MR diagnosis of macrodystrophia lipomatosa

Macrodystrophia lipomatosa of finger-A rare case report

Macrodystrophia lipomatosa is a rare form of nonhereditary congenital localized gigantism involving upper and lower limbs and is characterized by overgrowth of all the mesenchymal elements predominantly fibro-adipose component, in the distribution of a particular nerve, usually median nerve. It usually presents with progressive painless overgrowth of the involved limb, toe, or digit and is associated with macrodactyly. It might cause limitation of the movement of the involved part. Imaging has an important role in diagnosing this condition and differentiating it from malignant mimics. Imaging findings include hypertrophy of the mesenchymal elements of the involved digits and/or limbs predominantly fibro adipose component with associated overgrowth of the phalanges. In this case report, we present a case of unilateral involvement of index finger and thumb with associated macrodactyly.

Surgical Management of Macrodystrophia Lipomatosa, a rare case report of the left hand middle finger macrodactyly

INTRODUCTION

Macrodystrophia Lipomatosa is a rare congenital non-hereditary disorder, characterized by the presence of gigantism of a small part of the limb or the whole limb due to an overgrowth and disproportionate growth of fibroadipose tissue, causing macrodactyly.

CASE PRESENTATION

One case of the 14-year-old girl presented with an enlarged middle finger of her left hand since birth, discomfort during the last 6 months, and resistance to flex, was underwent surgery by performing debulking procedure and a yellow cord-like mass was obtained from the digital nerve covered and enlarged by fibrofatty tissue to the palm area, could be cut off completely. Imaging and histopathological examination revealed to macrodystrophia lipomatosa. We follow up the patient for the finger's range of motion, the neurological disturbance and re-enlargement of the tumor.

DISCUSSION

Since there were compression of the nerves, functional impairment due to enlarge fingers and cosmesis problems, the surgery was indicated. Types of surgery may include debulking of soft tissue, especially adipose tissue. The mass size was decrease, motor function and movement of the middle finger were normal post operatively, but sensory deficits persisted according to the distribution of the digital nerves. Three months and six years after surgery, no enlargement of the middle finger, normal motor function, normal finger movements but sensory deficit still persisted according to the distribution of the digital nerves.

CONCLUSION

Surgical management in macrodactyly due to macrodystrophia lipomatosa of the finger give the satisfactory result.

A patient with macrodystrophia lipomatosa bilaterally affecting the entire upper extremity: reporting of a rare case and literature review

The patient, a 58-year-old Asian female, had the progressive, bilateral overgrowth of the entire upper extremity since her childhood and has undergone debulking surgery twice in her country. However, overgrowth progressed after surgery. The patient was diagnosed with Macrodystrophia lipomatosa (MDL) by physical and imaging findings in our departments.

Primary Site Identification of Soft-Tissue Mass: Things to Know in MRI Assessment

The spectrum of soft-tissue mass is varied, including neoplastic and nonneoplastic/inflammatory lesions. However, soft-tissue tumors have similar imaging findings and, therefore, the diagnosis of soft-tissue mass is challenging. Although careful assessment of the internal characteristics on imaging can often narrow the differential diagnoses, the differential diagnosis may be out of the question if identification of the soft-tissue mass origin is missed. The purpose of this article is to review the imaging findings and the essential anatomy to identify the primary site of the soft-tissue mass, and discuss the associated potential pitfalls. In order not to fall into a pitfall, recognition of characteristic imaging findings indicating the origin of the soft-tissue mass and anatomical knowledge of the normal tissue distribution are necessary. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.

Macrodystrophia lipomatosa with fibrolipomatous hamartoma of medial plantar nerve and lipomatosis of thigh

Macrodystrophia lipomatosa (MDL) is a rare congenital non-hereditary condition characterised by an abnormal overgrowth of mesenchymal tissue of a digit or an extremity. Although MDL is interchangeably described by terms such as macrodactyly and macrosomia, the entity has to be differentiated from other acquired and hereditary causes of macrodactyly. Rare association with osteochondromas and lipomas in other parts of the body has also been reported. We present a case with gradual progressive swellings of the right great toe and right thigh, which was diagnosed to be a case of MDL of the great toe with fibrolipomatous hamartoma of medial plantar nerve and lipomatosis of the thigh based on characteristic imaging findings.

