1
|
Yamazaki H, Minato Y, Madhu D, Iida T, Banjyoya S, Kimura T, Furuta K, Nagae S, Itou Y, Takeuchi N, Takayanagi S, Kimoto Y, Kano Y, Sakuno T, Ono K, Ohata K. Extraction of terminal ileal lipomas to cecum can facilitate endoscopic resection: A case series with video. DEN open 2025; 5:e375. [PMID: 38694538 PMCID: PMC11058687 DOI: 10.1002/deo2.375] [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] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 05/04/2024]
Abstract
Large ileal lipomas over 2 cm can cause symptoms, that may require a resection. Due to the narrow lumen and thin walls of the ileum, endoscopic treatments can have a high risk of adverse events and require technical expertise, thus surgical resection is currently the mainstay of treatment. To overcome the technical challenges, we developed a novel method to endoscopically resect terminal ileal lipomas. The technique involves extracting the lesion into the cecum, which creates sufficient space to maneuver, and a better field of view. The lipoma is resected with endoscopic mucosal resection or endoscopic submucosal dissection. The appearance of the lipoma protruding out of the ileocecal valve resembles that of a tongue sticking out of the mouth, thus we named this the "tongue out technique". To assess the technical feasibility of this method, we retrospectively analyzed seven cases of terminal ileal lipoma that were endoscopically resected using the "tongue out technique" at NTT Medical Center Tokyo between January 2017 and October 2023. Technical success was 100% and en bloc resection was achieved in all cases. The median size was 31 (14-55) mm. Three cases were resected with endoscopic mucosal resection while endoscopic submucosal dissection was performed on the other four cases. There was one case of delayed post-endoscopic mucosal resection bleeding, which was caused by clip dislodgement. There were no perforations. No recurrence of the lipoma or associated symptoms have been observed. This new technique can allow more ileal lipomas to be treated with minimally invasive and organ-preserving endoscopic procedures.
Collapse
Affiliation(s)
- Hiroshi Yamazaki
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Yohei Minato
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Deepak Madhu
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Toshifumi Iida
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Susumu Banjyoya
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Tomoya Kimura
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Koichi Furuta
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Shinya Nagae
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Yohei Itou
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Nao Takeuchi
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Shunya Takayanagi
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Yoshiaki Kimoto
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Yuki Kano
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Takashi Sakuno
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Kohei Ono
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Ken Ohata
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| |
Collapse
|
2
|
Hamdi M, Hammoud KJ, Issa MY, Assad A. A Novel Case of Cervical Lipoma Arising From Surgical Incision. Ear Nose Throat J 2024:1455613241249085. [PMID: 38654496 DOI: 10.1177/01455613241249085] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Lipoma is a benign mesenchymal tumor primarily found in subcutaneous fat. Post-traumatic lipoma (PTL) sporadically associates with blunt of penetrating trauma, but the exact mechanism remains not fully understood. This article unveils a rare case of a 32-year-old male presenting with a cervical lipoma at a previous surgical incision, an unprecedented occurrence. The patient incidentally detected the mass and underwent complete excision, with pathology confirming the diagnosis. The etiology of PTL remains speculative, with proposed mechanisms postulating inflammatory chemokines inducing preadipocyte differentiation and acute trauma causing septal rupture, allowing lipoma formation. Notably, the prior use of blade in our patient's surgical procedure aligns with this hypothesis. The varied nature of trauma encompasses acute, blunt, and penetrating injuries. This case represents the second instance attributed to penetrating trauma and the first occurrence at a surgical incision site.
Collapse
Affiliation(s)
- Mohammad Hamdi
- Department of Otolaryngology-Head and Neck Surgery, Al-Mouwasat University Hospital, Faculty of Medicine, Damascus University, Damascus, Syria
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | - Kinana Jamal Hammoud
- Department of Otolaryngology-Head and Neck Surgery, Al-Mouwasat University Hospital, Faculty of Medicine, Damascus University, Damascus, Syria
- Faculty of Medicine, Tishreen University, Latakia, Syria
| | - Mohammad Yasin Issa
- Department of Otolaryngology-Head and Neck Surgery, Al-Mouwasat University Hospital, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Asef Assad
- Department of Otolaryngology-Head and Neck Surgery, Al-Mouwasat University Hospital, Faculty of Medicine, Damascus University, Damascus, Syria
| |
Collapse
|
3
|
Taweevisit M, Thorner PS. Fine needle aspiration of spindle cell lipoma-Lochkern cells as a clue for diagnosis: A case arising in the parotid gland. Diagn Cytopathol 2024; 52:E84-E87. [PMID: 38217263 DOI: 10.1002/dc.25271] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/07/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
Spindle cell lipoma (SCL) is a rare form of lipoma, typically occurring as a mass in the back, shoulder or posterior neck of adult males. Most cases present little diagnostic difficulty on fine needle aspiration (FNA), but can be problematic when the SCL is in an unusual location. The authors report a case in the parotid gland in a 75-year-old man. FNA was paucicellular and showed loose collections of spindle cells with mild to moderate atypia, admixed with ropy collagen fibers on a myxoid background. The nuclei showed occasional angulation, interpreted on FNA as suspicious for myoepithelial tumor or low-grade sarcoma. The subsequent excisional specimen was diagnosed as SCL. On retrospective review of the FNA, an additional finding was recognized: 'naked' nuclei with intranuclear lipid vacuoles and positive immunostaining for S100 protein, consistent with Lochkern cells of mature adipocytes. This case highlights the challenges of diagnosing SCL on cytology when no fat-containing cells are apparent on the smear, and stresses the significance of Lochkern cells as a clue for diagnosis.
