We report the case of a 65-year-old man who presented to the emergency department in August 2005 with a 72-hour history of sudden pain in the hypochondrium and right inguinal region, fever, malaise and urinary symptoms.
She has a history of hypertension and diabetes mellitus 2 under treatment, her mother had breast cancer, her father coronary disease and her sister a brain tumor.
Upon admission to the emergency department, blood pressure (BP) was 130, respiratory rate (HR): 80 pulses per minute, respiratory rate (RR): 18 breaths per minute, temperature (cm): 3
In the neck, a thyroid mass of 4 x 6 cm was observed. The mass was indurated, was not mobile and painless due to palpation, without inflammatory changes.
On physical examination, a large mass was found in the right flank and iliac fossa. The mass was not located in the left inguiniculous region tact. There was no inflammatory consistency, the mobile test showed a palpable mass.
The patient presents pain to the right lumbar percussion and urinary tract infection was confirmed by urocultive, intravenous antibiotic treatment was initiated.
Dehydrogenated lactate (LDH) levels were determined, resulting in 300 U/L.
During hospitalization he presented hyperglycemia (259 mg/dl), normal creatinine (0.8 mg/dl), Leukocytes 17850 Neuils 86% Hemoglobin 16 Platelets 275,000.
Antibiotic management decreased the signs of systemic inflammatory response.
A contrasted abdominal tomography (CT) was performed (September 2005) which reported the presence of a large mass in the right iliac fossa that displaces the bladder toward the contralateral side and continues to the right hemiscrotum.
No evidence of regional lymphadenopathy.
Exertion of the tumor was performed along with radical orchidectomy of the same side of a lobulated, lobulated mass, folded, surface, 5786 cm measured 34 x 22 x 1786 cm, and
Complete extraction was achieved without complications, the patient had a good postoperative clinical evolution, so it was decided to give exit on the 5th postoperative day.
1.
The pathology report confirms that the tumor lesion corresponds to a malignant neoplasm of mesenchymal and sarcomatous origin formed by tumoral adipogenic cells in which a differentiated hypnoid appearance is observed in the middle of which there are some pleomorphic cells bizar.
The tumor corresponds to a dedifferentiated liposarcoma in which the adipose component is classic well-differentiated liposarcoma (lipoma-like) from which emerges islands of chordosarcoma-free component with liposarcoma-free margins, corresponding to such findings
It is suggested to start local radiotherapy but the patient rejects it by accepting only periodic clinical controls.
During the follow-up, cervical aspiration cytology was performed, the pathological report of which reports papillary thyroid carcinoma, currently under follow-up by on.
Forty-eight months after resection of the inguinal mass the patient is asymptomatic, without clinical or paraclinical signs of tumor recurrence.