Retroperitoneal metastatic poorly differentiated carcinoma with β-human chorionic gonadotropin secretion presenting as a psoas abscess

Wang, Bingjin; Liu, Weifang; Shao, Zengwu; Zeng, Xiaofeng

doi:10.1097/md.0000000000006837

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Iliopsoas abscess is a relatively rare disorder that has a diversity of frequency depending on patients' race, gender, and preexisting diseases [1]. Sequential iliopsoas abscess has been reported in the immunological suppression in rheumatoid arthritis, cervical spondylosis infection, ulcerative colitis, malignant tumor cases, and cardiovascular disorders [22][23][24][25][26]. Our study demonstrated that undernutrition is an indicator for the possible presence of IPA; however, serum inflammatory markers may not be useful to differentiate IPA from other inflammatory responses.…”

Section: Discussionmentioning

confidence: 66%

Detection of mecA and 16S rRNA Genes Using Real‐Time PCR Can Be Useful in Diagnosing Iliopsoas Abscess, Especially in Culture‐Negative Cases: RT‐PCR for Iliopsoas Abscess

Choe

Kobayashi

Itô

et al. 2022

BioMed Research International

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The rapid detection of etiological agents is important for the successful treatment of iliopsoas abscess (IPA). The purpose of this study was to investigate the clinical utility of a real-time polymerase chain reaction (PCR) that targets the mecA gene for methicillin-resistant staphylococci (MRS) and the 16S rRNA gene for pan-bacteria. Our retrospective diagnostic study included 22 patients exhibiting IPAs and four patients with noninfectious iliopsoas mass regions who underwent computerized tomography or ultrasonography-guided biopsy and/or surgical treatment. Clinical symptoms, serum data, imaging analysis, and tissue microbiological culture were utilized for the diagnosis of IPA. The diagnostic accuracy of real-time PCR was determined based on the diagnosis of IPA and microbiological culture results. The microbiological culture was positive for 12 IPA cases that included 2 MRSA infections. Among 12 culture-positive IPA cases, 16S rRNA-PCR was positive in 12 and MRS-PCR in two. Among 10 culture-negative IPA cases, including 3 TB cases, 16S rRNA-PCR was positive in 8 and MRS-PCR in 2. In noninfectious iliopsoas mass patients, neither 16S rRNA nor MRS-PCR detected bacterial DNA. The sensitivity, specificity, positive predictive, and negative predictive values of 16S rRNA-PCR for diagnosing IPA were 0.91, 1.00, 1.00, and 0.67, respectively, while those for the diagnosis of MRS infection with MRS-PCR were 1.00, 0.92, 1.00, and 0.50, respectively. Real-time PCR targeting bacterial DNA can detect bacterial DNA in culture-negative cases and offer improved detectability of MRS infection in IPA patients.

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Section: Discussionmentioning

confidence: 66%

Detection of mecA and 16S rRNA Genes Using Real‐Time PCR Can Be Useful in Diagnosing Iliopsoas Abscess, Especially in Culture‐Negative Cases: RT‐PCR for Iliopsoas Abscess

Choe

Kobayashi

Itô

et al. 2022

BioMed Research International

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“…The serum beta-human chorionic gonadotropin has been used to detect normal or ectopic pregnancy, and it can also be used in following up carcinomas. In a case presented by [ 37 ] the biopsy of the left psoas demonstrated metastatic or infiltrating poorly-differentiated carcinoma with the secretion of Beta human chorionic gonadotropin. The subsequent pathological examination of the neoplasm showed the same pathologic morphology.…”

