The septa of Legueu and Juvara: an anatomic study

PURPOSE: To study the anatomy of the septa of Legueu and Juvara and interpalmar plate ligaments (IPPLs) of the hand. MATERIALS: Eleven cadaver hands were dissected. The number, attachments, dimensions, and relationships of the septa and IPPLs to other structures were determined. RESULTS: Eight septa were identified radial and ulnar for each digit. The radial were longer than the ulnar septa. The septa attached to the transverse ligament of the palmar aponeurosis superficially and to the soft-tissue confluence deeper and distally. They formed 7 compartments of 2 types flexor septal canals that contained the flexor tendons and web space canals that contained common digital nerves and arteries and lumbrical muscles. Grossly and histologically the septa were thicker and consisted of organized collagen distally but not proximally. Three IPPLs were identified: radial, central, and ulnar. These formed the floors of the second, third, and fourth web space canals. The IPPLs were more substantial, thicker, and had more fibrous appearance from radial to ulnar. The fibers of the radial and central IPPLs were oriented transversely, whereas those of the ulnar IPPL were oriented obliquely. CONCLUSIONS: Awareness of the anatomy of deep retinacular structures of the hand is important for surgical exposure in this area and possible involvement in conditions such as Dupuytren's disease.     

Dupuytren's disease in a child: a case report

Dupuytren's disease commonly affects men over the age of 40 years. It is very rare to find it in the paediatric age group. We describe a case of histologically proven Dupuytren's disease in a 10-year-old boy who presented with a nodule in his palm. Dupuytren's disease should be considered in the differential diagnosis of a nodule in hand or contracture of a finger joint in the paediatric age group.     

Dupuytren's disease involving the wrist

There is a well-established association with ectopic fibrosis in Dupuytren's disease, but involvement of the wrist is rare. To our knowledge there have been only 5 cases reported in the literature. The authors present a patient with Dupuytren's disease involving only the proximal palm and wrist who presented with functional limitation and a rapid clinical progression.     

Histiocytosis-X of the spinal cord: a case report

A rare case of histiocytosis-X of the spinal cord with evidence of intramedullary infiltration and epidural spinal cord compression is reported. The clinical, radiological, and histopathological features are discussed, and the pertinent literature is reviewed.     

Spermatic cord tuberculosis: a case report

A 65-year-old man visited our hospital with a complaint of a left inguinal mass. He had had a past history of tuberculosis. A left spermatic cord tumor was suspected. Left high orchiectomy was performed. The mass did not connect with the testis or epididymis. The removed mass measured 4 x 2 x 1.5 cm in size. Microscopic examination showed a granulomatous lesion with Langhans giant cells. Tuberculin skin test was moderately positive. From these findings we diagnosed the patient with tuberculosis in spermatic cord. Antituberculous chemotherapy was subsequently initiated. Two months after surgery, recurrence has not been found.     

Myxofibrosarcoma of the spermatic cord: a case report

A 77-year-old man visited our department with a painless mass in the left scrotum. He underwent left high orchiectomy with clinical diagnosis of testicular tumor. The tumor penetrated deeply into the internal inguinal ring. The tumor was resected as proximally as possible with positive surgical margin at the internal ring. Macroscopically, the left testis was intact in the resected specimen. Microscopic examination revealed that the tumor was consisted of myxoid stroma with spindle cells, and there was a large variation in histological findings. Immunohistchemical staining was positive with vimentin, and negative with alphaSMA, S-100, Myo D1, EMA, keratin, HMB45, and LCA. Accordingly, the tumor was diagnosed as myxofibrosarcoma, high-grade, of the spermatic cord. Postoperative CT scanning revealed multiple retroperitoneal lymph node metastases. He underwent radiation therapy, but soon developed lung metastases and pleural dissemination, and died 2 months after the operation. Myxofibrosarcoma, which had been called myxoid MFH is one of the most common soft tissue sarcomas. Myxofibrosarcoma or myxoid MFH of the spermatic cord is a rare disease. To our knowledge, only 7 cases have been reported in Japan to date.     

