1
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Alharbi K, Bilal A. Colonic Angiolipoma: A Rare Cause of Chronic Anemia and Rectal Bleeding. Cureus 2024; 16:e56678. [PMID: 38646340 PMCID: PMC11032499 DOI: 10.7759/cureus.56678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Angiolipomas are rare, benign tumors characterized by a mixture of adipose tissue and blood vessels, distinguishing them from lipomas. This case involves a 52-year-old woman with no significant medical history who presented with generalized weakness, fatigue, and intermittent, painless rectal bleeding over six months, initially dismissed as hemorrhoidal. Despite exhibiting mild pallor and trace rectal bleeding upon examination, significant iron-deficiency anemia was diagnosed through laboratory tests. Incorporating colonoscopy and computed tomography, the diagnostic process identified a 2 cm submucosal lesion in the ascending colon, characterized as a well-defined, fat-density mass. Histopathological analysis following surgical resection confirmed the diagnosis of a colonic angiolipoma. The patient's recovery, marked by the resolution of symptoms and normalization of hemoglobin levels, underscores the effectiveness of surgical treatment. This case highlights the diagnostic challenges posed by colonic angiolipomas due to their nonspecific symptoms. It emphasizes the importance of considering such rare entities in the differential diagnosis of gastrointestinal symptoms. This approach facilitates prompt and appropriate treatment, enriching the limited literature and advocating for clinical vigilance and interdisciplinary diagnostic strategies.
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Affiliation(s)
- Kawkab Alharbi
- General Surgery, Princess Noura bint abdulrahman University, Riyadh , SAU
| | - Ahmad Bilal
- General Surgery, Al-Dar Hospital, Medina, SAU
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2
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Fullenkamp A, Paolini B, Spruill L, Lewis M. Angiolipoma an Uncommon Breast Mass in Men: A Case Series. J Ultrasound Med 2024; 43:201-206. [PMID: 37842969 DOI: 10.1002/jum.16343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/08/2023] [Indexed: 10/17/2023]
Abstract
Angiolipomas are uncommon benign masses of the breast which are rarely described in the male breast. They do not have a typical mammographic appearance and can present with concerning features such as microcalcifications or irregular borders. Ultrasound is helpful in evaluating these masses most commonly appearing as oval, circumscribed, and hyperechoic. Clinical, radiological, and pathological information needs to be carefully evaluated as angiolipomas can be confused with malignant pathology. Three cases of angiolipomas of the male breast are reported in this study with mammographic, sonographic, and pathologic correlation.
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Affiliation(s)
- Austin Fullenkamp
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
| | - Brielle Paolini
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
| | - Laura Spruill
- Department of Pathology, Medical University of South Carolina, Charleston, SC, USA
| | - Madelene Lewis
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
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3
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Kang YJ, Lee SS, Kim SG. Intraoral approach for the treatment of non‑infiltrating angiolipoma of the floor of the mouth in an elderly patient: A case report with review of the literature. Exp Ther Med 2023; 26:458. [PMID: 37614439 PMCID: PMC10443065 DOI: 10.3892/etm.2023.12157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/10/2023] [Indexed: 08/25/2023] Open
Abstract
A 75-year-old male patient visited Gangneung-Wonju National University Dental Hospital (Gangneung, South Korea) with a 35-mm fluctuant lesion on the floor of the mouth. It was a dome-shaped exophytic lesion with its top on Wharton's duct orifice area. The encapsulated lesion was excised cautiously and the final diagnosis was non-infiltrating angiolipoma. To the best of our knowledge, this is the first report of an intraoral approach for the treatment of a non-infiltrating angiolipoma on the floor of the mouth in an elderly patient. Differentiating it from a ranula is essential for the surgical approach and, as there is a higher transition to infiltrating angiolipoma, definite treatment should be considered in elderly patients.
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Affiliation(s)
- Yei-Jin Kang
- Department of Oral and Maxillofacial Surgery, Gangneung-Wonju National University Dental Hospital, Gangneung, Gangwon 25457, Republic of Korea
| | - Sang-Shin Lee
- Department of Oral and Maxillofacial Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Gangwon 25457, Republic of Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Gangwon 25457, Republic of Korea
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4
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King KA, Tsao T, Abdulrahim A, Hildenbrand A. A Case of Thoracic Epidural Angiolipoma Causing Severe Spinal Cord Compression With Neurologic Manifestations. Cureus 2023; 15:e45305. [PMID: 37720116 PMCID: PMC10503948 DOI: 10.7759/cureus.45305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 09/19/2023] Open
Abstract
A spinal epidural angiolipoma is a rare, benign tumor of adipocytes and blood vessels that accounts only for a small percentage of all spinal axis tumors. We report a case of a 44-year-old male who presented with three months of progressive decreased sensation and strength from about six cm above the umbilicus down to his feet bilaterally. He presented to the emergency room when he could no longer walk. He also had neurogenic urinary retention and likely neurogenic constipation. Physical exam was notable for decreased sensation, decreased strength, and increased patellar reflexes bilaterally. MRI of the thoracic spine showed a posterior epidural mass that spanned from T2 to T3, measuring 1.2 x 1.7 x 4.3 cm, and severely compressed the spinal cord posteriorly. The patient underwent an urgent laminectomy for decompression and mass resection. Pathology was consistent with an angiolipoma. Postoperatively, he experienced a drastic improvement in strength and gross motor skills. The sensation had a partial return following surgery and continued to improve over the hospital stay. In general, the literature reports significant symptomatic improvement in patients with spinal epidural angiolipomas after surgical resection.
