Basaloid follicular hamartoma (BFH) is a rare, benign, skin adnexal tumor. Several clinical patterns have been reported, but they all share the same histopathological features. BFH may be hereditary or nonhereditary and can be accompanied by systemic diseases. Microscopic examination of BFH shows branching cords and anastomosing strands of basaloid cells in a loose, fibrous stroma. The most important pathological differential diagnosis is infundibulocystic basal cell carcinoma. These two lesions must be differentiated carefully based on clinical presentation and histopathological picture, and even molecular studies may be needed. We present a report of a 78-year-old woman with a solitary, asymptomatic, slow-growing skin tumor on her left scalp. No associated systemic disorders were found. On the basis of an excisional biopsy performed on the tumor, a pathological diagnosis of sporadic BFH was made.
Acute appendicitis involving the hernia sac is infrequent but well-documented in medical literature. In most instances, it occurs within the right inguinal (Amyand’s hernia) or right femoral hernia (de Garengeot hernia). The diagnosis is always mistaken for incarcerated groin hernia. During surgery, the appendix itself, either perforated or strangulated, is most commonly encountered within the hernia sac. In very rare occasions, only appendiceal pus is found in the hernia sac. In this paper, we report the case of a 90-year-old woman with acute appendicitis and a tender mass in the right groin. Typical findings of acute appendicitis by computed tomography (CT) and incarcerated femoral hernia with groin cellulitis misled us into preoperative diagnosis of strangulated femoral hernia. Acute phlegmonous inflammation of the incarcerated femoral hernia sac containing pus only and acute suppurative appendicitis were found intraoperatively. This case presents a rare complication of acute appendicitis and the first report of CT-documented appendiceal pus-contained femoral hernia. Knowledge of this rare condition is helpful in establishing preoperative diagnosis and patient management decisions.
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