Collapse
Affiliation(s)
- Mana Taweevisit
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- King Chulalongkorn Memorial Hospital and Thai Red Cross Society, Bangkok, Thailand
| | - Paul Scott Thorner
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
4
|
Stavrakakis IM, Georgopoulou V, Magarakis GE, Katsafarou MS. Sensory and Motor Median Nerve Neuropathy Due to a Deep Giant Hand Lipoma: A Case Report. Rev Bras Ortop 2024; 59:e323-e326. [PMID: 38606139 PMCID: PMC11006529 DOI: 10.1055/s-0041-1726072] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/08/2021] [Indexed: 10/21/2022] Open
Abstract
Lipomas are the most common soft-tissue tumors in the human body, but their location in the hand is rare. Symptomatic hand lipomas, due to nerve compression, are even rarer. We present a case of median nerve neuropathy as a result of a giant palm lipoma, located on the thenar and hypothenar areas of the hand. The patient had typical symptoms of carpal tunnel syndrome, along with compromised thumb motion. Intraoperatively, the recurrent motor branch of the median nerve was sitting on the lipoma under a great tension. This particular location of the motor branch of the median nerve in relation to the lipoma makes this case unique. The tumor was excised protecting the neurovascular structures, and a few weeks later the patient regained full thumb motion, grip strength, and resolution of dysesthesia.
Collapse
Affiliation(s)
| | | | - George E. Magarakis
- Departamento de Ortopedia, Venizeleio General Hospital of Heraklion, Creta, Grécia
| | - Maria S. Katsafarou
- Departamento de Ortopedia, General Hospital of Agios Nikolaos, Creta, Grécia
| |
Collapse
|
5
|
Heng V, Oh S, Leng H, Chhun V, Lee YD. Adult colorectal intussusception caused by giant lipoma-A case report. Clin Case Rep 2024; 12:e8682. [PMID: 38562575 PMCID: PMC10982120 DOI: 10.1002/ccr3.8682] [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: 08/30/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 04/04/2024] Open
Abstract
Key Clinical Message Adult intussusception commonly has a leading point. In the colon, malignancy is a prevalent etiology for the leading point; however, benign tumors should also be considered. We present a case of colorectal intussusception caused by a giant lipoma. Abstract Intussusception in adults is comparatively infrequent in contrast to children, and in adult colonic intussusception, malignancy is the predominant cause of the leading point. Lipoma, an uncommon tumor in the gastrointestinal tract, rarely induces colonic intussusception in adults. We present the case of a 55-year-old Cambodian man experiencing cramping abdominal pain. He presented with mild abdominal distension with tenderness in the lower abdomen. On the rectal examination a large palpable mass was detected three to four centimeters from the anal verge. Abdominal computerized tomography revealed a collapsed sigmoid colon with mesenteric fat invaginated into the lumen of the upper rectum. Emergency laparotomy was performed and during the surgery the sigmoid intussusception spontaneously reduced. A mass was identified in the mid-sigmoid colon, leading to the decision for segmental resection of the sigmoid colon with the mass and subsequent end-to-end anastomosis. Histological examination results confirmed the mass as a lipoma. Colorectal intussusception in adults due to a lipoma is a relatively rare, with only a few reported cases in the literature.
Collapse
Affiliation(s)
- Vouchly Heng
- Department of Education & TrainingHebron Medical CenterPhnom PenhCambodia
| | - Suk‐Kyu Oh
- Department of Education & TrainingHebron Medical CenterPhnom PenhCambodia
| | - Hour Leng
- Department of SurgeryHebron Medical CenterPhnom PenhCambodia
| | - Vireak Chhun
- Department of PathologyHebron Medical CenterPhnom PenhCambodia
| | - Young Don Lee
- Department of SurgeryHebron Medical CenterPhnom PenhCambodia
| |
Collapse
|
6
|
Yang Y, Zuo H, Ding M, Ma F, Zhao L, Zhang J. A Rare Lipoma of Tongue in a 4-Year-Old Child: A Case Report With Literature Review. Ear Nose Throat J 2024:1455613241237083. [PMID: 38470084 DOI: 10.1177/01455613241237083] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Lipoma of the tongue is a rare benign tumor that accounts for approximately 1% to 5% of all oral cavity tumors while 0.3% of tumors are of the tongue. Notably, it is rarer in children. In this article, we report the case of a 4-year-old girl with lipomas of the tongue. The lipomas were found at age 1 year by her parents, located on the tip, ventro, and dorsum of the tongue, and presenting with a trend to increase gradually. At the time of presentation to the hospital at age 4 years, the articulatory function of the patient was partially affected, and surgical excision was performed. The surgery was uneventful, and no evidence of recurrence was noted at 3 month follow-up.