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Affiliation(s)
- Kali A King
- Internal Medicine, Creighton University School of Medicine, Omaha, USA
| | - Tiffany Tsao
- Internal Medicine, Creighton University School of Medicine, Omaha, USA
| | - Ahmed Abdulrahim
- Pathology and Laboratory Medicine, Creighton University School of Medicine, Omaha, USA
| | - Alec Hildenbrand
- Internal Medicine, Creighton University School of Medicine, Omaha, USA
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5
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Hussain T, Ghosh I, Gerber C, Basu A, Tiwari M. Post-partum paraplegia following spinal anaesthesia: a report of two rare cases. J Surg Case Rep 2023; 2023:rjad081. [PMID: 36908690 PMCID: PMC9997445 DOI: 10.1093/jscr/rjad081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/05/2023] [Indexed: 03/14/2023] Open
Abstract
Pregnancy and lumbar puncture are rare instances that can precipitate sudden onset paraplegia in patients with otherwise slow-growing intradural tumours. Surgeons and anaesthesiologists should be aware of the etiological factors leading to pregnancy- and delivery-related rapid tumour growth and its complications. Lumbar puncture-related complications leading to acute precipitation of neurological symptoms must be addressed promptly for favourable outcome in such patients. We describe the report of two patients who developed acute onset paraparesis after spinal anaesthesia for caesarean section. Both were found to be having undiagnosed spinal tumours and managed surgically. We recommend urgent MRI in cases of acute onset non-resolving paraparesis in the peripartum period, for timely diagnosis and management of this rare clinical entity.
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Affiliation(s)
| | - Indranil Ghosh
- Advanced Medicare and Research Institute, Kolkata, India
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6
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Milosavljevic VM, Tadic BS, Grubor NM, Mitrovic MD, Ceranic MS, Toskovic BL, Terzic TT. Laparoscopic approach in the treatment of splenic angiolipomatous hamartoma: the first report of a case. J Int Med Res 2023; 51:3000605231153767. [PMID: 36734251 PMCID: PMC9900658 DOI: 10.1177/03000605231153767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Angiolipomatous hamartoma is a benign mesenchymal proliferation of unknown aetiology. Only a few cases have been documented in the published literature. This current case report describes a 57-year-old female patient who was hospitalized for an assessment of a previously radiologically-verified splenic lesion and further treatment. The patient had been surgically treated 10 years previously; a lobectomy of the superior left pulmonary lobe had been performed in order to remove a verified tumour lesion. A complete radiological examination was undertaken, which verified a spleen of a size that was within the physiological range, with a centrally-located lobular tumour lesion. Given the risk of splenic rupture, as well as the fact that the lesion's aetiology was still undetermined, and finally the fact that differential diagnostics indicated the possibility of a metastasis, the patient was treated surgically. Laparoscopic splenectomy, in the treatment of splenic diseases, even rare ones such as this, is not a novelty. Indeed, it needs to be applied as the standard approach, with the well-known benefits that the minimalized approach offers.
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Affiliation(s)
- Vladimir M. Milosavljevic
- Department for Hepato-Pancreato-Biliary Surgery, University
Hospital Medical Centre Bezanijska Kosa, Belgrade, Serbia
| | - Boris S. Tadic
- Department for Surgery with Anaesthesiology, Faculty of
Medicine, University of Belgrade, Belgrade, Serbia,Department for Hepato-Pancreato-Biliary Surgery, University
Clinic for Digestive Surgery, University Clinical Centre of Serbia, Belgrade,
Serbia,Boris Tadic, Department for
Hepato-Pancreato-Biliary Surgery, University Clinic for Digestive Surgery,
University Clinical Centre of Serbia, 6 Koste Todorovica, 11000 Belgrade,
Serbia.
