Abdominal masses have always been a dilemma for the surgeons and this problem is more so in retroperitoneal masses. In our case, the patient presented with retroperitoneal mass in the left lumbar region with no other specific local or systemic symptoms. The diagnosis of Castleman's disease was established only after histopathological examination of the mass after resection. Castleman's disease is an angiofollicular lymph node hyperplasia presenting either as a localized or a systemic disease. In our case, the patient presented with the localized form of the disease and as it is a rare presentation we are presenting this case.
Vascular malformations (VMs) are developmental abnormalities of the vascular system. Malformations may involve any segment of the vascular tree: arteries, capillaries, veins or lymphatics. High-flow arteriovenous malformations (AVMs) are associated with shunting of large amounts of arterial blood into the venous system; these lesions can have dynamic and dramatic hemodynamic manifestations, such as massive arteriolisation with gross venous engorgement, organomegaly of concerned anatomical region and high-output cardiac failure. Patients with Parkes Weber syndrome have clinically significant micro- or macrofistulous arteriovenous shunts, affecting usually one extremity. The patient has dilated, frequently visible pulsatile varicose veins and other visible signs of AV shunting. The abnormality is sporadic; it is likely a somatic mutation. There is frequent intraosseous involvement. The presence of high AV shunts differentiates Parkes Weber syndrome from Klippel-Trenaunay syndrome which is a clinical triad of capillary malformation, soft tissue and bone hypertrophy and venous and lymphatic malformations. The mutations in RASA 1 gene leads to Parkes Weber syndrome characterised by the presence of multiple, small (1-2 cm in diameter) capillary malformations mostly localized on the face and limbs. We report a case of congenital AVM of the lower limb causing cardiac decompensation. The patient was safely and successfully treated by performing a knee disarticulation.
Retroperitoneal lipomas are known for their rarity and varied presentations. We are reporting a case of giant retroperitoneal lipoma which presented as inguinal hernia.
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