Macrodystrophia Lipomatosa: A Single Large Radiological Study of a Rare Entity

Introduction:

We present one of the largest case series of Macrodystrophia lipomatosa, a rare congenital disorder of localized gigantism characterized by overgrowth of all the mesenchymal elements, predominantly involving the fibroadipose tissue.

Aims:

To detail the radiological features, pattern of distribution, associated conditions and to suggest an appropriate terminology to describe the condition.

Methods and Material:

It is a retrospective study. Data from PACS server dating from 2000 and 2018 was used. The cases with isolated enlarged limb or digit/digits with or without nerve involvement were included in the study.

Statistical Analysis Used:

Frequency and percentage were used for analysis of categorical variables.

Results:

A total of 31 cases was included for the final analysis, out of which 19 were males and 12 were females. Unilateral limb involvement was seen in 30 cases. The most common pattern identified was the ’nerve territory oriented’ type in 28 cases confined to the hand or foot, ’diffuse or pure lipomatous’ type in one case and mixed type was seen in two cases. The most common nerve territory involved was along the median nerve in the upper limb and along the medial plantar nerve in the lower limb. Neural involvement was seen in 16 cases of the upper limb and 10 cases of the lower limb. Syndactyly was seen in two cases, polydactyly in one case and symphalangism in one case.

Conclusions:

A diagnosis of macrodystrophia lipomatosa can be confidently made in cases with congenital isolated limb or digit/digits enlargement with or without fibrolipohamartoma of nerve. Radiographs and ultrasound are sufficient along with clinical examination to make accurate diagnosis. MRI is useful for assessing the extent and for planning surgery.

Macrodystrophia Lipomatosa of the Finger: A Case Report

Introduction

Macrodystrophia lipomatosa is a rare benign condition characterized by a progressive persistent proliferation of the mesenchymal components and elements, with a disproportionate increase in fibro-adipose tissue. It causes a debilitating functional and psychological effect on the patient and his family.

Case presentation

A 25-years-old male patient presented complaining of left middle finger swelling which was painless and progressive in size with no restriction of range of motion. Plain X-ray films of the left hand showed a heterogeneous lobulated soft tissue mass on the volar aspect of the middle finger which was confirmed by MRI scan. Surgery was performed by doing a left middle finger soft tissue excision and diagnosis of Macrodystrophia lipomatosa was confirmed by the histopathology report. Patient was on regular follow up in the clinic with no tumour recurrence and an excellent cosmetic as well as functional result with full finger joints range of motion.

Conclusion

Macrodystrophia lipomatosa should be suspected with this kind of presentations. Combination of the clinical history and examination with the aid of radiological assays aided in the diagnosis of this extremely rare case and led to the appropriate management by excising this mass and restoring the normal function of the patient's hand.

Macrodystrophia Lipomatosa of the Toe: A Rare Case Report

Macrodystrophia lipomatosa is a rare congenital hamartoma presenting as a localized or generalized gigantism of a limb or digit manifesting from infancy to late adulthood. It is a progressive enlargement of the soft tissue components, especially fibrofatty tissue. The patient presents to us because of cosmetic reasons or mechanical issues secondary to degenerative joint disease, or features of neurovascular compression due to large osteophytes. Here, we present a case of this anomaly of the left second toe with complaints of difficulty in walking and wearing shoes, for which toe reduction surgery with partial amputation was done.

Macrodystrophia lipomatosa: A troubled second big toe

We report the case of a 4-year-old boy who presented to our facility with an enlarged right second toe. After radiography ruled out acute pathology, an MRI showed increased adipose tissue at the distal aspect of the appendage. Although the parent felt that the appendage was unaesthetic, there was no functional issue, and further discussion with the pediatricians and pediatric surgeons eliminated the need for immediate intervention. Macrodystrophia lipomatosa is a rare entity that predominantly affects children. Distributed evenly in males and females, the disease refers to hypertrophy of fibroadipose tissue of the distal upper and lower extremities.

A Review of Macrodystrophia Lipomatosa: Revisitation

Macrodystrophia lipomatosa (MDL) is a rare congenital non-hereditary disorder that has significant impact on patient morbidity. This study provides a comprehensive review of the natural history, diagnosis, management, and outcomes of the disorder. A literature search in PubMed was conducted to identify cases of MDL from January 1950 to 14 February 2014. After ruling out articles without information related to the management of the disorder, a summary of 32 studies was performed. An additional three cases from the authors are also presented. Based on 57 journal articles and three additional cases from the authors, around 108 cases of MDL were reviewed. Most patients were males who were admitted to a treatment clinic in the first four years of life. The lower extremities were more frequently affected, with unilateral presentation being most common. They commonly underwent a single-staged surgical procedure with follow-up periods ranging from more than one year up to 21 years. Out of 43 cases that underwent surgical procedures, 13 reported no complications, and there were seven cases of esthetic satisfaction and 15 cases of significant functional improvement. Depending on the severity of a patient's condition, the use of non-invasive diagnostic tools should be carefully considered. Surgery might be a better choice of management than observation, taking into account possible future complications in the absence of surgery and the beneficial outcomes of surgical procedures.

