Insights on Lipomatosis after Platinum-Based Chemotherapy Use in Pediatric Oncology: A Case Report

Development of Multiple Subcutaneous Lipomas After Six Months of Hormone Replacement Therapy: A Case Report

Lipomas are common benign soft tissue tumors composed of mature adipocytes, typically presenting as slow-growing, painless subcutaneous nodules. While the underlying etiology remains unclear, various factors have been proposed as potential contributors. In some individuals, multiple subcutaneous lipomas can develop, and their occurrence has been considered in relation to systemic conditions or familial predisposition. Hormone replacement therapy (HRT), commonly used for menopausal symptom management, influences lipid metabolism and angiogenesis through hormonal signaling pathways; however, its potential role in lipoma formation remains uncertain. Herein, we present a case of a 57-year-old woman who developed multiple subcutaneous lipomas on the thighs and buttocks after initiating HRT. This case highlights a possible association between hormonal changes and lipoma formation, emphasizing the importance of further research into the mechanisms underlying adipose tissue growth.

Spinal epidural lipomatosis in pediatric medulloblastoma following chemotherapy, a case report and review of the literature

PURPOSE

Spinal epidural lipomatosis (SEL) is a relatively rare condition characterized by overgrowth of adipose tissue in the extradural space of the spinal canal. Compression of neural structures can lead to radiculopathy, loss of sensation and motor function, and urinary retention. Known causes of SEL include exogenous steroid use and obesity.

METHODS

We describe the unique case of idiopathic SEL in a 1-year-old male, the youngest reported to date, diagnosed with medulloblastoma and treated with chemotherapy and autologous stem cell rescue (AuSCR). We then perform a systemic review of the literature of this rare diagnosis, explore potential causes, and review management.

RESULTS

The patient was non-obese and received a cumulative dose of only 60 mg dexamethasone (150 mg/m2), far below pediatric cancer patients with SEL documented in the literature. The acute presentation of lipomatosis following chemotherapy and AuSCR, associated with transient elevated triglycerides (234 mg/dL), suggests this as a possible cause.

CONCLUSION

This case illustrates the development and resolution of SEL in a non-obese pediatric cancer patient with limited steroid use. While further study is needed to identify the etiology of SEL, this diagnosis should be evaluated for when reviewing spine imaging following chemotherapy or autologous stem cell rescue.

Importance of Multimodality Cardiac Imaging in the Diagnosis of Lipomatous Hypertrophy of the Interatrial Septum-A View beyond Standard Situations

Lipomatous hypertrophy of the interatrial septum (LHIAS) represents a benign proliferation of lipoid cells at the level of the interatrial septum (IAS) inducing an important thickening of this structure. It respects the fossa ovalis (FO) region, having a typical "hourglass" echocardiographic appearance. There are certain cases though, with unusual appearances and/or with associated pathologies that may induce similar lesions in the heart, in which the differential diagnosis cannot be guaranteed using only the standard methods. The final diagnosis has important implications in these patients' treatment plan. In this paper, we present an unusual case of a female patient undergoing chemotherapy for lung carcinoma, suspected of right atrial thrombosis/metastasis. As the diagnosis was unclear after transthoracic echocardiography (TTE), inducing the suspicion of an IAS mass with atrial wall infiltration, bi- and tridimensional transesophageal echocardiography (TOE) was performed, revealing a severely and homogenously hypertrophied IAS respecting the FO, but lacking a clear visualization of the atrial wall. The diagnosis of LHIAS was established by cardiac magnetic resonance (CMR) that certified the adipose nature of the structure, excluding the need for invasive investigations and/or treatment options. Multimodality imaging is very important for the clinician in adopting the best management plan for each individual patient.

Assessing Botulinum Toxin Effectiveness and Quality of Life in Axillary Hyperhidrosis: A One-Year Prospective Study

This study hypothesized that botulinum toxin (Botox) therapy would sustainably reduce sweat production in axillary hyperhidrosis patients over one year and significantly improve various quality-of-life aspects, including psychological well-being, social interactions, and daily functioning. The objectives were to quantitatively measure changes in sweat production and qualitatively assess the evolving impact on patients' quality of life over one year. Conducted prospectively at the Pius Brinzeu Clinical Emergency Hospital in Timisoara, Romania, this study complied with ethical standards and included adults with primary axillary hyperhidrosis unresponsive to conventional treatments. Participants underwent Botox injections and were evaluated at baseline, six months, and one year, using the Hyperhidrosis Disease Severity Scale (HDSS), WHOQOL-BREF, and the Dermatology Life Quality Index (DLQI), among other tools. Involving 81 patients, the study showed significant improvements in sweat production and quality-of-life metrics. Sweat production decreased from 0.81 g to 0.23 g per 15 min over one year (p < 0.001). HDSS scores reduced from 3.4 to 1.5, indicating a decrease in symptom severity (p < 0.001). The DLQI total score, assessing life quality impact, notably dropped from 19.9 to 6.9 (p < 0.001). Quality-of-life domains also showed significant improvements, especially in the social (from 65.3 to 73.4, p < 0.001) and environmental aspects (from 68.0 to 72.1, p < 0.001). Higher HDSS and sweat production were significantly associated with a lower quality of life on the DLQI (B coefficients of -4.1 and -2.5, respectively). Botulinum toxin therapy proved effective in reducing sweat production and improving the quality of life in axillary hyperhidrosis patients over a one-year period. These improvements were statistically significant in both physical and psychosocial domains. The study highlights the potential long-term benefits of Botox therapy for hyperhidrosis.

Advances in Cancer Therapy from Research to Clinical Practice-Surgical, Molecular or Systemic Management of Cancer

Cancer represents one of the most important general health problems of our day [...].

A Prospective Analysis of the Retinopathy of Prematurity Correlated with the Inflammatory Status of the Extremely Premature and Very Premature Neonates

Retinopathy of Prematurity (ROP) is a major cause of blindness in premature infants. This study aimed to evaluate the association between inflammatory markers and ROP development in extremely premature and very premature neonates and identify potential inflammatory biomarkers for ROP risk prediction. This prospective study was conducted from January 2021 to January 2023 in two clinical hospitals associated with the "Victor Babes" University of Medicine and Pharmacy Timisoara. The study population comprised neonates with a gestational age of less than 32 weeks. Various inflammatory markers, including total white blood cell count, polymorphonuclear leukocytes, C-reactive protein, interleukin-6, and lactate dehydrogenase, were analyzed from blood samples collected at birth and three days postnatally. ROP was diagnosed and classified following the International Classification of Retinopathy of Prematurity. The study included 48 neonates, 12 Extremely Premature Infants (EPI), and 36 Very Premature Infants (VPI). The EPI group had significantly higher mean interleukin-6 and lactate dehydrogenase levels at birth and three days postnatally than the VPI group. C-reactive protein levels at three days were significantly higher in the VPI group. Umbilical cord inflammation and ROP severity were found to have a statistically significant positive correlation. Half of the EPIs had moderate to severe ROP, significantly more than in the VPI group. The duration of oxygen supplementation, mechanical ventilation, Continuous Positive Airway Pressure (CPAP), gestational age less than 28 weeks, and umbilical cord inflammation at or above stage 3 were significant risk factors for developing ROP stage 2 or above. Elevated CRP and IL-6 were also significantly associated with an increased risk of developing ROP stage 2 or above, highlighting their potential as biomarkers for ROP risk prediction. This study suggests a significant association between inflammatory markers and ROP development in extremely premature and very premature neonates. These findings could contribute to the identification of potential inflammatory biomarkers for ROP risk prediction, improving early diagnosis and intervention strategies for this condition.