Collapse
Affiliation(s)
- Yong Yang
- Plastic Surgery Department, Tianjin Children's Hospital, Children's Hospital, Tianjin University, Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China
| | - Hailiang Zuo
- Plastic Surgery Department, Tianjin Children's Hospital, Children's Hospital, Tianjin University, Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China
| | - Meiyun Ding
- Plastic Surgery Department, Tianjin Children's Hospital, Children's Hospital, Tianjin University, Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China
| | - Fujiang Ma
- Plastic Surgery Department, Tianjin Children's Hospital, Children's Hospital, Tianjin University, Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China
| | - Linsheng Zhao
- Pathology Department, Tianjin Children's Hospital, Children's Hospital, Tianjin University, Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China
| | - Jiancheng Zhang
- Plastic Surgery Department, Tianjin Children's Hospital, Children's Hospital, Tianjin University, Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China
| |
Collapse
|
7
|
Ezike KN, Okwudire-Ejeh IA, Ahmed SI, Salu IK, Aghahowa ME, Dallang B, Umar UM. Benign Lipomatous Soft Tissue Tumors in Nigerians: An Analysis of the Clinical and Morphological Features of a Common but Important Entity. Cureus 2024; 16:e56618. [PMID: 38646250 PMCID: PMC11031710 DOI: 10.7759/cureus.56618] [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: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Benign lipomatous tumors are soft tissue tumors that exhibit a predominant adipocytic phenotype. Lipomas are the archetype and are the most common benign soft tissue tumors in adults but relatively uncommon in children. Their sex incidence is equivocal. They sometimes occur in combination with other mesenchymal elements, giving rise to variants including fibrolipoma, angiolipoma, myolipoma, spindle cell lipoma, chondroid lipoma, osteolipoma, and chondrolipoma. Their clinical significance is mainly due to the cosmetic disfigurement of patients and the differential diagnosis of malignant soft tissue tumors. Occasionally, due to their large size or presence near vital organs, they may cause life-threatening and/or excruciating pressure symptoms. This study was purposed to address the dearth of local studies on the clinical and morphological characteristics of benign lipomatous tumors in Nigerians, to compare these with those of other populations, and to establish baseline data. Materials and methods This was a retrospective study of all benign lipomatous tumors seen in the anatomic pathology and forensic medicine department of Asokoro District Hospital, Abuja, Federal Capital Territory, Nigeria, over an eight-year period. Surgical pathology reports were retrieved for patients' biodata and clinical information. The appropriate slides were retrieved, and reviewed, and new sections were cut where necessary. The tumors were classified according to the 2020 World Health Organization (WHO) guidelines and categorized based on size as small, medium, or giant. The data obtained were analyzed, and the results were presented as tables, bar charts, ratios, and percentages. Results Four hundred and eighteen cases met the inclusion criteria. Of these, 58.4% (244/418), occurred in females, while 41.6% (174/418) occurred in males. The age range was six to 91 years, while the median age was 42 years. The least number of cases, 0.5% (2/418), were seen in patients aged less than 10 years, while the majority, 35.4% (148/418), occurred in the fifth decade, followed by 27.8% (116/418) in the fourth. Size-wise, the majority of tumors, 60% (253/418), were medium, followed by small, 22.8% (95/418). Giant-sized tumors significantly accounted for 16.7% (70/418) of the cases. The diagnostic spectrum comprised conventional lipoma and variants such as fibrolipoma, spindle cell lipoma, pleomorphic lipoma, angiolipoma, chondrolipoma, intramuscular lipoma, and osteolipoma. Lipoma and fibrolipoma dominated with 87.1% (364/418) and 10.0% (42/418), respectively, while the rest accounted for <3%. The majority, 31.8% (133/418), occurred in the back/shoulder region, followed by the lower limb with 18.2% (76/418). Only two cases occurred in the abdominal/pelvic region. More tumors occurred in females in all the regions except the head and neck, which had a male-to-female ratio of 1.5:1. Multiple site tumors were more common in males in a ratio of 2.5:1. Most, 41.1% (39/95), of the small-sized tumors, occurred in the head/neck region, largely involving the face, 48.7% (19/39). Conclusion Our study showed many similarities in the clinical and morphological features of benign lipomatous tumors between Nigerians and other regions of the world. A notable finding, however, was the significantly higher proportion of giant benign lipomatous tumors when compared to studies from other regions, a finding that warrants further studies.
Collapse
Affiliation(s)
- Kevin N Ezike
- Anatomic Pathology and Forensic Medicine, Nile University of Nigeria, Abuja, NGA
| | | | - Sule I Ahmed
- Orthopaedic Surgery, Asokoro District Hospital, Abuja, NGA
| | | | - Michael E Aghahowa
- Surgery, Nile University of Nigeria, Abuja, NGA
- Surgery, Asokoro District Hospital, Abuja, NGA
| | - Bamnan Dallang
- Anatomic Pathology and Forensic Medicine, Nile University of Nigeria, Abuja, NGA
| | - Umar M Umar
- Radiology, Nile University of Nigeria, Abuja, NGA
| |
Collapse
|
8
|
Inoue T, Kumai T, Yoshizaki T, Takahara M. Lipoma Arising in the Eustachian Tube. Cureus 2024; 16:e56597. [PMID: 38646351 PMCID: PMC11031621 DOI: 10.7759/cureus.56597] [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: 03/19/2024] [Indexed: 04/23/2024] Open
Abstract
Lipomas are among the most common soft tissue tumors. Surgical removal of lipoma is considered if the patient has symptoms or cosmetic challenges. Lipomas that develop from any fat tissue in the body and involve the eustachian tube are extremely rare. Herein, we report the case of a patient with a lipoma arising in the eustachian tube. We also summarized the literature on tumors originating from the eustachian tubes. A 62-year-old female presented to our department with a five-year history of left nasal congestion. Nasal endoscopy revealed a tumor in the left eustachian tube. The tumor was considered a lipoma on computed tomography (CT) and magnetic resonance imaging (MRI) and was removed using a transnasal endoscopic approach. Nasal endoscopy and radiologic imaging can be used to detect tumors in the nasopharynx, including the eustachian tubes. Magnetic resonance imaging is particularly useful for the diagnosis of lipomas. A lipoma in the eustachian tube can cause nasal congestion and aural fullness, and the transnasal endoscopic approach is useful for tumor removal.