Benign soft-tissue lesions of the fingers: radiopathological correlation and clinical considerations

Soft-tissue lesions of the fingers are commonly found in daily clinical practice. A wide range of tumors and pseudotumors have been described in this location, and the majority of them are benign. Ganglion cysts are the most common entity, and the localized type of tenosynovial giant cell tumors are the most frequent solid condition. Both may be easily recognized owing to their typical clinical and radiological characteristics. However, categorization of the spectrum of soft-tissue lesions of the fingers remains limited, despite imaging development, and many patients undergo surgery before radiological or histological diagnosis. Clinical history, radiographic features, and ultrasound and magnetic resonance patterns may help in obtaining the correct diagnosis or reducing the list of differential diagnoses. Radiologists should be familiar with imaging findings so that they can determine the size, extension, and affected neighboring anatomical structures, and provide information that allows adequate presurgical counseling.

Imaging of pediatric pathology during the Iraq and Afghanistan conflicts

United States Armed Forces radiologists deployed to Afghanistan and Iraq in modern military conflicts may encounter pediatric patients as a casualty of war or when providing humanitarian assistance to the indigenous population. Pediatric patients account for 4-7% of admissions at U.S. military hospitals during the Iraq and Afghanistan conflicts. It is pertinent for radiologists in the humanitarian care team to be familiar with imaging pediatric trauma patients, the pathology endemic to the local population, and delayed presentations of congenital and developmental disorders to adequately care for these patients. The radiological manifestations of various pediatric disorders seen in the setting of the Iraq and Afghanistan conflicts will be explored.

Macrodystrophia lipomatosa of a fifth digit: a case report

Macrodystrophia lipomatosa (MDL) is a rare, nonhereditary, congenital malformation that primarily affects the proliferation of mesenchymal structures. It presents with localized macrodactyly of one or more digits. The characteristic pathology is associated with hypertrophic fibroadipose tissues, more so to the plantar aspect of the foot. This condition can pose a threat to vascular supply, innervation, and even joint function. We present a single case of a 4-year-old male patient who presented with progressive enlargement of a unilateral left fifth digit since birth. The patient became increasingly symptomatic. Amputation was the selected treatment, and on pathological review of the specimen, the diagnosis of MDL was confirmed. The patient is approximately 1 year postoperative and has recovered uneventfully with an improved quality of life. The purpose of this article is to raise awareness of this condition with an emphasis on diagnosis through ancillary imaging results.

LEVELS OF EVIDENCE

Therapeutic, Level IV: Case report.

Multiple neural fibrolipomas with macrodactyly

Neural fibrolipoma is an uncommon tumor-like lesion that involves the upper extremity and usually arises in the median nerve. It is associated with macrodactyly in one-third of the cases. A 3-year-old girl presented with increasing size of fingers of both the hands since birth. Clinical examination revealed macrodactyly of two fingers of the right hand and three fingers of the left. Surgical reduction was performed and microscopy of the biopsy specimen established the diagnosis of neural fibrolipoma. Knowledge of the clinicopathological features is necessary for accurate diagnosis and treatment of this rare entity.

Adipose lesions of nerve: the need for a modified classification

OBJECT

Adipose lesions of nerve are rare and poorly understood. Their current classification, although not universally accepted, generally includes lipomatosis of nerve with or without localized macrodactyly, and intra- as well as extraneural lipoma. The authors believe that the spectrum of these lesions and their interrelationships are not currently appreciated. They propose an adaptation to the existing framework to illustrate the expanding spectrum of adipose lesions of nerve by considering lipomatosis and lipoma singly or in combination.

METHODS

Fourteen representative cases are presented to demonstrate not only the intraneural and extraneural examples of lipomatosis and lipoma, but also their anatomical combinations.

RESULTS

Based on the cases presented and a careful literature review, a conceptual approach to the classification of adipose lesions of nerve is generated. This approach incorporates the 2 essential lesions, lipomatosis of nerve and lipoma, in both their intra- and extraneural forms. This permits expansion to encompass combinations.