| | - Nikola M. Grubor
- Department for Surgery with Anaesthesiology, Faculty of
Medicine, University of Belgrade, Belgrade, Serbia,Department for Hepato-Pancreato-Biliary Surgery, University
Clinic for Digestive Surgery, University Clinical Centre of Serbia, Belgrade,
Serbia
| | - Milica D. Mitrovic
- Centre for Radiology and Magnetic Resonance Imaging, University
Clinical Centre of Serbia, Belgrade, Serbia
| | - Miljan S. Ceranic
- Department for Surgery with Anaesthesiology, Faculty of
Medicine, University of Belgrade, Belgrade, Serbia,Department for Hepato-Pancreato-Biliary Surgery, University
Clinic for Digestive Surgery, University Clinical Centre of Serbia, Belgrade,
Serbia
| | - Borislav L. Toskovic
- Department for Hepato-Pancreato-Biliary Surgery, University
Hospital Medical Centre Bezanijska Kosa, Belgrade, Serbia,Department for Surgery with Anaesthesiology, Faculty of
Medicine, University of Belgrade, Belgrade, Serbia
| | - Tatjana T. Terzic
- Department for Hepato-Pancreato-Biliary Surgery, University
Clinic for Digestive Surgery, University Clinical Centre of Serbia, Belgrade,
Serbia,Institute of Pathology, Faculty of Medicine, University of
Belgrade, Belgrade, Serbia
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7
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Laeke T, Yibeltal M, Kwon YD. Thoracic spinal angiomyolipoma: case report from an Ethiopian neurosurgical teaching hospital. Illustrative case. J Neurosurg Case Lessons 2022; 4:CASE22216. [PMID: 36471580 PMCID: PMC9724004 DOI: 10.3171/case22216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Angiomyolipoma (AML) of the spine is a rare benign neoplasm (accounting for 0.14%-1.2% of all spine tumors) that is often described along with angiolipoma because of their similarities. They occur almost exclusively in the extradural space, with the thoracic spine being the commonest level. OBSERVATIONS The authors present the clinical presentation, diagnosis, and treatment of an extremely rare case of thoracic spine AML in a 47-year-old male patient. The patient underwent laminectomy and gross total resection of the tumor and had an excellent immediate postoperative neurological recovery and long-term functional neurological outcome. LESSONS It is always wise to consider rare benign spinal epidural neoplasms such as spinal AMLs in the differential diagnosis of spinal epidural mass, despite metastasis being the commonest epidural tumor with variable modes of treatment, because the management of benign spinal epidural masses such as spine AML is always surgical and associated with an excellent long-term outcome.
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Affiliation(s)
- Tsegazeab Laeke
- Department of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, Ethiopia; and
| | - Mestet Yibeltal
- Department of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, Ethiopia; and
| | - Young Dae Kwon
- Department of Surgery, Neurosurgery Unit, Myungsung Christian Medical Center, Addis Ababa, Ethiopia
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8
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Abstract
Angiolipomas of the breast are rare; however, they are an important entity for the radiologist who determines radiologic-pathologic concordance and recommends appropriate management. They can present as a palpable concern, prompting diagnostic workup, or can be detected on screening breast examinations. They often present as a circumscribed low-density mass on mammography, which is hyperechoic on sonography; associated fibrin thrombi can produce soft tissue density and/or hypoechoic foci that appear hypointense on T1-weighted MRI. Due to the nonspecific radiographic appearance, tissue sampling is often required for definitive diagnosis. Pathologically, angiolipomas can be difficult to distinguish from angiosarcomas; however, scattered microthrombi in small blood vessels are a typical feature of angiolipomas. Generally, in the setting of radiologic-pathologic concordance, angiolipomas do not need to be excised and can be followed clinically when palpable. Surgical excision can be pursued when certain high-risk features, such as nuclear enlargement, an infiltrative pattern, endothelial mitoses, and a high proliferation rate, are present in the core-needle biopsy specimen.
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Affiliation(s)
- Emily Babiss
- Weill Cornell at NewYork-Presbyterian, Department of Radiology, New York, NY, USA
| | - Esther Cheng
- Weill Cornell at NewYork-Presbyterian, Department of Radiology, New York, NY, USA
| | - Eralda Mema
- Weill Cornell at NewYork-Presbyterian, Department of Radiology, New York, NY, USA
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9
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Yaro JP, Ibrahim Y, Mann A, Chan JY, Mansuri MS. A Challenging "Achy" Neck. Cureus 2022; 14:e24544. [PMID: 35651440 PMCID: PMC9138194 DOI: 10.7759/cureus.24544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/11/2022] Open
Abstract
Lipomas are common benign mesenchymal tumours that may occur in many regions of the body. Giant neck lipomas are uncommon, especially when they arise from the neck and extend into the thorax. In this case report, we present a unique case of a giant submuscular lipoma involving the posterior neck triangle extending down to the scapular tip. A 43-year-old male presented with a six-month history of two slow-growing masses involving the left neck and scapular region. MRI demonstrated a single large fat suppressing lesion underlying the left trapezius muscle extending down to the scapula with homogenous signal return and smooth outline measuring 4.5x7.5 cm by 16 cm. Histology showed features consistent with lipoma. Giant lipomas in the neck post a significant diagnostic and surgical challenge. The importance of pre-operative planning and patient involvement in decision-making are essential.
