An 88-year-old male patient, inviting -amaurosis- with depressive symptoms, resident in a socio-sanitary establishment of the elderly, inguino hours, with Cexima tumor in treatment for 24 weeks,
No fever or voiding syndrome.
It has an externally ill-defined, fibrous tumor, fluctuating apex, suggestive of cord abscess is persistent.
Ultrasound and ultrasound shows bilateral hydrocele with normal tests a heterogeneous mass of echostructure with anechoic areas suggestive of abscess and abscess.
The contrast-enhanced central gas, particularly hydropelvic, presents an abundant mass in the left and surrounds both nodules, with two 3.5 cm hyperdense nodules and another 8 cm thicker in the posterior face.
The patient needs drainage of his abscess and placement of a urinary catheter during his admission.
A left inguinal cord tumor was found in the surgical exploration and another one at the left muscular level, performing an extended resection of both tumors.
In the Department of Pathology of our Hospital we received several pieces, with specification, the largest, of origin and minor, of inguinal muscular origin.
Musculoskeletal and connective tissue disorders
The lesion referred as inguinal, 7x4x5 cm presented a well-defined neoformation inside, not in a capsule with firm elastic and whitish consistency.
1.
Microscopically, we found two mesodermic tumors of different biological structure, the first malignant and the second benign but with focal colitis for the first.
We observed fusoid eruption and neoformation of mesoderm with extensive necrosis and edema of the tumor, as well as nuclear exocarbens and other epithelioid and myxoid cells, many of them bi- prominent.
The mitotic activity level reaches 5 mitotic levels (x cga).
There are areas of stromal hyalinization with presence of multifocal areas with multinucleated giant cells, other stars of myxoid appearance and a prominent vascular pattern with hyaline fibrosis in some vascular walls.
Pleomorphic areas with intermixed collagen stroma.
Cytophagocytosis
It is noteworthy that all neoformation is covered by a dense nonspecific acute and chronic inflammatory process with the presence of microabscesses in peripheral areas.
1.
On the other hand, the inguinal region tumor also corresponds to benign mesoderm smooth muscle, with microcalcifications and marked hyalinization, which shows focal proliferation and mesodermic neoplasia described.
See immunophenotype and immunohistochemical panel of both tumors.
1.
The diagnosis corresponds to a malignant focal fibrotic hydrooma (FH) of the cord is compatible with left-sided invasion (M. with nonspecific immunophenotype) inflammatory pattern (CM) and inflammatory pattern (FCM), more(+)
