1/11. Retrorectal cyst: a rare tumor frequently misdiagnosed.BACKGROUND: The rarity of retrorectal cysts and their nonspecific clinical presentations often lead to misdiagnoses and inappropriate operations. In recent years, several such patients have been referred to our institutions for evaluation and treatment of misdiagnosed retrorectal cysts. A review of these patients is presented. STUDY DESIGN: medical records of the colorectal surgery divisions at two institutions were reviewed. patients found to have previously misdiagnosed retrorectal cysts were identified. Preliminary diagnoses, radiologic examinations, operative procedures, and final diagnoses were obtained. RESULTS: Seven patients with retrorectal cysts who had been misdiagnosed before referral were identified. These patients had been treated for fistulae in ano, pilonidal cysts, perianal abscesses; psychogenic, lower back, posttraumatic, or postpartum pain, and proctalgia fugax before the correct diagnosis was made. patients underwent an average of 4.1 operative procedures. physical examination in combination with CT scanning made the correct diagnosis in all patients. All patients underwent successful resection through a parasacrococcygeal approach, and six of seven did not require coccygectomy. The resected tumors included four hamartomas, two epidermoid cysts, and one enteric duplication cyst. CONCLUSIONS: Retrorectal cysts are a rare entity that can be difficult to diagnose without a high index of clinical suspicion. A history of multiple unsuccessful procedures should alert the clinician to the diagnosis of retrorectal cyst. Once suspected, the correct diagnosis can be made with physical examination and a CT scan before a definitive surgical procedure.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/11. Sparing surgery for an epiderom cyst of the testis: a case report and literature review.Epidermoid cyst of the testis is relatively rare and accounts for less than 1% of all testicular neoplasms. This condition usually occurs in young men and it is mostly detected by self-examination or routine physical examination. The case of a 27-year-old male with an epidermoid cyst of the testis is discussed. The diagnosis was based on ultrasonography and management was with testicular-sparing surgery. At 2-year follow-up, the patient had had no relapse or metastasis. In epidermoid cysts of the testis, high-frequency ultrasonography is a reliable diagnostic imaging method. Organ-preserving surgery is recommended in the management of these lesions.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
3/11. Testicular epidermoid cyst in Klinefelter's syndrome.A 38-year-old Japanese man was referred to our outpatient clinic for treatment of infertility. semen analysis showed azoospermia. Chromosome analysis revealed a 47XXY karyotype, and non-mosaic Klinefelter's syndrome (KFS) was diagnosed. Upon physical examination, the patient's right testicular volume was 30 mL and the left testicular volume was 3 mL. Laboratory tests showed normal levels of lactate dehydrogenase, alpha-fetoprotein, and human chorionic gonadotropin beta-subunit. The plasma luteinizing hormone and follicle-stimulating hormone levels were increased to 15.7 mIU/mL and 45.9 mIU/mL, respectively. The plasma testosterone was decreased to 0.25 ng/mL. magnetic resonance imaging showed a right testicular mass of low-signal intensity on the T1-weighted image and of high-signal intensity on the T2-weighted image. Therefore, the final diagnosis was KFS with a right testicular tumor. Thus, a right high orchiectomy was performed. Histological examination revealed an epidermoid cyst of the right testis. Epidermoid cysts in cases of KFS are rare. To our knowledge, only seven cases, including ours, have been reported in the literature.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
4/11. Epidermal inclusion cyst of the heel.An inclusion cyst develops from the introduction of epidermal fragments into a heterotopic location, where it grows through accumulation of epithelial and keratinous debris. This is caused by a combination of increased physical activity and the imposition on the site. Inclusion cysts are seen most frequently in younger and more active patients, rather than in older individuals. This case is unique because the epidermal inclusion cyst occurred on the plantar aspect of the foot of an elderly, sedentary patient who had not sustained any injury to the area.- - - - - - - - - - ranking = 0.052775171033098keywords = physical (Clic here for more details about this article) |
5/11. Epidermoid splenic cyst detected on a sports physical examination.A 14-year-old female had a large, nontender abdominal mass on a routine sports physical examination. Following evaluation by ultrasound and computed tomography scan there was an initial attempt at drainage. The mass was subsequently removed. The diagnosis was epidermoid cyst of the spleen. In this report, we discuss the epidemiology and management of a splenic cyst, a rarely encountered diagnosis in adolescents, and emphasize the life-saving potential of the abdominal examination in sports medicine.- - - - - - - - - - ranking = 5keywords = physical examination, physical (Clic here for more details about this article) |
6/11. Epidermoid cysts of the testis: a report of three cases and an analysis of 141 cases from the world literature.Epidermoid cysts of the testis are rare and represent about 1% of all testicular tumors. An analysis of 141 cases reported to date in the world literature, including the cases reported here, indicates that 50% of the lesions occur in the third decade and 86% between the second and fourth decade. The most common presentations are painless enlargement of the testis (41%) for an average period of 2.25 years or incidental detection during routine physical examination (33%). Clinically, a discrete testicular nodule can be palpated in the majority of the cases (76%). Pathologic findings are those of a squamous lined cyst containing keratin with absence of appendages or other elements. It is believed that, despite the benign nature of the lesion, they should be treated by orchiectomy so that a thorough pathologic examination can be done to establish a confident diagnosis. While some controversy exists about their source of origin, all the evidence, including the age, more common occurrence among whites, and the rare reported cases arising in cryptorchid testis points to a germ cell origin for these lesions. The epidermoid cyst should thus be recognized as another subtype in the category of germ cell tumors of the testis and perhaps the ovary.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/11. Presacral tumors: case report, review of the literature.A case report involving a 42-year-old female is presented. The symptoms and objective physical findings manifest a diagnostic problem. The anatomical site of the tumor depends on the consideration of the numerous possible etiological factors, and one of which is the embryologic knowledge of the region involved. The clinical, pathological, and embryologic features of a case of presacral tumor is presented.- - - - - - - - - - ranking = 0.052775171033098keywords = physical (Clic here for more details about this article) |
8/11. Evaluation of an aviator with chronic disequilibrium, oscillopsia, and central sleep apnea.A case is presented of an aviator with chronic disequilibrium, oscillopsia, and central sleep apnea. history, physical examination, and special studies are presented establishing a diagnosis of epidermoid tumor at the foramen magnum. Differential diagnosis and relation of findings to the lesion are presented. The aeromedical significance of this case is to reinforce the importance of persistence and the team concept in establishing diagnoses when aviators present with confusing or unexplained symptoms.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
9/11. Let the finger linger.Retrorectal masses are rare and of insidious onset. We report a consecutive series of six such cases (males = 4, females = 2). The main presenting complaint was back pain and the most reliable physical sign was a palpable mass posteriorly on rectal examination (all cases). C T scan was the most radiologically informative investigation. Surgical intervention was undertaken using both anterior (trans-abdominal) and posterior (retrorectal) approaches. The majority of the masses excised were benign and all patients, to date, remain well.- - - - - - - - - - ranking = 0.052775171033098keywords = physical (Clic here for more details about this article) |
10/11. A 67-year-old woman with pain and tenderness in the left long finger.The following case is presented to illustrate the roentgenographic and clinical findings of a condition of interest to the orthopaedic surgeon. Initial history, physical findings, and roentgenographic examinations are presented along with the final histologic and differential diagnoses.- - - - - - - - - - ranking = 0.052775171033098keywords = physical (Clic here for more details about this article) |
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