Section: Resultsmentioning

confidence: 99%

Differential Diagnosis of Abdominal Tuberculosis in the Adult—Literature Review

Ionescu

Nicolescu

Madge³

et al. 2021

Diagnostics

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Tuberculosis (TB) is a public health issue that affects mostly, but not exclusively, developing countries. Abdominal TB is difficult to detect at first, with the incidence ranging from 10% to 30% of individuals with lung TB. Symptoms are non-specific, examinations can be misleading, and biomarkers commonly linked with other diseases can also make appropriate diagnosis difficult. As a background for this literature review, the method used was to look into the main characteristics and features of abdominal tuberculosis that could help with differentiation on the PubMed, Science Direct, and Academic Oxford Journals databases. The results were grouped into three categories: A. general features (the five forms of abdominal tuberculosis: wet and dry peritonitis, lymphadenopathy, lesions at the level of the cavitary organs, lesions at the level of the solid organs), B. different intra-abdominal organs and patterns of involvement (oesophageal, gastro-duodenal, jejunal, ileal, colorectal, hepatosplenic, and pancreatic TB with calcified lymphadenopathy, also with description of extraperitoneal forms), and C. special challenges of the differential diagnosis in abdominal TB (such as diagnostic overlap, the disease in transplant candidates and transplant recipients, and zoonotic TB). The study concluded that, particularly in endemic countries, any disease manifesting with peritonitis, lymphadenopathy, or lesions at the level of the intestines or solid organs should have workups and protocols applied that can confirm/dismiss the suspicion of abdominal tuberculosis.

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Retroperitoneal abscess as a presentation of colon cancer: The largest case set analysis to date, which extracted from our unit and the literature

Zhou,

Wan,

et al. 2023

Front. Oncol.

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ObjectiveColon cancer with retroperitoneal abscess is a rare and easily misdiagnosed disease and has only been reported via case. There is an urgent need to conduct a dataset analysis for such patients, which is crucial to improving the survival rate and quality of life of these patientsMethodsPatients with colon cancer associated with retroperitoneal abscess were extracted from our hospital and the PubMed, EMBASE and Web of Science databases. Clinical information, including the patients’ basic characteristics, clinical symptoms, laboratory tests, imaging examinations, treatment methods and prognosis was analyzed.ResultsSixty-one patients were analyzed, with an average age of 65 years. The proportions of right and left colon cancers were 63.9% and 36.1%, respectively. A total of 98.0% of the patients had adenocarcinoma. Many patients have insidious symptoms such as fever and weight loss. At the first medical visit, pain was the most common symptom (71%), with pain in the thigh (21.8%), abdomen (21.8%), and waist and back (14.5%) ranking among the top three. The misdiagnosis rate of the patients referred to our department was 75%, while the overall misdiagnosis rate in the literature was 43.9%. Laboratory tests show that these patients often have elevated white blood cells and anemia. CT examination showed that 87.2% of patients had an iliopsoas muscle abscess, and tumors were not simultaneously detected in 37.2%. A total of 33.9% of patients had local abscesses of the iliopsoas muscle, 26.4% had drainage into the subcutaneous tissue of the waist and upper buttocks, and 22.6% had drainage around the adductor muscle group of the thigh. These patients have a variety of treatments, and many patients have undergone multiple and unnecessary treatments. Thirteen patients died after surgery, and 6 died in the hospital, of whom four were patients undergoing direct surgery, and the other 7 died after discharge due to cachexia.ConclusionColorectal cancer with retroperitoneal abscess is a relatively rare and easily misdiagnosed subtype of colon cancer. It is more likely to occur in right-sided colon adenocarcinoma. The main clinical symptom is pain caused by the drainage of pus to the corresponding areas of the waist, abdomen, and legs. CT is the preferred diagnostic method. Actively treating the abscess and then transitioning to standard colon cancer treatment can prevent patient death and improve treatment quality.

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Retroperitoneal metastatic poorly differentiated carcinoma with β-human chorionic gonadotropin secretion presenting as a psoas abscess

Cited by 3 publications

References 25 publications

Detection of mecA and 16S rRNA Genes Using Real‐Time PCR Can Be Useful in Diagnosing Iliopsoas Abscess, Especially in Culture‐Negative Cases: RT‐PCR for Iliopsoas Abscess

Detection of mecA and 16S rRNA Genes Using Real‐Time PCR Can Be Useful in Diagnosing Iliopsoas Abscess, Especially in Culture‐Negative Cases: RT‐PCR for Iliopsoas Abscess

Differential Diagnosis of Abdominal Tuberculosis in the Adult—Literature Review

Retroperitoneal abscess as a presentation of colon cancer: The largest case set analysis to date, which extracted from our unit and the literature

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