perianal mucinous adenocarcinoma is presented. This is a rare anal tumour with a low grade, well-differentiated histological pattern. Its pathogenesis remains obscure, although a long antecedent history of fistula in ano and associated perianal sepsis is characteristic. The exact etiological relationship with anal fistula is not clearly established. The upper rectum is usually spared. Perianal Paget's disease is often seen in association with the tumour. Metastases occur late and spread is usually to the inguinal group of lymph nodes. Clinical diagnosis is often delayed and difficult. Treatment is abdominoperineal resection with block dissection of the inguinal lymph nodes if the glands are involved.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
4/10. hidradenitis suppurativa of the anogenital region: response to isotretinoin.hidradenitis suppurativa, a chronic relapsing disease of apocrine gland-bearing areas, most frequently occurs in the axillae, groin, perineal, and perianal regions. Hidradenitis of vulva is frequently misdiagnosed and inadequately treated. The case of a 15-year-old nulliparous black female adolescent referred for evaluation of multiple draining fistulas of the anogenital region is presented. Diagnostic studies for granulomatous disease were negative. Results of a barium enema were normal and biopsies were compatible with the diagnosis of hidradenitis suppurativa. She was treated for 22 weeks with isotretinoin, 1 mg/kg daily, with an excellent response. Side effects were minor and included cheilitis, mild xerosis, and a transient elevation of serum alkaline phosphatase levels. Few patients with severe hidradenitis have been responsive to this synthetic vitamin a derivative. A review of the literature indicates that the results of treatment with isotretinoin for hidradenitis have been at best equivocal. isotretinoin should never be used during pregnancy because of known teratogenic effects. women of childbearing age must use effective contraception during treatment.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
5/10. Hedrocele: report of a case and review of the literature.Hedrocele represents an unusual variant of the rare posterior perineal hernia and results from a defect in the rectogenital septum. In the male, because of the prostate gland and the resistance of the perineal body, a hernia through this defect is directed posteriorly through the anterior wall of the rectum. diagnosis is based upon an awareness of the entity combined with the finding of an anterior intraluminal rectal mass. Correction requires celiotomy and closure of the anatomic defect.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/10. Perianal abscess due to enterobius vermicularis. Report of a case.A case of recurrent perianal abscess caused by enterobius vermicularis infestation of the anal canal and glands in an 11-year-old boy is reported.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
7/10. Anal lymphoma presenting as a perianal abscess.A case of perianal abscess secondary to anal lymphoma affecting a human immunodeficiency virus negative patient is presented. Causes of perianal abscess other than anal glandular infection are important, although the proportion of abscesses reported to be secondary to these other causes is found to vary widely in the literature. A biopsy of the wall of an anorectal abscess should be taken when suspicion of an unusual cause arises.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
8/10. Supralevator anorectal abscess presenting as acute low back pain and sciatica.Anorectal abscess is a suppurative process that begins in the anal glands. Clinical presentation is variable and depends on the direction and tissue plane along which the infection tracks. All cases require urgent incision and drainage. We report an unusual case of a supralevator abscess in a man who presented to the emergency department on two occasions with acute low back pain and sciatica. The case demonstrates the importance and difficulty of identifying the exceptional case among the numerous routine cases of mechanical low back pain. Attentiveness to atypical features should direct the clinician to a more extensive evaluation for serious illness. The case also illustrates that sciatica is not a diagnostic end-point but rather a label for a pain syndrome that encompasses a long differential diagnosis.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
9/10. Anal duct/gland cyst: report of a case and review of the literature.PURPOSE: The purpose of this communication is to report a case of anal duct/gland cyst and review cases of perianal and presacrococcygeal mucus-secreting cysts reported in the literature with emphasis on their histopathologic features. METHOD: Our patient presented with coccydynia. An extraluminal retrorectal tumor was felt on rectal examination. A computerized tomographic scan demonstrated a presacrococcygeal mass closely related to the anorectal junction. The tumor and the coccyx were excised using a posterior approach. Cases of perianal and presacrococcygeal mucus-secreting cysts reported in the literature were reviewed. RESULTS: In our case, the tumor proved to be an anal duct/gland cyst. Some of the reported cases of presacrococcygeal glandular cysts had histopathologic features suggestive of anal duct/gland origin. CONCLUSION: diagnosis of anal duct/gland cyst is based on routine histologic features, histochemical characteristics of mucus, and/or the presence of a communication with an anal duct or crypt. Based on these criteria, some of the reported cases of mucus-secreting cysts occurring around the anorectum may prove to be anal duct/gland in origin.- - - - - - - - - - ranking = 10keywords = gland (Clic here for more details about this article) |
10/10. Perianal hidradenoma papilliferum occurring in a male: a case report.Hidradenoma papilliferum is a rare apocrine gland tumour, described only once previously in a male. We present the second such case.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
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