Collapse
Affiliation(s)
- Takahiro Inoue
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, JPN
| | - Takumi Kumai
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, JPN
| | - Tomoki Yoshizaki
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Kosei Hospital, Asahikawa, JPN
| | - Miki Takahara
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, JPN
| |
Collapse
|
9
|
Traub F, De Jager T, Hofmann UK, Farah G, Sachsenmaier SM. Desmoid Fibromatosis Fused With a Lipoma in the Upper Arm. Cureus 2024; 16:e55430. [PMID: 38567225 PMCID: PMC10986155 DOI: 10.7759/cureus.55430] [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: 03/03/2024] [Indexed: 04/04/2024] Open
Abstract
Lipoma, the most common mesenchymal tumor, often appears as a slow-growing mass in the musculoskeletal system (MSK). While generally non-invasive, their location can cause symptoms. Desmoid fibromatosis (DF), a rare and locally aggressive neoplasm, poses challenges in MSK system diagnosis and management due to its infiltrative nature. Despite lacking metastatic potential, DF has a high recurrence rate, classifying it as "intermediate, locally aggressive" in the WHO classification. Collaborative efforts among orthopedic surgeons, radiologists, and pathologists are crucial for accurate diagnosis and treatment planning for all tumors of the MSK system. This case report presents the first documented example of a DF within a lipoma, highlighting the challenges of diagnosing and treating musculoskeletal tumors.
Collapse
Affiliation(s)
- Frank Traub
- Orthopaedics and Traumatology, University Medical Center of Johannes Gutenberg University Mainz, Mainz, DEU
| | - Tobias De Jager
- Orthopaedic Surgery, Eberhard Karls University of Tübingen, Tübingen, DEU
| | - Ulf K Hofmann
- Orthopaedic Surgery, Eberhard Karls University of Tübingen, Tübingen, DEU
| | - George Farah
- Orthopaedics and Traumatology, University Medical Center of Johannes Gutenberg University Mainz, Mainz, DEU
| | | |
Collapse
|
10
|
Kloub M, Calvis E, Abdelmesih B, Milia R, Atiyat R, Dacosta TJ. Submucosal Lipoma in the Rectum Found Incidentally During Colonoscopy Screening: A Case Report. Cureus 2024; 16:e56587. [PMID: 38646407 PMCID: PMC11031272 DOI: 10.7759/cureus.56587] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Gastrointestinal (GI) tract lipomas are a benign entity of GI tumors. In this case report, we present a 53-year-old patient who was found to have a rectal lipoma incidentally in an asymptomatic middle-aged female during a routine colonoscopy screening. The tumor was excised during colonoscopy and sent for histopathology, which confirmed the diagnosis. We also provide a literature review of GI lipomas, focusing on their occurrence in the rectum.
Collapse
Affiliation(s)
- Mohammad Kloub
- Internal Medicine, Saint Michael's Medical Center, Newark, USA
| | - Earyn Calvis
- Medicine, Saint George's University, School of Medicine, New York, USA
| | - Bavly Abdelmesih
- Medicine, Saint George's University, School of Medicine, New York, USA
| | - Rachel Milia
- College of Osteopathic Medicine, University of New England College of Osteopathic Medicine, Biddeford, USA
| | - Raed Atiyat
- Internal Medicine, Division of Gastroenterology and Hepatology, Saint Micheal's Medical Center, Newark, USA
| | - Theodore Jr Dacosta
- Gastroenterology and Hepatology, Saint Michael's Medical Center, Newark, USA
| |
Collapse
|
11
|
Gupta SV, Durge S, Rahate NP, Rahate PV. Lipoma Growing on the Back for 26 Years: A Bizarre Case Report. Cureus 2024; 16:e56999. [PMID: 38681398 PMCID: PMC11046375 DOI: 10.7759/cureus.56999] [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: 03/06/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024] Open
Abstract
Lipoma is one of the most typical and benign tumors. They are typically regarded as a mass that is painless, asymptomatic, and slow-growing. It is composed of fat cells of the adult type. It can occur anywhere in the body and is often called a "universal" or ubiquitous tumor. They can develop in any region containing adipose tissue, with a higher prevalence in the subcutaneous tissue of the trunk and the nape of the neck and the limbs and occasionally in other locations, including the hand. There are three main varieties: encapsulated, diffuse, and multiple lipomas. A few lipomas may contain other tissues: fibrolipoma, neurolemma, and myelolipoma. Lipoma, when present for a long time, may undergo certain changes. This is particularly true in cases of lipoma under subcutaneous tissues of the thigh, buttock, or retroperitoneal lipoma. Such changes can be malignant, sarcomatous, calcification, or saponification. Clinically, a lipoma can occur in different anatomical situations; according to this, a lipoma can be classified into subcutaneous type, subfascial type, intramuscular type, subserous type, submucous type, intra-articular type, or it can be intraglandular. Lipomas, the most prevalent benign mesenchymal tumors, consist of mature lipocytes. Typically, lipomas are small, weighing only a few grams, with a maximum diameter usually under 2 cm. The term "giant" is applied when a lipoma reaches a diameter of at least 10 cm or weighs a minimum of 1,000 g. Due to their substantial size, giant lipomas can lead to functional limitations, such as lymphedema, pain syndromes, or nerve compression. Given the unique nature of this condition, characterized by the considerable size of the lesion and the challenges in both diagnosis and treatment, we present a case involving a 45-year-old woman with a giant lipoma in the suprascapular region.