Leiomyosarcoma of the spermatic cord: a case report

A 61-year-old man presented to our hospital with a 1.5-year history of a gradually enlarging mass in the left scrotum. The mass was apart from the testis and fixed to the spermatic cord. The firm consistency and heterogeneous expression on ultrasonography suggested a malignant tumor. Orchiectomy with high ligation of the spermatic cord was performed and a histological examination revealed leiomyosarcoma of the spermatic cord. Distant metastases were not observed. Because the incidence of local recurrence has been reported to be high, we performed irradiation to control the disease. At 32 months post-surgery he was alive with no evidence of disease.     

Leiomyosarcoma of the spermatic cord: a case report

A 63-year-old man presented with painless hard swelling of left scrotal contents. Left orchiectomy with high ligation of the spermatic cord was done with clinical diagnosis of testicular tumor. Histopathologically, this tumor was diagnosed as leiomyosarcoma, primarily, arising from the spermatic cord. After operation, prophylactic radiotherapy (60Co, 5,890 rad) was given locally. There has been neither local recurrence nor metastasis for 10 months after operation. This is the 18th case of leiomyosarcoma of the spermatic cord in Japan.     

Liposarcoma of the spermatic cord: a case report

A case of spermatic cord liposarcoma is reported. A 66-year-old male visited our hospital with the complaint of right scrotal swelling. Laboratory and radiological examinations were unremarkable. A right high orchiectomy with en bloc resection of pericordal tissue was performed. Histological examination revealed well-differentiated liposarcoma of spermatic cord. There are 19 cases of spermatic cord liposarcoma reported in Japan.     

Liposarcoma of the spermatic cord: a case report

Objective

The aim of the article is to summarize experience in the pathology, diagnosis and treatment of spermatic cord liposarcoma (SCL).

Methods

The clinical data of a patient with liposarcoma of the spermatic cord was reviewed in combination with related literature.

Results

A 24-year-old male presented with a 1-year history of a mass in the right hemiscrotum. The tumor was resected and right inguinal orchidectomy was performed. The tumor had not recurred after 6 months follow-up.

Conclusion

Spermatic cord liposarcoma (SCL) is a rare medical condition and it is therefore difficult to establish guidelines for treatment, diagnosis and prognosis. Radical orchidectomy with wide local excision of the mass is the recommended therapy, while adjuvant radiotherapy may be considered in intermediate or high-grade tumors and recurrent liposarcomas. The role of chemotherapy is not well-defined.     

Myxofibrosarcoma involving the external saphenous nerve: a case report

Myxofibrosarcoma, also known as "myxoid malignant fibrous histiocytoma" is one of the most common soft tissue sarcomas in the extremities of adult patients. Most cases are characterized by a multinodular and/or infiltrative pattern with a tendency to infiltrate along fascial planes. We report a case of myxofibrosarcoma with an unusual presentation. Despite the clinical impression of a complete surgical resection, microscopic sarcomatous foci extended along the perineurium of the external saphenous nerve proximally up to 20 cm away from the main tumour. This unique case represents an extreme example of the locally agressive behaviour of soft tissue sarcomas and illustrates the microscopic tumour invasion along major nerves.     

Chondromyxoid fibroma involving the entire metacarpal: a case report

The occurrence of chondromyxoid fibroma in the hand is rare. We report a case of chondromyxoid fibroma involving the whole fourth metacarpal that was treated by curettage and cancellous bone allograft.     

Penile abscess involving the corpus cavernosum: a case report

A patient with a penile abscess containing mixed colonies of bacteria is presented. Ultrasound scan confirmed the physical examination findings of involvement of the corpus cavernosum. After incision and drainage the patient has normal erectile function.     

Leiomyoma of spermatic cord: a case report

A 68-year-old male was admitted to our hospital with the complaint of left painless mass of extratesticular scrotal content. Laboratory examinations were unremarkable. The tumor was resected by operation. The removed specimen was solid, 15 x 15 x 20 mm in size. Histopathological findings revealed leiomyoma. Other cases from the Japanese publications, together with our case, are reviewed.