11-year-old Male with Right-sided Anterior Thigh Mass

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Journal of Investigative Medicine





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Case report An 11-year-old Caucasian male with the history of alopecia universalis presents with a right-sided anterior thigh mass. While obtaining a history the mother reports that 5 days prior to presenting the patient began to have a gradual onset of increasing anterior thigh pain. Over the next subsequent days, the patient began to develop a new mass. The patient described the pain as localising and aching with a 6 out 10 on the pain scale, He denies any history of trauma, insect bites, recent travel. The patient did mention possible cat scratch four weeks prior to presentation in the hand but the wound had already healed. On the day of presentation, the parents went to an urgent care which did an ultrasound that showed right inguinal lymphadenopathy and sent the patient to the emergency room for further management. On examination, his vital signs are temperature 98 degrees Celsius, heart rate 85 beats/minute, respiratory rate 20 breaths/minute, saturating 98% on room air. The patient was in no acute distress. The right anterior thigh there is noticeable swelling about 5 cm by 7 cm, and ~1 cm tall. The swelling has diffused margins; it is mobile and tender. No other regions of LAD. The skin overlying the mass is erythematous. No tracks. No fissures The rest of the physical exam was within normal limits. Laboratory studies are obtained, and a CBC and CMP are within normal limits. An LDH is 456 and uric acid is 5.4. An MRI showed right inguinal adenopathy; There are 2 large adjacent lymph nodes. These are measured together as 3.4 × 2.1 × 4.3 cm. No abscess; hip joint effusion noted Additional interventions and workup lead to the diagnosis.


Medicine and Health Sciences



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