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Affiliation(s)
- John P Yaro
- Otolaryngology, University Hospitals of Derby and Burton, Derby, GBR
| | - Yousef Ibrahim
- Otolaryngology, University Hospitals of Derby and Burton, Derby, GBR
| | - Amandeep Mann
- Pathology, University Hospitals of Derby and Burton, Derby, GBR
| | - Jo-Yen Chan
- Radiology, University Hospitals of Derby and Burton, Derby, GBR
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10
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Alfaraj AS, Almohamad AA, Alqabbani NS, Alghazwi MH, Alharbi AM, Ahmed AA, Aljumah MK, Aljumaah NY, Kadhem HE, Al Jalooud HH, AlMohsen ZS, Alharbi KM, Al Abbas HE, Al Khalifah FB, Al-Hawaj F. Colonic Angiolipoma: An Extremely Rare Tumor Clinically Masquerading as Acute Appendicitis. Cureus 2021; 13:e20659. [PMID: 35028238 PMCID: PMC8743046 DOI: 10.7759/cureus.20659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2021] [Indexed: 11/05/2022] Open
Abstract
The clinical presentation of right iliac fossa pain, anorexia, and vomiting are the classic clinical features of acute appendicitis. However, a broad spectrum of manifestations may result in a similar clinical picture, including gastrointestinal, genitourinary, and gynecologic pathologies. Imaging studies are crucial to establishing the diagnosis. Here, we report the case of a 58-year-old man who presented to the emergency department with a one-week history of right lower quadrant abdominal pain. The pain was associated with nausea, vomiting, and frequent bowel motions. There was no history of fever or weight loss. The examination of the abdomen showed localized tenderness and guarding in the right iliac fossa. The basic laboratory investigation was within the reference range. The computed tomography scan demonstrated a well-circumscribed intraluminal mass lesion in the ascending colon with no evidence of complete obstruction. The mass was slightly heterogeneous but had fat attenuation. There was no evidence of invasion. There was no stranding of the adjacent fat. The radiological findings were consistent with colonic lipoma. The patient underwent laparoscopic surgery and had a segmental resection of the tumor with primary anastomosis. The appendix was also resected. Histopathological examination showed mature adipose cells along with thin-walled, capillary-sized vessels representing a benign angiolipoma. Further, the resected appendix was completely normal and showed no evidence of acute inflammation. Colonic angiolipoma is an extremely rare tumor. This case demonstrated that a large angiolipoma of the ascending colon may show a presenting clinical picture similar to that of acute appendicitis. Complete resection of the tumor is associated with an excellent outcome.
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Affiliation(s)
| | - Asma A Almohamad
- College of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | | | | | - Amina A Ahmed
- College of Medicine, Xi'an Jiaotong University, Xi'an, CHN
| | | | | | - Hawra E Kadhem
- College of Medicine, Xi'an Jiaotong University, Xi'an, CHN
| | | | | | - Kawkab M Alharbi
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Hassan E Al Abbas
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | | | - Faisal Al-Hawaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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11
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Nakamura D, Kobayashi N, Miyazawa M, Satomi H, Ihara N, Tsunoda M. Primary posterior mediastinal angiolipoma: a case report. J Surg Case Rep 2021; 2021:rjab168. [PMID: 33981406 PMCID: PMC8101613 DOI: 10.1093/jscr/rjab168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
An angiolipoma is a benign tumor, and a primary mediastinal angiolipoma is extremely rare. Herein, we describe the presentation and management of a posterior mediastinal angiolipoma in a woman with loss of consciousness. Chest computed tomography (CT) revealed a contrast-enhancing mass in the right posterior mediastinum, with intercostal arterial blood supply identified on three-dimensional reconstruction CT (3D-CT). Magnetic resonance imaging revealed a fatty component. Pre-operative embolization of the supplying intercostal artery was performed to reduce intraoperative bleeding. Mass resection was performed using video-assisted thoracic surgery. Histopathology confirmed angiolipoma diagnosis. Although rare, a posterior mediastinum angiolipoma should be considered a possibility; 3D-CT and pre-operative embolization may be useful in the surgical treatment of hypervascular mediastinal tumors, such as angiolipomas.
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Affiliation(s)
- Daisuke Nakamura
- Department of Thoracic Surgery, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Nobutaka Kobayashi
- Department of Thoracic Surgery, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Masahisa Miyazawa
- Department of Thoracic Surgery, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Hidetoshi Satomi
- Department of Pathology, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Nobumaro Ihara
- Department of Radiology, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Mayu Tsunoda
- Department of Radiology, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
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12
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Wang L, Tang Y, Yin H, Hu S. 18F-PSMA-1007 PET/CT uptake in multiple angiolipomas caused by PSMA expression in capillaries: a case report. Transl Androl Urol 2021; 10:991-996. [PMID: 33718100 PMCID: PMC7947451 DOI: 10.21037/tau-20-1099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Prostate specific membrane antigen (PSMA) is a transmembrane glycoprotein that was originally cloned in the membrane of prostate gland epithelial cells. It has been confirmed to be highly expressed in prostate cancer cells, and in some non-prostatic tissues, including the brain and some benign lesions. PSMA-based imaging has been extensively used for the assessment of prostate carcinoma. The high uptake of PSMA imaging in these non-prostate cancer lesions may lead to some misdiagnosis. It is of important clinical significance to explore the possible causes of high PSMA uptake in these lesions. Here, we present a case of a 77-year-old man with prostate carcinoma who underwent a whole-body 18F-PSMA-1007 positron emission tomography/computed tomography (PET/CT) scan for staging. The results of the scan showed intense tracer uptake in both the prostatic bed and in multiple subcutaneous lesions. The subcutaneous lesions were later found to be angiolipomas by histopathological examination. Immunohistochemistry demonstrated strong positive cytoplasmic PSMA staining in lesional prostate cancer cells in prostate carcinoma, and mild-to-moderate positive cytoplasmic capillary PSMA staining in angiolipoma fatty density nodules. Our case report therefore demonstrated that 18F-PSMA-1007 PET/CT uptake in multiple angiolipomas was caused by PSMA expression in capillaries, and further knowledge of PSMA expression in benign lesions may be critical to minimize false-positive findings with 18F-PSMA-1007 PET/CT imaging.
