Myatt RW1*, Orosz Z1, Teh J1, Issa F2 and Gibbons CLM1
1Nuffield Orthopedic Centre, Oxford University Hospitals NHS Foundation Trust, UK 2Department of Surgical Sciences, University of Oxford and Buckinghamshire Healthcare NHS Trust, UKFulltext PDF
Benign Perineal Pseudotumors (BPPs) can result from repetitive microtrauma in saddle sports. Also known as a ‘cyclist’s nodule’, ‘perineal nodular induration’ or ‘third testicle’, this fibrous soft tissue mass may be referred to a number of different medical specialists for investigation and management. Soft tissue sarcomas and other malignant or benign aggressive neoplasia, albeit rare, can affect the perineal region mimicking BPP and should be excluded. MRI, needle biopsy (ideally with radiological guidance), and referral to a specialist Sarcoma Unit is indicated to ensure the safe management of this condition. For confirmed cases of BPP, management may include conservative or operative options, considering the important anatomical structures in this area and the requirement for plastic reconstructive techniques in some instances.
Cyclist’s nodule; Saddle sports; Pseudotumor; Perineal nodular induration
Myatt RW, Orosz Z, Teh J, Issa F, Gibbons CLM. Benign Perineal Pseudotumor from Repetitive Microtrauma Associated with Saddle Sports: A Report and Guidelines for Management. Ann Plast Reconstr Surg. 2020; 4(4): 1066.