Collapse
Affiliation(s)
- Samiksha V Gupta
- Psychiatry and Behavioral Sciences, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shubham Durge
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nachiket P Rahate
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | | |
Collapse
|
12
|
Taylor TN, Murray RD, Morrow DL, Duff J, Voskuil RT. Infiltrative Intramuscular Lipoma with Overlying Fascial Defect in the Anterior Thigh: A Case Report. Cureus 2024; 16:e56274. [PMID: 38623105 PMCID: PMC11017948 DOI: 10.7759/cureus.56274] [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: 03/15/2024] [Indexed: 04/17/2024] Open
Abstract
This case report details a unique presentation of an infiltrative intramuscular lipoma in the anterior thigh of a 51-year-old female with an overlying fascial defect. The patient reported a progressively enlarging left thigh mass associated with pain exacerbated by knee movement and exercise. MRI revealed a homogeneous intramuscular lipoma without contrast enhancement with a fascial defect. An 8 cm longitudinal incision exposed a 7 x 4 cm fascial defect overlying the lipomatous mass within the rectus femoris muscle. Pathological analysis confirmed an intramuscular lipoma without malignancy. Follow-ups at two, six, and 12 weeks demonstrated pain resolution and no soft tissue bulge. This case underscores the importance of distinguishing intramuscular lipomas from other neoplasms, such as lipomatosis and liposarcomas. The association of a fascial defect with intramuscular lipomas is unprecedented and may be due to the increased pressure on the fascia by the lipoma. The report emphasizes the role of MRI in diagnosis and appropriate surgical management, and highlights the need for further exploration into the etiology of fascial defects associated with intramuscular lipomas.
Collapse
Affiliation(s)
- Tristen N Taylor
- Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, USA
| | - Richard D Murray
- Department of Orthopaedic Surgery, University of Tennessee Health Science Center College of Medicine, Chattanooga, USA
| | - Dillon L Morrow
- Department of Orthopaedic Surgery, University of Tennessee Health Science Center College of Medicine, Chattanooga, USA
| | - Joseph Duff
- Department of Orthopaedic Surgery, University of Tennessee Health Science Center College of Medicine, Chattanooga, USA
| | - Ryan T Voskuil
- Department of Orthopaedic Surgery, University of Tennessee Health Science Center College of Medicine, Chattanooga, USA
| |
Collapse
|
13
|
Suleiman J, Mremi A, Tadayo J, Lodhia J. Giant liposarcoma of the thigh: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241229858. [PMID: 38333517 PMCID: PMC10851710 DOI: 10.1177/2050313x241229858] [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: 10/10/2023] [Accepted: 01/17/2024] [Indexed: 02/10/2024] Open
Abstract
Liposarcoma is a tumor derived from primitive cells that undergo adipose differentiation. They comprise 10%-35% of all soft tissue sarcomas. We present a 46-year-old female patient with a 4-year history of a giant swelling on the lateral aspect of the left thigh. Wide local excision of the mass was performed and histopathological analysis revealed a well-differentiated liposarcoma. Liposarcomas commonly appear in the extremities and have distinct features on imaging studies. Surgical treatment and histology are the most important prognostic factors for patients with lipomatous tumors, as complete surgical excision reduces local recurrence rate.
Collapse
Affiliation(s)
- Jamil Suleiman
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
| | - Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
| | - Joshua Tadayo
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
| | - Jay Lodhia
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
| |
Collapse
|
14
|
Soleimani H, Aminzadeh B, Hassannejad E, Payandeh A, Oudi B, Karimabadi N. A rare case of giant mediastinal thymo lipoma in an 18-year man. Clin Case Rep 2024; 12:e8530. [PMID: 38374882 PMCID: PMC10875628 DOI: 10.1002/ccr3.8530] [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: 12/20/2023] [Revised: 01/20/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024] Open
Abstract
Thymolipoma is a rare benign thymic lesion that can manifest as a sizable anterior mediastinal mass. Considering their rarity and challenging preoperative diagnosis, it is crucial to consider these tumors when dealing with anterior mediastinal masses.
Collapse
Affiliation(s)
- Hourieh Soleimani
- Department of Radiology, Faculty of medicineMashhad University of Medical SciencesMashhadIran
| | - Behzad Aminzadeh
- Department of Radiology, Faculty of medicineMashhad University of Medical SciencesMashhadIran
| | - Ehsan Hassannejad
- Department of Radiology, School of MedicineBirjand University of Medical SciencesBirjandIran
| | - Asma Payandeh
- Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Batul Oudi
- Pathology Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Neda Karimabadi
- Department of Radiology, Faculty of medicineMashhad University of Medical SciencesMashhadIran
| |
Collapse
|
15
|
Ai J, Zarb R, Cassidy S, Lin K. A Rare Case of a Giant Intramuscular Lipoma of the Upper Extremity in a Pediatric Patient. Cureus 2024; 16:e53575. [PMID: 38445164 PMCID: PMC10914407 DOI: 10.7759/cureus.53575] [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: 02/04/2024] [Indexed: 03/07/2024] Open
Abstract
Although lipomas are the most common benign soft tissue tumors, the non-infiltrating intramuscular subtype is relatively uncommon. As these masses typically present between the ages of 40 and 70, few cases have been reported in the pediatric population. We present a case of a giant intramuscular lipoma of the biceps brachii in an adolescent. He presented with a slow-growing, tender mass and had no neurovascular compromise of the limb. MRI was utilized to visualize the mass, and a muscle-sparing excisional biopsy was performed. Histologic evaluation confirmed a diagnosis of a benign lipoma. The patient went on to heal without a functional deficit. Large, growing soft tissue masses warrant work-up to rule out malignancy. Advanced imaging and excisional biopsy are necessary to confirm the diagnosis of a benign giant intramuscular lipoma, which is especially rare within the pediatric population. We discuss the prevalence and treatment of intramuscular lipomas, including a literature review of reports in the pediatric population.
