Learning objectives
Because the gluteal region consist of different tissue types (skin,
subcutaneous and deep fat,
blood vessels,
anorectal canal,
muscles,
neural tissue and bones),
many varied lesions can be encountered.
In this presentation,
we aim to review the computed tomography (CT) and magnetic resonance imaging (MRI) findings of gluteal lesions on the basis of case examples.
Background
The imaging findings on CT and/or MRI in asymptomatic patients or in patients with pain,
palpable lump or erythema in the gluteal region were evaluated.
The lesions located in or extending into the gluteal region in our patients:
Gluteal arteriovenous malformation
Superior gluteal artery aneurysm
Hidradenitis suppurativa
Abscess
Perianal fistula
Invasion of anal cancer
Sebaceous cyst complicated with sinus
Hematoma
Lipoma
Liposarcoma
Dystrophic calcifications secondary to intramuscular injections
Myositis ossificans
Malignant mesenchymal tumor
Ewing’s sarcoma
Metastasis
Lymph node metastasis
Findings and procedure details
Gluteal arteriovenous malformations (AVM) (Figure 1): AVM’s are congenital vascular lesions that arise secondary to a developmental defect in the vascular system in the 4-6th gestational weeks.
There is a direct connection between the artery and the vein,
but no capillary bed exists.
AVM’s contain tortuous dilated feeding arteries and draining veins.
AVM’s can cause cosmetic defects,
and compression to the peripheral nerves leading to pain and functional disorders.
Eventually,
this abnormal hemodynamic cause steal phenomenon,
venous hypertension and ischemic ulcers,
dermatitis due to venous...
Conclusion
Pathologic entities in the gluteal region reflect the diversity of tissue types present.
These pathologies can be infectious,
inflammatory,
traumatic,
and benign or malignant neoplasms.
Cross-sectional imaging methods,
such as CT and MRI,
are useful for defining the extent of disease and may show pathognomonic features,
enabling a precise diagnosis.
References
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Diagnostic methods,
treatment modalities,
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Medicina (Kaunas) 2012; 48:388-398.
2.
Schorn B,
Reitmeier F,
Falk V,
et al.
True aneurysm of the superior gluteal artery: case report and review of the literature.
J Vasc Surg 1995; 21:851-854.
3.
Sullivan CM,
Regi JM.
Pseudoaneurysm of the superior gluteal artery following bone marrow biopsy.
Br J Haematol 2013; 161:289-291.
4.
Balık E,
Eren T,
Bulut T,
et al.
Surgical approach to extensive hidradenitis...