CONCLUSIONS

To press the concept that adipose tumors of nerve are a broad but interrelated spectrum of lesions, the authors propose modification of the present classification system. This approach provides an orderly platform for progress, reflects understanding of these interrelated lesions, and facilitates optimal treatment by distinguishing resectable from nonresectable components.

Macrodystrophia lipomatosa: four case reports

AIM

Macrodystrophia lipomatosa is a rare cause of gigantism of limb which can be confused with other common causes like congenital lymphedema. It presents usually with loss of function and cosmetic problems. Four cases are described with emphasis on clinical presentation, differential diagnoses, imaging and treatment options.

METHODS & RESULTS

Four patients of macrodystrophia lipomatosa were thoroughly examined and subjected to investigations.

CONCLUSION

Besides diligent clinical examination, imaging and histopathology are crucial in clinching the diagnosis.

MRI diagnosis of fibrolipomatous hamartoma of the median nerve and associated macrodystrophia lipomatosa

Fibrolipomatous hamartoma is an uncommon congenital disorder, which is characterized by disproportionate hyperplasia of adipose tissue infiltrating along the perineurium, the epineurium and the affected nerve trajectory. We present a case of combined fibrolipomatous hamartoma and macrodystrophia lipomatosa of the median nerve. The involved sites included the left palm, wrist and forearm. Part of the patient's middle finger had been amputated due to previous macrodystrophia lipomatosa; however, the lesion continued to enlarge and was accompanied by numbness. Magnetic resonance imaging demonstrated a typical fibrolipomatous hamartoma with high signal intensity of fat on both T1-weighted and T2-weighted images, characteristic coaxial cable appearance on axial images, and spaghetti appearance on sagittal images. A similar skipped lesion at the median nerve of the middle forearm was also noted. To the best of our knowledge, this has not been reported in the English literature.

Macrodystrophia lipomatosa with multiple entrapment neuropathies: a case report

Macrodystrophia lipomatosa is a rare nonhereditary congenital malformation that mainly affects mesenchymal structures. The pathology is associated with hypertrophic fibro-adipose tissues. One or more of the digits of the extremities are affected. This condition is previously described as macrodactyly, megalodactyly, or localized gigantism. This article describes a 48-year-old male patient who presented with the enlargement of unilateral (right) lower limb, especially of the first toe and tarsal tunnel syndrome. Although there is no clinically significant involvement of the upper extremities, bilateral cubital and unilateral carpal tunnel syndromes were also detected and macrodystrophia lipomatosa with multiple entrapment neuropathies was diagnosed in the patient.

Magnetic resonance imaging of a case of monomelic macrodystrophia lipomatosa

Macrodystrophia lipomatosa is a rare form of non-hereditary congenital localized gigantism. Radiographs and magnetic resonance imaging of one such case in a 3-year-old girl is presented in which the entire right-lower limb was affected. Radiographs revealed excessive soft tissue hypertrophy and exostoses-like bony overgrowth from the metatarsals. Magnetic resonance images showed excess unencapsulated fatty proliferation and fatty infiltration of the involved muscles.

Macrodystrophia lipomatosa extending into the upper abdomen

We report a case of macrodystrophia lipomatosa in an infant with extension of hypertrophied fatty tissue into the abdomen and abdominal wall. The patient not only presented with typical limb abnormalities but also an abdominal mass. We reviewed the literature on the subject, and believe that our case is rare because the hypertrophied lipomatous tissue extended into the abdomen.

Benign fatty tumors: classification, clinical course, imaging appearance, and treatment

Lipoma is the most common soft-tissue tumor, with a wide spectrum of clinical presentations and imaging appearances. Several subtypes are described, ranging from lesions entirely composed of mature adipose tissue to tumors intimately associated with nonadipose tissue, to those composed of brown fat. The imaging appearance of these fatty masses is frequently sufficiently characteristic to allow a specific diagnosis. However, in other cases, although a specific diagnosis is not achievable, a meaningful limited differential diagnosis can be established. The purpose of this manuscript is to review the spectrum of benign fatty tumors highlighting the current classification system, clinical presentation and behavior, spectrum of imaging appearances, and treatment. The imaging review emphasizes computed tomography (CT) scanning and magnetic resonance (MR) imaging, differentiating radiologic features.