Collapse
Affiliation(s)
- Jeffrey Ai
- Plastic Surgery, Medical College of Wisconsin, Milwaukee, USA
| | - Rakel Zarb
- Plastic Surgery, Medical College of Wisconsin, Milwaukee, USA
| | - Sarah Cassidy
- Plastic Surgery, Medical College of Wisconsin, Milwaukee, USA
| | - Kant Lin
- Plastic Surgery, Medical College of Wisconsin, Milwaukee, USA
| |
Collapse
|
16
|
Malik F, Allbee AW, Zhang PJ. Intra-Abdominal and Retroperitoneal Benign Lipomatous Tumors-An Extremely Rare Mimic of Liposarcoma and its Diagnostic Challenge. Int J Surg Pathol 2024; 32:46-57. [PMID: 37131332 PMCID: PMC10901880 DOI: 10.1177/10668969231167511] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/20/2023] [Accepted: 03/17/2023] [Indexed: 05/04/2023]
Abstract
Background. Lipomas are common superficial soft tissue tumors of mature adipocytes. In contrast, well-differentiated/dedifferentiated liposarcoma typically presents in the retroperitoneum as large masses. We provide clinicopathologic and follow-up details of 9 retroperitoneal/intra-abdominal benign lipomatous tumors (BLT) and discuss the utility of ancillary fluorescence in situ hybridization (FISH) in distinguishing from their malignant counterparts. Design. Clinicopathologic details and histology of 9 intra-abdominal and retroperitoneal lipomas were studied along with ancillary CD10 immunohistochemistry (IHC) and FISH for MDM2 and CDK4 amplification. Results. There were 6 females and 3 males. Median age at diagnosis was 52 years (range 36-81 years). Seven were identified incidentally and 2 presented with primary complaints. On imaging, 7 were considered suspicious for liposarcoma. Grossly, the tumors ranged from 3.4 to 41.2 cm (median 16.5 cm). Histologically, all cases showed well-differentiated BLT, further classified as lipoma (n = 7; 1 with metaplastic ossification, 2 with prominent vessels, and 4 ordinary lipomas) and lipoma-like hibernoma (n = 2)-the latter 2 showed intramuscular lesions with interspersed brown fat. CD10 IHC showed strong staining in the 2 hibernomas, whereas the staining was weak in the remaining. MDM2 and CDK4 amplification were negative by FISH in all. Follow-up (median 18 months) did not show recurrence on clinical or imaging evaluation. Conclusion. Retroperitoneal/intra-abdominal BLT are extremely rare and are indistinguishable clinically and radiographically from liposarcoma. This necessitates molecular confirmation even when the histology is convincingly benign, for a confident diagnosis. Our cohort shows that conservative excision without removal of abutted organs is sufficient in most cases.
Collapse
Affiliation(s)
- Faizan Malik
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew W. Allbee
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Paul J. Zhang
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
17
|
Minervini F, Sergi CM, Scarci M, Kestenholz PB, Valentini L, Boschetti L, Bertoglio P. Benign tumors of the chest wall. J Thorac Dis 2024; 16:722-736. [PMID: 38410554 PMCID: PMC10894435 DOI: 10.21037/jtd-23-464] [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: 03/21/2023] [Accepted: 11/27/2023] [Indexed: 02/28/2024]
Abstract
Benign tumors of the chest wall are rare tumors that might arise from all the tissues of the chest: vessels, nerves, bones, cartilage, and soft tissues. Despite benign features, these tumors can have several histological characteristics and different behaviors. Even if they do not influence life expectancy, rarely they may have a potential risk of malignant transformation. They can cause several, oft, unspecific symptoms but more than 20% of affected patients are asymptomatic and are being diagnosed incidentally on chest radiograph or computed tomography scan. Pain is the most common described symptom. Together with a detailed medical history, a rigorous and meticulous clinical and radiological assessment is mandatory. If radiological features are unclear or in case surgery could not be performed, a biopsy should be indicated to establish a diagnosis. Radical surgical resection can often be offered to resect and cure these neoplasms, but this is might not be true for all types of tumors and, in some cases, their dimension or position might contra-indicate surgery. Given the rarity of these tumors, there is a lack of treatment's guidelines and prospective trials that include a significant number of patients. This review discusses, according to the latest evidence, the histological features and the best treatment of several chest wall benign tumors.
Collapse
Affiliation(s)
- Fabrizio Minervini
- Division of Thoracic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Consolato Maria Sergi
- Division of Anatomic Pathology, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
| | - Marco Scarci
- Department of Thoracic Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - Peter B. Kestenholz
- Division of Thoracic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Leonardo Valentini
- Department of Thoracic Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Laura Boschetti
- Department of Medical Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Pietro Bertoglio
- Department of Thoracic Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Alma Mater Studiorum, University of Bologna, Bologna, Italy
| |
Collapse
|
18
|
Panteleev VI, Kriger AG, Gushcha AO, Dzhigkaeva MM. [Small pelvis lipoma spreading to the gluteal region]. Khirurgiia (Mosk) 2024:97-101. [PMID: 38258695 DOI: 10.17116/hirurgia202401197] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
We present a 36-year-old woman with small pelvis lipoma spreading to the gluteal region through the greater sciatic foramen. Resection of lipoma was performed via two accesses (lower median laparotomy and semilunar incision in the gluteal region). The tumor was the content of sciatic hernia that is extremely rare. Combination of surgical approaches can provide favorable outcomes in these patients.
Collapse
Affiliation(s)
| | - A G Kriger
- Russian Radiology Research Center, Moscow, Russia
- Russian Medical Academy of Continuing Professional Education, Moscow, Russia
| | - A O Gushcha
- Neurology Research Center, Moscow, Russia
- Russian Medical Academy of Continuing Professional Education, Moscow, Russia
| | | |
Collapse
|
19
|
Kher C, Chakole S. Giant Lipoma: A Case Report. Cureus 2024; 16:e53000. [PMID: 38406157 PMCID: PMC10894661 DOI: 10.7759/cureus.53000] [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: 12/07/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024] Open
Abstract
Lipomas are one of the most common, benign, slow-growing tumours composed of adipose (fat) tissue. These soft, rubbery lumps are usually painless and move easily when touched. Lipomas are generally small, ranging from less than an inch to a few inches in diameter. However, when a lipoma grows to a size larger than 10 cm (about 4 in), it is referred to as a giant lipoma. Only about 1% of all lipomas can be called "giant". Though usually they are benign, in the case of a very large lipoma it is essential to rule out the possibility of malignancy before embarking on its surgical treatment. Lipomas can occur anywhere in the body, but they are most commonly found on the neck, shoulders, back, abdomen, arms, or thighs. Here, we present a case of a 42-year-old woman with a giant lipoma over her left scapula.
