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Journal of Cancer Research and... 2013Sacrococcygeal neoplastic lesions are very rare entities and therefore, a diagnostic and therapeutic challenge. They include developmental cysts, inflammatory,... (Review)
Review
Sacrococcygeal neoplastic lesions are very rare entities and therefore, a diagnostic and therapeutic challenge. They include developmental cysts, inflammatory, neurogenic, osseous and miscellaneous lesions. In this review, we discuss the incidence, symptoms, characteristics, diagnostic methods and treatment strategies of these enigmatic lesions. We have to highlight the high index of suspicion that is necessary when dealing with chronic sacrococcygeal pain or multiple perianal abscesses or persistent perianal drainage, because any misinterpretation may result in unfavorable outcomes.
Topics: Humans; Neoplasms; Sacrococcygeal Region
PubMed: 24125963
DOI: 10.4103/0973-1482.119297 -
Wound Management & Prevention Aug 2019Existing evidence is inadequate to assume increased skin temperature is a risk factor for the development of pressure ulcers (PUs).
UNLABELLED
Existing evidence is inadequate to assume increased skin temperature is a risk factor for the development of pressure ulcers (PUs).
PURPOSE
The purpose of this prospective, descriptive study was to examine the relationship between sacral skin temperature and PU development.
METHODS
Using convenience sampling methods, patients who were hospitalized in the tertiary intensive care unit (ICU) of the internal medicine department of a university hospital in İzmir, Turkey, between April and December 2015 were eligible to participate if they were ⟩18 years of age, had an expected hospital stay of at least 5 days, a Braden score ≤12, and were admitted without a PU. Demographic and clinical data collected included age, gender, body mass index, diagnosis, mattress type, length of follow-up (days), systolic and diastolic blood pressure, body temperature, hemoglobin level, sacral skin temperatures in the supine and lateral positions, room temperature, PU stage and duration, and Braden score. Temperature was measured the day of hospitalization as a baseline measurement (day 1) and once every day thereafter up to 22 days, until the patient did or did not develop a PU, died, was no longer undergoing position change, or was discharged. Sacral skin temperature was taken immediately after the patient was moved to a lateral position following 120 minutes of supine position (referred to as sacral skin temperature measurement) and after 30 minutes in lateral position (referred to as sacral skin temperature measurement). Data were collected using paper-and-pencil questionnaires and entered into a software program for analysis. Descriptive statistics, Student's test, one-way analysis of variance test, Pearson product-moment correlation analysis, and Spearman's rank-order correlation analysis were used for data analysis.
RESULTS
Of the 37 patients who met the inclusion criteria and were monitored for at least 5 days, 21 (56.8%) developed PUs. No statistically significant difference in supine position sacral skin temperature on day 1 or day 5 was found between patients who did and did not develop a PU (36.90° C ± 0.29° C and 37.15° C ± 0.53° C, respectively, on day 1; = -1.656, = .112; and 37.37° C ± 0.53° C and 37.30° C ± 0.79° C, respectively, on day 5; = 0.259, = .798). Day 5 lateral position skin temperatures also did not differ significantly between the 2 groups (37.44° C ± 0.44° C and 37.31° C ± 0.75° C, respectively; = 1.306, = .621). A statistically significant difference was noted between mean sacral skin temperature in the supine position among patients ages 75 to 90 years compared with patients 38 to 64 years and 65 to 74 years (36.93° C ± 0.39° C; F = 13.221, = .000) and with use of a viscoelastic mattress compared with an alternating pressure air mattress and continuous lateral rotation alternating pressure air mattress (37.85° C ± 0.54° C; F = 14.039, = .000). No statistically significant differences in sacral skin temperatures were found for any of the of the other variables assessed.
CONCLUSION
Sacral skin temperatures were not statistically different between ICU patients who did and did not develop a PU. Additional research may help increase understanding of the relationship between skin temperature and PU development.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Pressure Ulcer; Prospective Studies; Risk Factors; Sacrococcygeal Region; Skin Temperature; Turkey
PubMed: 31373568
DOI: No ID Found -
AJNR. American Journal of Neuroradiology Mar 1998We report the imaging findings of pericoccygeal hidrocystoma in a 52-year-old woman. Sonography showed a large cystic lesion with internal echoes in the pericoccygeal...
We report the imaging findings of pericoccygeal hidrocystoma in a 52-year-old woman. Sonography showed a large cystic lesion with internal echoes in the pericoccygeal region; it appeared as a well-defined, low-density mass on CT, and as a high-signal-intensity mass on T1- and T2-weighted MR images. Histopathologic examination revealed an apocrine hidrocystoma.
Topics: Female; Hidrocystoma; Humans; Magnetic Resonance Imaging; Middle Aged; Sacrococcygeal Region; Sweat Gland Neoplasms; Ultrasonography
PubMed: 9541324
DOI: No ID Found -
Medical Archives (Sarajevo, Bosnia and... Apr 2021Infantile hemangiomas (IH) are the most common vascular, benign tumors of childhood with a prevalence of 4-5%. Due to intense vasculogenesis, they proliferate during...