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Affiliation(s)
- Long Wang
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yongxiang Tang
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Hongling Yin
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, China
| | - Shuo Hu
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Biological Nanotechnology of National Health Commission, Xiangya Hospital, Central South University, Changsha, China
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13
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Ikpeze T, Kulp A, Williams D, Huber A, Mesfin A. Lumbar Extradural Angiolipoma: Clinical Presentation and Management. Cureus 2020; 12:e12380. [PMID: 33527059 PMCID: PMC7842241 DOI: 10.7759/cureus.12380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Angiolipomas are rare primary benign tumors that can arise in the epidural canal and cause stenosis. Of the few cases of spinal angiolipomas described, most lesions have been located in the thoracic spine, and presentation of angiolipoma in the lumbar spine is very rare. The surgical management of a 39-year-old morbidly obese woman with angiolipoma that caused stenosis with neurogenic claudication and urinary changes is described. The lesion spanned L1-L2 and surgical management consisted of T12-L2 laminectomy and en-bloc resection of the lesion. During the latest follow-up, four years after the surgery, the patient’s neurological symptoms showed improvement and there was no recurrence.
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Affiliation(s)
- Tochukwu Ikpeze
- Emergency Medicine, Hospital Corportation of America Kingwood, University of Houston, Houston, USA
| | - Abigail Kulp
- Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, USA
| | - Devin Williams
- Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, USA
| | - Aaron Huber
- Pathology, University of Rochester Medical Center, Rochester, USA
| | - Addisu Mesfin
- Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, USA
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14
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Saggini A, Santonja C, Nájera L, Palmedo G, Kutzner H. Frequent activating PIK3CA mutations in sporadic angiolipoma. J Cutan Pathol 2020; 48:211-216. [PMID: 32662895 DOI: 10.1111/cup.13809] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/05/2020] [Accepted: 07/01/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Angiolipoma (AL) is considered as a lipoma variant that is characterized by the combination of mature adipocytes and capillary blood vessels diffusely distributed within the tumor. With the exception of recurrent PRKD2 mutations of uncertain pathogenetic significance, the genetic abnormalities of ALs are unknown, in the absence of any of the specific chromosomal aberrations described in other lipoma variants. METHODS Formalin-fixed and paraffin-embedded blocks of 13 conventional ALs and 5 cellular ALs from 17 individuals were retrieved and analyzed for mutations in exons 9 and 20 of PIK3CA by polymerase chain reaction and Sanger sequencing. RESULTS Activating PIK3CA mutations were identified in 14 tumors (78%). All PIK3CA-mutated samples carried the same exon 9 mutation, c.1634A>C (p.E545A). No mutation was detected in exon 20 of PIK3CA. No significant difference between PIK3CA-mutated and wild-type samples appeared to exist based on age, gender, and location of the tumor. All 5 cellular ALs carried the p.E545A PIK3CA mutation. CONCLUSION The high frequency of the p.E545A PIK3CA mutation in both conventional and cellular ALs suggests that activation of the PI3K/AKT pathway plays a key role in AL pathogenesis and reinforces the concept that cellular AL should be regarded as a variant of AL.
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Affiliation(s)
| | - Carlos Santonja
- Department of Pathology, Jiménez Díaz Foundation University Hospital, Madrid, Spain
| | - Laura Nájera
- Department of Pathology, Puerta de Hierro University Hospital, Madrid, Spain
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Reiser V, Haj Yahya B, Chaushu G, Kaplan I, Hamzani Y. Angiolipoma in the Head and Neck: Imaging, Diagnosis and Management. ACTA ACUST UNITED AC 2020; 56:medicina56060283. [PMID: 32532063 PMCID: PMC7353847 DOI: 10.3390/medicina56060283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/28/2020] [Accepted: 06/08/2020] [Indexed: 11/22/2022]
Abstract
Angiolipoma, distinguishable from other lipomas by its excessive degree of vascular vessels, are rare in the head and neck and require unique management. A slow growing mass, located underneath the inferior border of the right mandibular angle of a 51-year-old female, was excised under general anesthesia. Unexpected excessive bleeding during the excision was observed and the histological specimen was diagnosed as angiolipoma. As shown in this case report, pre-operative imaging modalities have a crucial influence and are sufficient to diagnose and manage angiolipomas. The “Gold standard” treatment is excision with clear margins and bleeding management should be taken into account according to appropriate differential diagnosis.
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Affiliation(s)
- Vadim Reiser
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel; (V.R.); (B.H.Y.); (G.C.)
| | - Bahaa Haj Yahya
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel; (V.R.); (B.H.Y.); (G.C.)
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel; (V.R.); (B.H.Y.); (G.C.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Ilana Kaplan
- Department of Oral Pathology, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel;
| | - Yafit Hamzani
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel; (V.R.); (B.H.Y.); (G.C.)