Collapse
Affiliation(s)
- Chinmay Kher
- Surgery, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, IND
| |
Collapse
|
20
|
Nakanishi Y, Shinkuma S, Mitsui Y, Ogawa K, Hirai T, Asada H, Shobatake C. Ultrasonographic findings in nevus lipomatosus cutaneous superficialis: What differentiates this tumor from other soft tissue tumors? J Dermatol 2024; 51:56-61. [PMID: 37804078 DOI: 10.1111/1346-8138.16998] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/31/2023] [Accepted: 09/27/2023] [Indexed: 10/08/2023]
Abstract
Nevus lipomatosus cutaneous superficialis is a rare, benign hamartoma characterized by mature adipocyte proliferation in the dermis. It is frequently difficult to distinguish clinically from soft tissue tumors, including lipoma, neurofibroma, venous malformation, and angiolipoma. Notably, the classical form, which shows multiple and sometimes enlarged nodules, is difficult to differentiate from liposarcoma based on clinical examination, computed tomography, and magnetic resonance imaging findings. Therefore, to ascertain the utility of ultrasonography in diagnosing nevus lipomatosus cutaneous superficialis, sonographic examinations were performed on eight patients with nevus lipomatosus cutaneous superficialis. All patients had ill-defined hyperechoic masses in the dermis or from the dermis to the subcutis, and the posterior echoes were attenuated in seven patients. Color Doppler sonography revealed no blood flow to the lesions. Ultrasound images were created using the reflections of ultrasound waves at interfaces with different acoustic impedances. Therefore, it is assumed that, in nevus lipomatosus cutaneous superficialis, the ultrasound beam is scattered by ectopic mature adipocytes intermingled with collagen bundles, which are shown as hyperechoic masses. Furthermore, the scattering of the ultrasound beam is thought to reduce tissue penetration, which may attenuate the posterior echo.
Collapse
Affiliation(s)
- Yukiko Nakanishi
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Satoru Shinkuma
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Yasuhiro Mitsui
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Dermatology, Nara Prefecture General Medical Center, Nara, Japan
| | - Kohei Ogawa
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toshiko Hirai
- Department of General Diagnostic Imaging Center, Nara Medical University School of Medicine, Kashihara, Japan
- Department of Radiology, Nara Prefecture Seiwa Medical Center, Sango, Japan
| | - Hideo Asada
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Chinatsu Shobatake
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| |
Collapse
|
21
|
Deacu M, Bosoteanu M, Enciu M, Cozaru GC, Cojocaru O, Baltatescu GI, Nicolau AA, Orasanu CI, Caraban BM, Voda RI. The Predictive Role of the Histopathological Scoring System in Adipose Tumors- Lipoma, Atypical Lipomatous Tumor, and Liposarcoma. Diagnostics (Basel) 2023; 13:3606. [PMID: 38132190 PMCID: PMC10742782 DOI: 10.3390/diagnostics13243606] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Lipomatous tumors are the most frequent soft tissue neoplasms. Sometimes their differential diagnosis is difficult to perform only by microscopic analysis. This study aims to create a histopathological scoring system and highlight the impact of intratumoral microvascular density. This study was conducted over 10 years. We analyzed the main pathogenic pathways (MDM2 and CDK4), as well as the tumor microvascularization (CD31 and CD34) by immunohistochemical tests. We also analyzed the status of the MDM2 gene by CISH. These data, together with the clinical and histopathological information, were statistically analyzed by appropriate tests. We identified 112 eligible cases, with most of the patients being in their sixth decade of life, with a slight predominance of the female sex. We found important associations like tumor location linked to nuclear pleomorphism severity and microvascularization density correlated with atypia severity. Also, we observed that a maximum diameter of a tumor of at least 69 mm is associated with the presence of tumor necrosis. The score designed in this study shows an increased sensitivity and specificity for the diagnosis of lipomas (100%, respectively, 97%), atypical lipomatous tumors (93.8%, respectively, 82.3%), and liposarcomas (100%, respectively, 90.5%). This present study enhances the present data by bringing to attention the histopathological score with a role in differential diagnosis, as well as in the prediction of immunohistochemical and genetic tests. Also, we highlighted the importance of microvascular density, especially in the diagnosis of liposarcomas.
Collapse
Affiliation(s)
- Mariana Deacu
- Clinical Service of Pathology, Department of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania; (M.D.); (M.B.); (M.E.); (O.C.); (G.I.B.); (A.A.N.); (R.I.V.)
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania;
| | - Madalina Bosoteanu
- Clinical Service of Pathology, Department of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania; (M.D.); (M.B.); (M.E.); (O.C.); (G.I.B.); (A.A.N.); (R.I.V.)
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania;
| | - Manuela Enciu
- Clinical Service of Pathology, Department of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania; (M.D.); (M.B.); (M.E.); (O.C.); (G.I.B.); (A.A.N.); (R.I.V.)