BACKGROUND
Infantile hemangiomas (IH) are the most common vascular, benign tumors of childhood with a prevalence of 4-5%. Due to intense vasculogenesis, they proliferate during infancy, then involute at an unpredictable rate, extent of involution, and quality of residual tissue. Depending on the location, they may be associated with anomalies of other organ systems (PHACE, PELVIS syndroms). In recent decades, knowledge about hemangiomas has improved, and therefore therapeutic possibilities have improved. Today, the non-selective beta blocker-propranolol is considered the drug of first choice in the treatment of infantile hemangiomas. It is desirable to start treatment in the proliferative phase of hemangioma growth for the best possible effect. The dynamics of drug administration, time interval of dose increase and monitoring of patients during treatment vary from one Institution to another and are still the subject of discussion.
OBJECTIVE
We presented the case of a child with infantile hemangioma of the lumbo-sacral region, treated with combination therapy with systemic propranolol and topical timolol, with satisfactory effect in the end.
CONCLUSION
Propranolol is considered a drug with well-studied side effects and a safety profile. During 6 months of treatment, it leads to complete or almost complete withdrawal of the hemangioma. Treatment should be started in the hemangioma proliferation phase for the best possible therapeutic effect.
Topics: Administration, Topical; Adrenergic beta-Antagonists; Bosnia and Herzegovina; Female; Hemangioma; Humans; Infant; Propranolol; Sacrococcygeal Region; Timolol; Treatment Outcome; Vasodilator Agents
PubMed: 34219878
DOI: 10.5455/medarh.2021.75.158-161 -
World Neurosurgery Jul 2022Sacral cysts are classically divided into Tarlov cysts and meningeal diverticula. However, the pathogenesis of sacral cysts remains unclear. This study aimed to clarify...
BACKGROUND
Sacral cysts are classically divided into Tarlov cysts and meningeal diverticula. However, the pathogenesis of sacral cysts remains unclear. This study aimed to clarify a novel type of sacral extradural spinal meningeal cyst with a specific arachnoidal structure.
METHODS
Nine patients with prophylactic diverticula were included in the study. All patients underwent MRI preoperative reconstruction and traditional neck transfixation.
RESULTS
All patients presented with more than one symptom. The major symptom was lower extremity pain, followed by lower extremity numbness (77.8%, 7/9), lower extremity weakness (55.6%, 5/9), bowel/bladder and sexual dysfunction (55.6%, 5/9), and tenesmus (22.2%, 2/9). After long-term follow-up, the outcome was classified as improved in 9 patients (100%).
CONCLUSIONS
The clinical findings of this study illustrate a special subtype and may help explain the mechanism of sacral cyst formation.
Topics: Arachnoid Cysts; Central Nervous System Cysts; Diverticulum; Humans; Pain; Sacrococcygeal Region; Sacrum; Tarlov Cysts
PubMed: 35307586
DOI: 10.1016/j.wneu.2022.03.052 -
World Journal of Gastroenterology Oct 2011This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic... (Review)
Review
This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: a recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle--a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.
Topics: Anal Canal; Chronic Pain; Diagnosis, Differential; Humans; Pelvic Pain; Pudendal Neuralgia; Rectum; Sacrococcygeal Region
PubMed: 22110274
DOI: 10.3748/wjg.v17.i40.4447 -
Developmental Biology Aug 2021Mouse models of Spina bifida (SB) have been instrumental for identifying genes, developmental processes, and environmental factors that influence neurulation and neural...
Mouse models of Spina bifida (SB) have been instrumental for identifying genes, developmental processes, and environmental factors that influence neurulation and neural tube closure. Beyond the prominent neural tube defects, other aspects of the nervous system can be affected in SB with significant changes in essential bodily functions such as urination. SB patients frequently experience bladder dysfunction and SB fetuses exhibit reduced density of bladder nerves and smooth muscle although the developmental origins of these deficits have not been determined. The Pax3 Splotch-delayed (Pax3) mouse model of SB is one of a very few mouse SB models that survives to late stages of gestation. Through analysis of Pax3 mutants we sought to define how altered bladder innervation in SB might arise by tracing sacral neural crest (NC) development, pelvic ganglia neuronal differentiation, and assessing bladder nerve fiber density. In Pax3 fetal mice we observed delayed migration of Sox10+ NC-derived progenitors (NCPs), deficient pelvic ganglia neurogenesis, and reduced density of bladder wall innervation. We further combined NC-specific deletion of Pax3 with the constitutive Pax3 allele in an effort to generate viable Pax3 mutants to examine later stages of bladder innervation and postnatal bladder function. Neural crest specific deletion of a Pax3 flox allele, using a Sox10-cre driver, in combination with a constitutive Pax3 mutation produced postnatal viable offspring that exhibited altered bladder function as well as reduced bladder wall innervation and altered connectivity between accessory ganglia at the bladder neck. Combined, the results show that Pax3 plays critical roles within sacral NC that are essential for initiation of neurogenesis and differentiation of autonomic neurons within pelvic ganglia.