From the archives of the AFIP: benign musculoskeletal lipomatous lesions

Benign lipomatous lesions involving soft tissue are common musculoskeletal masses that are classified into nine distinct diagnoses: lipoma, lipomatosis, lipomatosis of nerve, lipoblastoma or lipoblastomatosis, angiolipoma, myolipoma of soft tissue, chondroid lipoma, spindle cell lipoma and pleomorphic lipoma, and hibernoma. Soft-tissue lipoma accounts for almost 50% of all soft-tissue tumors. Radiologic evaluation is diagnostic in up to 71% of cases. These lesions are identical to subcutaneous fat on computed tomographic (CT) and magnetic resonance (MR) images and may contain thin septa. Lipomatosis represents a diffuse overgrowth of mature fat affecting either subcutaneous tissue, muscle or nerve, and imaging is needed to evaluate lesion extent. Lipoblastoma is a tumor of immature fat occurring in young children, and imaging features may reveal a mixture of fat and nonadipose tissue. Angiolipoma, myolipoma, and chondroid lipoma are rare lipomatous lesions that are infrequently imaged. Spindle cell and pleomorphic lipoma appear as a subcutaneous lipomatous mass in the posterior neck or shoulder, with frequent nonadipose components. Hibernoma appears as a lipomatous mass with serpentine vascular elements. Benign lipomatous lesions affecting bone, joint, or tendon sheath include intraosseous lipoma, parosteal lipoma, liposclerosing myxofibrous tumor, discrete lipoma of joint or tendon sheath, and lipoma arborescens. Intraosseous and parosteal lipoma have a pathognomonic CT or MR appearance, with fat in the marrow space or on the bone surface, respectively. Liposclerosing myxofibrous tumor is a rare intermixed histologic lesion commonly located in the medullary canal of the intertrochanteric femur. Benign lipomatous lesions may occur focally in a joint or tendon sheath or with diffuse villonodular proliferation in the synovium (lipoma arborescens) and are diagnosed based on location and identification of fat. Understanding the spectrum of appearances of the various benign musculoskeletal lipomatous lesions improves radiologic assessment and is vital for optimal patient management.

Hamartoma fibrolipomatoso e macrodistrofia lipomatosa: análise dos achados clínicos e de imagem em quatro casos, com revisão da literatura

O hamartoma fibrolipomatoso neural e a macrodistrofia lipomatosa são doenças raras, com achados de imagem característicos. Radiografias simples, estudos de ressonância magnética e prontuários médicos de quatro pacientes foram revisados. Em um paciente, foi realizada cirurgia com confirmação histopatológica. Em três pacientes, os achados clínicos e de imagem foram considerados suficientes para o diagnóstico. Descrevemos dois casos de macrodistrofia lipomatosa isolada, um caso de hamartoma fibrolipomatoso do nervo mediano e um caso de coexistência das duas condições. As radiografias simples, nos casos de macrodistrofia lipomatosa, mostraram aumento difuso de partes moles e estruturas ósseas, com estrias radiotransparentes entremeadas às fibras musculares. Os dois casos de hamartoma fibrolipomatoso ocorreram no nervo mediano, com achados, à ressonância magnética, de fascículos nervosos espessados com baixo sinal nas imagens ponderadas em T1 e T2, com infiltração homogênea de gordura entre estes, aparecendo com alto sinal em T1 e baixo sinal em T2 com saturação de gordura. O aspecto do nervo aos cortes axiais é de "cabo coaxial". Nota-se extensão para a ramificação dos nervos, aspecto típico desta lesão. As características de imagem da macrodistrofia lipomatosa e do hamartoma fibrolipomatoso neural, principalmente pela ressonância magnética, permitiram o diagnóstico preciso destas condições freqüentemente coexistentes.

Progressive pedal macrodactyly surgical history with 15 year follow-up

Macrodactyly can affect the fingers and/or toes1. Histopathologic examination will distinguish macrodactylia fibrolipomatosis or neural fibrolipoma with macrodactyly, from macrodactylia as a part of neurofibromatosis. Surgical repair is aimed at decreasing the size of the affected foot so it is as near in size and shape to the normal foot as possible. Surgical approaches have included reconstructive surgery (usually staged debulking procedures), epiphyseal plate arrest and amputation. Repeated reconstructive surgical procedures, as illustrated in this report covering patient care over a 15 year period, are usually necessary due to recurring soft tissue and boney enlargement.

