Sir,We report on a case of mucinous adenocarcinoma arising from a fistula-in-ano, which formed a huge subcutaneous mass in the buttock.A 68-year-old diabetic man was referred to our hospital. Two years prior to the admission, the patient had first recognized a small subcutaneous nodule which gradually increased in size. On admission, he complained of a spontaneous pain. The mass measured 12×7 cm, and the covering skin had some ulcers with a foul smell.A contrast-enhanced transverse T1-weighted MR image (Fig. 1) revealed a huge cystic mass. The wall showed marked contrast uptake. Some enhancing solid components were also disclosed. The content showed homogenous low signal intensity on T1-weighted images, whereas a T2-weighted image (not shown) revealed marked hyperintensity.On another transverse image (Fig. 2), which was obtained at the cranial aspect of the lesion, a tubular structure was disclosed. This finding implied a fistula between the mass and the anus, although no direct continuity was identified.These MR findings in conjunction with the clinical course strongly sugEur Radiol (

A 55-year-old woman complained of a subcutaneous mass in her left buttock. MR images revealed an ill-defined soft tissue mass that crossed the fascia of the gluteus maximus muscle. Some surrounding edema was noted. The lesion showed some contrast uptake after administration of Gd-DTPA. An excisional biopsy revealed sarcoidosis involving both the muscle and subcutaneous tissue across the fascia, mimicking a sarcoma.

Lymph nodes may occasionally become apparent in the free jejunal flap. There was no suggestion of metastatic lymph nodes when examined retrospectively. We speculate that this reaction was the result of environmental changes attributable to surgery.

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