Topics: Animals; Cell Differentiation; Disease Models, Animal; Female; Ganglia; Male; Mice; Mice, Inbred C57BL; Nervous System; Neural Crest; Neural Tube Defects; Neurogenesis; PAX3 Transcription Factor; Paired Box Transcription Factors; SOXE Transcription Factors; Sacrococcygeal Region; Spinal Dysraphism; Urinary Bladder
PubMed: 33839113
DOI: 10.1016/j.ydbio.2021.03.024 -
Ugeskrift For Laeger Nov 2015Subcutaneous myxopapillary ependymoma is a very rare entity, and to our knowledge this is the first published case from Denmark. A previously healthy 32-year-old male...
Subcutaneous myxopapillary ependymoma is a very rare entity, and to our knowledge this is the first published case from Denmark. A previously healthy 32-year-old male presented with subcutaneous swelling and tenderness located at the top of the intergluteal cleft. The circular soft tumour, measuring 1.7 × 1.7 × 1.2 cm, was removed surgically. After histopathological examination with several immunohistochemical and special stainings, the diagnosis surprisingly was subcutaneous myxopapillary ependymoma. The tumour was removed with free margins and no metastases were found on follow-up CT- and MRI scans.
Topics: Adult; Ependymoma; Humans; Male; Sacrococcygeal Region
PubMed: 26651556
DOI: No ID Found -
Polski Przeglad Chirurgiczny Feb 2022<b>Introduction:</b> As a rule, the treatment of pilonidal cysts is based on a surgical approach. Surgical treatment depends on the form of the disease and...
<b>Introduction:</b> As a rule, the treatment of pilonidal cysts is based on a surgical approach. Surgical treatment depends on the form of the disease and surgeon's preferences regarding the method. The treatment process does not consider preoperative treatment that would affect the structural components of the skin involved in the pathological process. The results of surgical treatment remain unsatisfactory, leading to a significant number of recurrences and long-term healing of the postoperative wound. </br></br> <b> Materials and methods:</b> Morphological examination of the pieces of skin with altered sacrococcygeal tissues after radical surgical treatment of 46 patients with pilonidal cyst of the sacrococcygeal region was performed, and 46 patients with acne inversa of the intergluteal cleft, groin and scalp were selected. The sex distribution of patients with pilonidal cysts was as follows: 43 (91.3%) male patients, 3 (6.5%) female patients. Among 46 patients with acne inversa and dissecting cellulitis, the distribution was as follows: 32 (69.6%) male patients and 14 (30.4%) female patients. Patients with pilonidal cysts of the sacrococcygeal region underwent surgical treatment according to the developed method of economical median resection using sutures with internal fixation. </br> </br> <b> Results:</b> Considering and comparing the morphological picture observed in the pathomorphological examination of histological specimens in patients with pilonidal cysts, acne inversa, dissecting cellulitis, the similarity of changes in most patients is noteworthy. "Acne inversa" was first described in 1839 by Velpeau, who originally called the disease "hydradenitis suppurativa", believing that inflammatory changes occur in the sweat glands [1-3]. In 1854, surgeon Verneuil described this disease, and later it was named after him. We observed chronic proliferative inflammation in different layers of the dermis and subcutaneous tissue (the main focus is in the subcutaneous tissue, but closely related to the dermis and epidermis). </br></br> <b>Discussions:</b> Pilonidal cyst of the sacrococcygeal region, especially without hair in the cavity of the cyst, can be considered as a type of acne inversa with appropriate location. We believe that the use of local and systemic retinoids, namely isotretinoin, in the treatment of patients with this disease other than surgery, together with other groups of drugs traditionally used in the treatment of pilonidal cysts, may be promising in the treatment of pilonidal cysts.
Topics: Acne Vulgaris; Cellulitis; Female; Hidradenitis Suppurativa; Humans; Male; Pilonidal Sinus; Sacrococcygeal Region
PubMed: 36047363
DOI: 10.5604/01.3001.0015.5983 -
BMJ Case Reports Feb 2023Teratomas in the neonatal age group are mostly benign at first, and the common site is the sacrococcygeal region. They are rarely associated with HIV infection. We...
Teratomas in the neonatal age group are mostly benign at first, and the common site is the sacrococcygeal region. They are rarely associated with HIV infection. We report a case of an HIV-exposed newborn with a congenital teratoma at the post-auricular site who developed an infection. Early intervention by total surgical resection will prevent complications such as infections and malignant transformation. A term baby was delivered spontaneously by an HIV-positive mother who was on her regular medications. Prenatal ultrasound carried out in the third trimester showed a cyst swelling on the right post-auricular region. Radiological imaging and the histopathological result revealed a congenital teratoma. A wide major excision with preservation of the facial nerve was performed at the age of 8 weeks. Post-auricular teratomas are the rarest anatomical location and the prevalence of malignant transformation from benign is very low. If left untreated, this tumour is associated with high mortality and malignant transformation rates. An early complete surgical excision allows a good result with a low risk of complications and recurrence.
Topics: Infant; Infant, Newborn; Pregnancy; Female; Humans; HIV Infections; Teratoma; Mothers; Sacrococcygeal Region; Cell Transformation, Neoplastic
PubMed: 36746517
DOI: 10.1136/bcr-2022-252977