- Correspondence:
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Kravtsov O, Techawatanaset K, Cherian S, Jorns JM. Benign vascular lesions and angiolipomas of the breast: Radiologic-pathologic correlation. Breast J 2020; 26:1906-1908. [PMID: 32166889 DOI: 10.1111/tbj.13805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Oleksandr Kravtsov
- Departments of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Kurt Techawatanaset
- Departments of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Solomon Cherian
- Departments of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Julie M Jorns
- Departments of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
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Albano S, Ramnot A, Siddiqi J, Mahato D. Medical and Legal Implications of MRI Scout Imaging in a Surgical Patient with Case Presentation. Cureus 2020; 12:e6833. [PMID: 32181076 PMCID: PMC7051123 DOI: 10.7759/cureus.6833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Spinal epidural angiolipoma is an uncommon finding; this case is presented to display the medical and legal implications of MRI scout imaging. In this case, a preceding period of ambiguous and non-focal symptoms led to an MRI of the lumbar spine without contrast with a scout image that captured a thoracic lesion. Review of the scout film led to a subsequent MRI of the thoracic spine with and without contrast that aided clinical decision making leading to surgical resection of the identified lesion and resolution of symptoms for this patient. The use of scout imaging has been described in the literature, but no concise agreement among physicians or professional medical societies exists regarding what utility, if any, may be obtained from the review of scout imaging. A discussion of medical legal implications of MRI scout imaging follows.
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Affiliation(s)
- Stephen Albano
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | - Ajay Ramnot
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | - Javed Siddiqi
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
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18
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Sundararajan SR, Rajagopalakrishnan R, Rajasekaran S. Arthroscopic Excision of Angio-Fibro-Lipomatous Hamartoma of the Knee: A Rare Case Report. Indian J Orthop 2019; 53:732-735. [PMID: 31673174 PMCID: PMC6804391 DOI: 10.4103/ortho.ijortho_330_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Angio-fibro-lipomatous hamartoma is a benign adipose tissue tumor very rarely seen in musculoskeletal distribution, and its incidence in the knee joint has never been reported. The patient in our case presented with knee pain of 2 years' duration, following blunt trauma. Preoperatively, veno-lymphatic malformation/hemangioma was considered as the diagnosis. Only after arthroscopic excision biopsy, histopathological examination, retrospective radiological analysis, and a review of literature, we were able to diagnose this rare condition. The histopathological picture of this benign adipose tissue tumor contained a mixture of mature adipose tissue and fibrous and vascular tissues. Here, in this case report, we discuss about PTEN gene causing PTEN hamartoma of soft tissue and angiolipoma presentations and its variants.
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Affiliation(s)
| | - Ramakanth Rajagopalakrishnan
- Department of Arthroscopy and Sports Medicine, Ganga Hospital, Coimbatore, Tamil Nadu, India,Address for correspondence: Dr. Ramakanth Rajagopalakrishnan, Ganga Hospital, Coimbatore, Tamil Nadu, India. E-mail:
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19
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Sebastiano C, Gennaro L, Brogi E, Morris E, Bowser ZL, Antonescu CR, Pareja F, Brennan S, Murray MP. Benign vascular lesions of the breast diagnosed by core needle biopsy do not require excision. Histopathology 2017. [PMID: 28644513 DOI: 10.1111/his.13291] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS Surgical excision of all benign vascular lesions of the breast identified by core needle biopsy has been recommended in the past to rule out a more serious lesion. In this study we investigated the clinical, radiological and pathological findings in patients diagnosed with a benign vascular lesion at our institution to assess whether excision may be spared for lesions without atypia. METHODS AND RESULTS We searched the electronic medical record for patients with a vascular lesion of the breast diagnosed between 2000 and 2015. The study population consisted of 84 patients, 83 females and one male. The index diagnoses included 76 benign vascular lesions, five vascular lesions with cytological atypia and three angiosarcomas. A radiologist reviewed all pre- and post-biopsy imaging studies; all cases had concordant radiological and pathological findings. Based on radiological and histological correlation, the vascular lesion accounted for the radiological target in 40 (48%) cases and was deemed an incidental finding in 44 (52%). Seven of 32 (22%) targeted and 10 of 44 (23%) incidental benign vascular lesions underwent surgical excision; there were no upgrades at excision. No recurrences or clinical events were observed in patients with a targeted or incidental benign vascular lesion with a median follow-up of 39 months and 40.6 months, respectively. CONCLUSION Our data suggest that benign vascular lesions diagnosed on core biopsy with concordant radiological and pathological findings do not warrant surgical excision.
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Affiliation(s)
| | - Lucas Gennaro
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth Morris
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Zenica L Bowser
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cristina R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Fresia Pareja
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sandra Brennan
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Melissa P Murray
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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20
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Clayman E, King K, Harrington MA. Corticosteroid-Associated Angiolipomatosis. Eplasty 2017; 17:ic9. [PMID: 28458766 PMCID: PMC5389016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Eric Clayman
- Division of Plastic Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Kathryn King
- Division of Plastic Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla,Correspondence:
| | - Michael A. Harrington
- Division of Plastic Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla
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Wu Z, Wan H, Shi M, Li M, Wang Z, Yang C, Gao W, Li Q. Bronchoscopic resection of bronchial angiolipoma: A rare case report. Mol Clin Oncol 2017; 5:850-852. [PMID: 28101361 DOI: 10.3892/mco.2016.1069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 10/20/2016] [Indexed: 11/06/2022] Open
Abstract
Angiolipoma is a rare benign tumor that most commonly occurs in the extremities and trunk. Angiolipomas originating in the bronchial tree are extremely rare. To the best of our knowledge, only one such case, confined to the bronchus intermedius, has been reported to date. The present study describes the case of an asymptomatic 74-year-old man with a yellowish round mass incidentally discovered at the orifice of the right lower bronchus during a routine health check. The tumor originated from the membranous part of the right inferior bronchus. Using a high-frequency electric snare and argon plasma coagulation under general anesthesia, successful bronchoscopic resection of the tumor was performed. At 15 months after the surgery, the patient remained recurrence- and symptom-free.
