Primary Pyomyositis Mimicking Soft-tissue Sarcoma: A Case Report.
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Date
2013-01
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Abstract
Aims: Our aim was to present a case of pyomyositis and highlight the need to
distinguish it from a soft-tissue sarcoma which it can closely mimic.
Presentation of Case: We report a 51-year old diabetic patient who presented with a
painful swelling in the right upper arm, which was not associated with fever. The mass
was well defined, tender and firm but lacked other signs of inflammation such as redness
or increased local warmth. Even the magnetic resonance imaging (MRI) findings were
more in favor of a soft-tissue sarcoma. A diagnosis of pyomyositis was revealed when
the trucut biopsy performed, yielded frank pus discharge.
Discussion and Conclusion: This case illustrates a diagnostic quandary of a soft tissue
mass. There may be a paucity of inflammatory signs in patients with an underlying
immunocompromised state, masking an initial diagnosis of pyomyositis. Although softtissue
sarcomas generally present as painless lumps, they can be painful especially with
larger tumors that are increasing in size, further adding to a diagnostic dilemma. While
MRI is a valuable tool for early diagnosis of pyomyositis, it can still be misleading.
Prompt biopsy is recommended to facilitate the correct diagnosis.
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Keywords
Pyomyositis, muscle, soft-tissue sarcoma, mimic, misdiagnose, MRI
Citation
Dhanoa Amreeta, Singh Vivek Ajit, Vijayananthan Anushya. Primary Pyomyositis Mimicking Soft-tissue Sarcoma: A Case Report. British Journal of Medicine and Medical Research. 2013 Jan-Mar; 3(1): 189-197.