Case report: urinoma in the proximal thigh mimicking a soft tissue neoplasm
Case Report
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Abstract
Soft tissue tumors form a heterogeneous group of benign and malignant lesions. Those with a high fluid content may be particularly challenging in diagnosis. We present a 78-year-old man with a dolorous, progressive mass in the adductor region of the lower left extremity. At the end of a long diagnostic pathway, the pseudocystic tumor was eventually identified as a urinoma, caused by a prostatosymphyseal fistula that had occurred as a late complication of transurethral resection of the prostate. Our finding represents a rare variant of soft tissue tumors in the lower extremities, which MR-based urography can help to reveal.
Keywords
Tumor Myxoid Urinoma TURP PSF Complication MR urographyNotes
Compliance with ethical standards
Conflict of interest
None.
References
- 1.Fletcher CDM, Unni KK, Mertens F, Organization WH, Pathology IAo. Pathology and Genetics of Tumours of Soft Tissue and Bone: IARC Press, 2002.Google Scholar
- 2.Ferrari A, Sultan I, Huang TT, Rodriguez-Galindo C, Shehadeh A, Meazza C, et al. Soft tissue sarcoma across the age spectrum: a population-based study from the surveillance epidemiology and end results database. Pediatr Blood Cancer. 2011;57(6):943–9.CrossRefGoogle Scholar
- 3.Ng VY, Scharschmidt TJ, Mayerson JL, Fisher JL. Incidence and survival in sarcoma in the United States: a focus on musculoskeletal lesions. Anticancer Res. 2013;33(6):2597–604.PubMedGoogle Scholar
- 4.Kransdorf MJ. Malignant soft-tissue tumors in a large referral population: distribution of diagnoses by age, sex, and location. AJR Am J Roentgenol. 1995;164(1):129–34.CrossRefGoogle Scholar
- 5.Mathew R, Kaveriappa G, Shetty M, Suresh H. Subcutaneous urinoma: a rare sequelae to percutaneous nephrolithotomy. Muller J Med Sci Res. 2015;6(1):78–80.CrossRefGoogle Scholar
- 6.Lee J, Darcy M. Renal cysts and urinomas. Semin Interv Radiol. 2011;28(4):380–91.CrossRefGoogle Scholar
- 7.Titton RL, Gervais DA, Hahn PF, Harisinghani MG, Arellano RS, Mueller PR. Urine leaks and urinomas: diagnosis and imaging-guided intervention. Radiographics. 2003;23(5):1133–47.CrossRefGoogle Scholar
- 8.Plateau B, Ruivard M, Montoriol PF. Prostatosymphyseal fistula and osteomyelitis pubis following transurethral resection of the prostate: CT and MRI findings. J Med Imaging Radiat Oncol. 2015;59(6):713–5.CrossRefGoogle Scholar
- 9.Elshout PJ, Verleyen P, Putzeys G. Osteitis pubis after TURP: a rare complication difficult to recognize. Urol Case Rep. 2016;4:55–6.CrossRefGoogle Scholar
- 10.Kats E, Venema PL, Kropman RF. A rare complication after endoscopic resection of the prostate: osteitis pubis due to a prostate-symphysis fistula. J Urol. 1997;157(2):624.CrossRefGoogle Scholar
- 11.Gillitzer R, Melchior SW, Jones J, Fichtner J, Thuroff JW. Prostatosymphyseal fistula after transurethral resection of the prostate. J Urol. 2001;166(3):1001–2.CrossRefGoogle Scholar
- 12.Wolf RF, Elzen AH, de Jong IJ. Homan van der Heide JN, Jager PL, Boeve WJ. [Giant urinoma of the thigh]. Ned Tijdschr Geneeskd. 1998;142(16):908–12.PubMedGoogle Scholar
- 13.Kats E, Venema PL, Kropman RF, Kieft GJ. Diagnosis and treatment of osteitis pubis caused by a prostate-symphysis fistula: a rare complication after transurethral resection of the prostate. Br J Urol. 1998;81(6):927–8.CrossRefGoogle Scholar
- 14.Schneider T, Bach D, Rübben H. Das Urinom des Oberschenkels. Der Urologe B. 1999;39(6):505–7.CrossRefGoogle Scholar
- 15.Bugeja S, Andrich DE, Mundy AR. Fistulation into the pubic symphysis after treatment of prostate cancer: an important and surgically correctable complication. J Urol. 2016; 195(2):391–398%@ 0022–5347.Google Scholar
- 16.Sanchez A, Rodriguez D, Cheng JS, McGovern FJ, Tabatabaei S. Prostato-symphyseal fistula after photoselective vaporization of the prostate: case series and literature review of a rare complication. Urology. 2015;85(1):172–7.CrossRefGoogle Scholar
- 17.Ma LD, McCarthy EF, Bluemke DA, Frassica FJ. Differentiation of benign from malignant musculoskeletal lesions using MR imaging: pitfalls in MR evaluation of lesions with a cystic appearance. AJR Am J Roentgenol. 1998;170(5):1251–8.CrossRefGoogle Scholar
- 18.Cox JA, Bartlett E, Lee EI. Vascular malformations: a review. Semin Plast Surg. 2014;28(2):58–63.CrossRefGoogle Scholar
- 19.Sepulveda A, Buchanan EP. Vascular tumors. Semin Plast Surg. 2014;28(2):49–57.CrossRefGoogle Scholar
- 20.Willems SM, Schrage YM, Baelde JJ, Briaire-de Bruijn I, Mohseny A, Sciot R, et al. Myxoid tumours of soft tissue: the so-called myxoid extracellular matrix is heterogeneous in composition. Histopathology. 2008;52(4):465–74.CrossRefGoogle Scholar
- 21.Kindblom LG, Angervall L. Histochemical characterization of mucosubstances in bone and soft tissue-tumors. Cancer. 1975;36(3):985–94.CrossRefGoogle Scholar
- 22.Willems SM, Wiweger M, van Roggen JF, Hogendoorn PC. Running GAGs: myxoid matrix in tumor pathology revisited: what’s in it for the pathologist? Virchows Archiv: Int J Pathol. 2010;456(2):181–92.CrossRefGoogle Scholar
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