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Affiliation(s)
- Zhiqiang Wu
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Hongli Wan
- Department of Gynecology and Obstetrics, Sichuan Provincial Communications Department Highway Bureau Hospital, Chengdu, Sichuan 611731, P.R. China
| | - Min Shi
- Department of Pathology, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Ming Li
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Zhanpeng Wang
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Caixia Yang
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Wei Gao
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Qingxin Li
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
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22
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Shin YS, Kim YJ, Park IS, Chu YC, Kim JH, Lee HY, Lee KH, Kang YH. Sonographic Differentiation Between Angiolipomas and Superficial Lipomas. J Ultrasound Med 2016; 35:2421-2429. [PMID: 27738296 DOI: 10.7863/ultra.15.08050] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 02/09/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The purpose of this study was to compare the sonographic findings of angio lipomas with those of superficial lipomas. METHODS Preoperative sonograms of 26 angiolipomas from 18 patients and 47 superficial lipomas from 43 patients that were confirmed by biopsy were reviewed retrospectively. The echo texture, echogenicity, internal echogenic stranding, vascularity, visualization of lateral and superficial-deep tumor capsules, shape, and tumor length, width, and length-to-width ratio were evaluated and compared between angiolipomas and superficial lipomas. RESULTS Angiolipomas frequently appeared as heterogeneous (19 of 26 [73.1%]), hyperechoic (23 of 26 [88.5%]), and ovoid (17 of 26 [65.4%]) masses with lesser visualized lateral tumor capsules (6 of 26 [23.1%]), whereas superficial lipomas appeared as homogeneous (36 of 47 [76.6%]), isoechoic (35 of 47 [74.5%]), and spindle-shaped (23 of 47 [48.9%]) masses with well-visualized lateral capsules (33 of 47 [70.2%]), and the differences were statistically significant (P < .001). Vascularity was seen in 4 angiolipomas (16.7%) and in no superficial lipomas (0%). The mean length and width ± SD of angiolipomas (2.2 ± 1.02 and 0.6 ± 0.27 cm, respectively) were smaller than those of superficial lipomas (4.2 ± 1.52 and 1.1 ± 0.51 cm), with statistical significance (P< .001). The other sonographic findings did not reveal statistically significant differences between the tumor types. CONCLUSIONS Sonography might help differentiate angiolipomas from superficial lipomas.
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Affiliation(s)
- Yoon Sang Shin
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - Yeo Ju Kim
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - In Suh Park
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - Young Chae Chu
- Department of Pathology, Inha University Hospital, Incheon, Korea
| | - Jun Ho Kim
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - Ha Young Lee
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - Kyung Hee Lee
- Department of Radiology, Inha University Hospital, Incheon, Korea
| | - Young Hye Kang
- Department of Radiology, Inha University Hospital, Incheon, Korea
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Abstract
Echogenic breast lesions are generally thought to be benign. We herein report four cases of echogenic breast lesions that were seen at our centre over 38 months. One patient had a prior history of wide excision and radiotherapy for breast cancer and was imaged as part of routine cancer surveillance, while the other three were recalled for further assessment following an abnormal screening mammogram. All four patients were assessed on ultrasonography, which demonstrated an echogenic lesion in each patient. All four lesions underwent ultrasonography-guided core biopsy, followed by excision biopsy. The indications for biopsy were interval increase in the size of lesion or indeterminate features demonstrated in the lesion. Three lesions were benign, while the lesion from the patient who had received previous radiotherapy was angiosarcoma. Not all echogenic lesions are benign and lesions with suspicious features on ultrasonography should undergo biopsy.