MRI of the abnormal pediatric hand and wrist with plain film correlation

Based on a pool of 24 selected cases of nontraumatic pathology of the hand and wrist in patients under the age of 18 years, collected from three pediatric hospitals, the authors have illustrated a number of congenital, inflammatory, and infectious conditions as well as tumors of bones and soft tissues, utilizing MRI with plain film correlation. Due to different MR signal characteristics, the etiology of macrodactyly may be recognized, e.g., vascular and/or fatty versus neurofibromatosis, etc. In septic arthritis, MR has shown abnormal marrow signal in adjacent bones denoting osteomyelitis, often unexpected from the plain film appearance. Tenosynovitis has a specific MR appearance: Fluid in the tendon sheath gives high signal on T2-weighted imaging. In arthritis--because of the associated hyperemia--there is definite synovial enhancement easily visible immediately after Gd-chelate injection. Gd also helps identify viable tissues postinfection as well as viable tumor tissue (versus scar or necrotic tissue) in tumors. Plain radiography is the imaging method of choice for diagnosis and differential diagnosis of most cases of bone cysts, tumors, and tumor-like conditions, e.g., simple and aneurysmal bone cysts, enchondroma, and osteoid osteoma. In the study of masses, MRI gives excellent detail regarding tumor staging and the extent of soft tissue tumors as well as the soft tissue component of bone tumors. In the hand and wrist, aneurysmal bone cysts are usually confined within a metacarpal or carpal bone, showing high signal intensity on T2-weighted imaging, often with fluid/fluid levels. If ganglion cysts are excluded, the most commonly encountered soft tissue masses are the vascular malformations. MR angiography can demonstrate the vascularity of the lesion. Some benign soft tissue lesions have a characteristic MR appearance, e.g., ganglion cysts, lipomata, and accessory muscles.

MR findings of macrodystrophia lipomatosa

Macrodystrophia lipomatosa is a congenital form of localized gigantism characterized by an overgrowth of all mesenchymal elements with a disproportionate increase of adipose tissue. We describe a patient with macrodystrophia lipomatosa affecting the foot who exhibited characteristic MR findings that distinguish the lesion from other conditions associated with localized gigantism.

Fibrolipomatous hamartoma: MR imaging findings

OBJECTIVE

To analyze the MR imaging features of fibrolipomatous hamartoma (FLH) of nerves.

DESIGN AND PATIENTS

MR imaging studies from six patients (three men and three women) were retrospectively reviewed by three musculoskeletal radiologists. In four patients, a biopsy of the nerve lesion was performed. In two patients, biopsy data were unavailable and the diagnosis was based on the clinical history combined with the MR imaging findings.

RESULTS AND CONCLUSION

MR imaging demonstrated fusiform nerve enlargement that was caused by fatty proliferation and thickening of nerve bundles. Nerve bundles appeared as serpentine tubular structures, hypointense on both T1- and T2-weighted images. The degree of fatty proliferation varied among patients. In addition, significant variation in the distribution of fat along the course of the nerves was noted. In three patients, FLH followed the branching pattern of the nerves, a characteristic pathologic finding. In two patients, intramuscular fat deposition (biceps and tibialis posterior muscles) was present. MR imaging findings of FLH are typical, allowing a confident diagnosis. The variation of fatty proliferation among patients and involved nerves as well as the tendency of the abnormalities to follow the branching pattern of the nerves is well demonstrated with MR imaging. FLH may present as an isolated nerve lesion, may be associated with intramuscular fat deposition, or may occur as a feature of macrodystrophia lipomatosa (MDL).

Magnetic resonance imaging in macromelia and macrodactyly

We report five cases presenting with soft tissue and bone overgrowth that demonstrate the ability of MRI to establish a diagnosis in the absence of specific clinical features. Disorders included macrodystrophia lipomatosa, angiolipomatosis, Klippel-Trenaunay-Weber syndrome, blue rubber bleb naevus syndrome and one case of segmental limited hypertrophy. The MRI appearances, and other radiological features of these conditions are discussed. MRI is recommended in all cases of macrodystrophy when the clinical features and plain film findings are indeterminate.

Radiologic case study. Macrodystrophia lipomatosa

Macrodystrophia lipomatosa is a rare form of gigantism involving an extremity consisting of predominately fibroadipose tissue. Radiographically, it appears as hypertrophy of soft tissues and bone. CT and MR scanning delineate the tissues involved and are virtually diagnostic, demonstrating the predominantly adipose component as well as the overgrowth of the bones, nerves, and vessels also involved.