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Affiliation(s)
- Lin Wah Goh
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore
| | - Su Lin Jill Wong
- Department of Oncologic Imaging, National Cancer Centre, Singapore
| | - Puay Hoon Tan
- Department of Pathology, Singapore General Hospital, Singapore
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Rahmati-Holasoo H, Alishahi M, Shokrpoor S, Jangarannejad A, Mohammadian B. Invasion of melanoma to angiolipoma in a male Siamese fighting fish, Betta splendens, Regan. J Fish Dis 2015; 38:925-930. [PMID: 25271738 DOI: 10.1111/jfd.12301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 07/10/2014] [Accepted: 07/21/2014] [Indexed: 06/03/2023]
Affiliation(s)
- H Rahmati-Holasoo
- Department of Aquatic Animal Health, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - M Alishahi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - S Shokrpoor
- Department of Pathology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - A Jangarannejad
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - B Mohammadian
- Department of Pathology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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25
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Álvarez-López MÁ, Salvatierra J, Sanz A. Thrombosis of multiple angiolipomas due to acenocumarol treatment. J Cutan Pathol 2015; 42:919-20. [PMID: 26418501 DOI: 10.1111/cup.12600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 03/19/2011] [Accepted: 04/18/2011] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Andres Sanz
- Department of Pathology, Hospital Universitario Carlos Haya, Malaga, Spain
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26
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Nam YH, Park SC, Kim HJ, Lee SW, Kim J, Choi DH, Kang CD, Lee SJ, Lee S. Angiolipoma of the stomach presenting with anaemia. Prz Gastroenterol. 2014;9:371-374. [PMID: 25653734 PMCID: PMC4300344 DOI: 10.5114/pg.2014.47498] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 01/22/2013] [Accepted: 02/12/2013] [Indexed: 01/21/2023]
Abstract
Angiolipoma is a morphological variation of the lipoma and is a benign tumour that consists of mature adipose tissue and proliferating blood vessels. It occurs very rarely in the digestive tract, especially the stomach. We report a gastric angiolipoma in a 58-year-old woman admitted for anaemia and melena. Endoscopy showed a large polypoid mass with superficial ulceration in the anterior wall of the gastric antrum. Endoscopic ultrasound showed an about 2 cm sized isoechoic lesion at the third echo layer, with the echogenic portion on the luminal side of the lesion. Laparoscopic wedge resection was performed and histological examination showed that the lesion had encapsulated adipose tissue at the submucosal layer and stromal fibrosis just below superficial ulceration. There were blood vessels with thick walls among the mature fat cells. Therefore, the lesion was diagnosed as an angiolipoma.
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Ohnishi Y, Watanabe M, Fujii T, Yasui H, Kubo H, Kakudo K. Infiltrating angiolipoma of the lower lip: A case report and literature review. Oncol Lett 2014; 9:833-836. [PMID: 25621058 PMCID: PMC4301520 DOI: 10.3892/ol.2014.2737] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 09/08/2014] [Indexed: 01/04/2023] Open
Abstract
Infiltrating angiolipoma (IAL) is a rare lesion and is a clinicopathological variant of angiolipoma. IAL occurs most commonly in the trunk and extremities, it is rarely found in the head and neck regions and extremely rare in the oral cavity. This study presents the case of a 74-year-old female with IAL of the lower lip. To the best of our knowledge, this is the first case of IAL arising in the lower lip to be reported. Microscopically, IAL was unencapsulated and mature lipocytes were separated by a branching network of proliferating small vessels that infiltrated the adjacent tissues. Therefore, complete excision was difficult to perform. Magnetic resonance imaging has been reported to be valuable in determining the extent of the tumor and asserting a preoperative diagnosis. According to previous studies, the recurrence rate of IAL following surgical extirpation is 35–50%. Furthermore, the levels of mRNA expression of the vascular endothelial growth factor (VEGF) family members in the tumor were investigated. VEGF-A and -B expression were detected, however, VEGF-C and -D were expressed at extremely low levels. Excisional biopsy was performed under local anesthesia. During four years of follow-up, no evidence of tumor recurrence had been identified. An operating microscope may be utilized for the total removal of an IAL to minimize damage to normal tissues. This report indicates that mast cell-derived VEGF may be responsible for the enhanced vascularity in the tumor. We would therefore consider careful extirpation with no wide safety margin to be the procedure of choice, except when the tumor invades irregularly into the muscles.
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Affiliation(s)
- Yuichi Ohnishi
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Masahiro Watanabe
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Tomoko Fujii
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Hiroki Yasui
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Hirohito Kubo
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Kenji Kakudo
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
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Affiliation(s)
- Sanaa Lemtibbet
- Université Med V, Service de dermatologie, CHU Ibn Sina, Rabat, Maroc
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Palaia G, Gaimari G, Giudice RL, Galanakis A, Tenore G, Romeo U. Excision of an oral angiolipoma by KTP laser: a case report. Ann Stomatol (Roma) 2011; 2:28-31. [PMID: 22238720 PMCID: PMC3254385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
MATERIALS AND METHODS A 66 year old woman was referred to our observation, since the presence of a painless swelling located on the right cheek mucosa. A surgical approach with KTP laser was performed with the mucosal preservation technique. RESULTS Follow up after seven days, sixty days and four months did not showed any complication and the histological examination reported the diagnosis of AL. DISCUSSION AL is a relatively rare tumor of the head and neck region, although it occurs more commonly in the extremities and the trunk. This tumor has been rarely reported in the oral cavity and when seen in this area, it involves in the lip, cheek, tongue, mandible, and palate. ALs are also intraosseous in the mandible and intramuscular in the pterygoid fossa. KTP laser excision showed to be resolutive and avoid of complications. CONCLUSIONS AL of the cheek is a very rare patology, but when it appears, it requires a surgical excision.
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Affiliation(s)
- Gaspare Palaia
- Corresponding author: Gaspare Palaia, Via Feronia, 148, 00157 Rome, Italy, Mobile +39 339 4522515, fax +39 06 7806974, E-mail:
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