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania;
| | - Georgeta Camelia Cozaru
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania;
- Clinical Service of Pathology, Department of Genetics, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Oana Cojocaru
- Clinical Service of Pathology, Department of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania; (M.D.); (M.B.); (M.E.); (O.C.); (G.I.B.); (A.A.N.); (R.I.V.)
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania;
| | - Gabriela Izabela Baltatescu
- Clinical Service of Pathology, Department of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania; (M.D.); (M.B.); (M.E.); (O.C.); (G.I.B.); (A.A.N.); (R.I.V.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania;
| | - Anca Antonela Nicolau
- Clinical Service of Pathology, Department of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania; (M.D.); (M.B.); (M.E.); (O.C.); (G.I.B.); (A.A.N.); (R.I.V.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania;
| | - Cristian Ionut Orasanu
- Clinical Service of Pathology, Department of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania; (M.D.); (M.B.); (M.E.); (O.C.); (G.I.B.); (A.A.N.); (R.I.V.)
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania;
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania;
| | - Bogdan Marian Caraban
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania;
- Clinical Department of Plastic Surgery, Microsurgery—Reconstructive, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Raluca Ioana Voda
- Clinical Service of Pathology, Department of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania; (M.D.); (M.B.); (M.E.); (O.C.); (G.I.B.); (A.A.N.); (R.I.V.)
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania;
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania;
| |
Collapse
|
22
|
Wu KY, Raghunathan A, Spinner RJ. Segmental extraneural lipomatosis of the superficial peroneal nerve: illustrative case. J Neurosurg Case Lessons 2023; 6:CASE23557. [PMID: 38048561 DOI: 10.3171/case23557] [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] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/11/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Adipose lesions of nerve are rare tumors that can cause nerve symptoms from either intrinsic or extrinsic compression. OBSERVATIONS The authors present a case of a patient with a 10-year history of progressive, persistent leg pain and dorsal foot paresthesias/dysesthesias. Imaging revealed several nondistinct nodules of indeterminate significance along the course of the superficial peroneal nerve (SPN). Surgery demonstrated six distinct extraneural lipomas studded on a 10-cm segment of the main SPN and one of its muscular branches in the midleg. The lesions were adherent to the SPN, without an easy dissection plane; therefore, a neurectomy was performed. Histology revealed the nerve was associated with multiple extraneural lipomas with focal evidence of prior trauma. At 4 months postoperatively, the patient's pain had resolved completely, and she was able to resume normal physical activities. LESSONS The current classification of adipose lesions of nerve includes intraneural and extraneural lipomas and lipomatosis of nerve (fibrolipomatous hamartoma). The unique features of the present case include the discrete and segmental nature of the extraneural lipomas adherent to the nerve. Its etiology is unknown, and the histology would be suggestive of either a traumatic or a degenerative process.
Collapse
|
23
|
Ghita BC, Ayyoub S, Mariam T, Allah OA. Septal Lipoma and Cleft Palate: Particular Association, Particular Treatment? Cleft Palate Craniofac J 2023; 60:1655-1658. [PMID: 35945817 DOI: 10.1177/10556656221117730] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Congenital tumors of the oral cavity are infrequent and is dominated by teratogenic tumors. They are rarely associated with cleft palate. Congenital lipoma of the palate in patients with cleft palate remains exceptional. We report a case of congenital septal lipoma with cleft palate (the third case of such association is reported in the literature) and discuss the surgical treatment in light of the evolution of the patient.
Collapse
Affiliation(s)
- Belmaati Cherkaoui Ghita
- Departement of plastic and reconstructive surgery. Mohammed VI hospital university, Oujda, Morocco
| | - Souarji Ayyoub
- Departement of plastic and reconstructive surgery. Mohammed VI hospital university, Oujda, Morocco
| | - Tajir Mariam
- Departement of genetic, Mohammed VI hospital university, Oujda, Morocco
| | - Oufkir Ayat Allah
- Departement of plastic and reconstructive surgery. Mohammed VI hospital university, Oujda, Morocco
| |
Collapse
|
24
|
Weng X, Jiang L, Zhou M. Massive anterior mediastinal lipoma causing cardiac arrest in a middle-aged male: a case report and literature review. Future Cardiol 2023; 19:747-752. [PMID: 38112188 DOI: 10.2217/fca-2023-0107] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/25/2023] [Indexed: 12/21/2023] Open
Abstract
Lipoma is a common benign soft tissue tumor, but its size and location can lead to serious issues. We report a case of a 48 year-old male patient who experienced sudden cardiac arrest outside the hospital. After resuscitation and examination, we determined that this was due to a massive mediastinal lipoma compressing the lungs, leading to respiratory failure and pulmonary encephalopathy, ultimately resulting in cardiac arrest. This case serves as a reminder to promptly identify and manage chest lipomas to avoid compression and functional impairment of the respiratory system. Early evaluation and treatment of massive lipomas are crucial for preventing complications.
Collapse
Affiliation(s)
- Xulin Weng
- Department of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
| | - Le Jiang
- Department of Emergency Intensive Care Unit, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
| | - Menglu Zhou
- Department of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
| |
Collapse
|
25
|
Malik F, Cooper K. Anisometric Cell/Dysplastic Lipomas in a Retinoblastoma Survivor: Report of a Case with Review of the Literature. Int J Surg Pathol 2023; 31:1632-1637. [PMID: 36898668 PMCID: PMC10616988 DOI: 10.1177/10668969231157779] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 03/12/2023]
Abstract
Different authors have recently described a subtype of lipoma characterized by variation of adipocyte size, single cell fat necrosis, and a subset with minimal to mild nuclear atypia, and termed these as anisometric cell/dysplastic lipoma (AC/DL). These lipomas follow a benign course and rarely recur. In 3 examples, AC/DL has occurred in patients with childhood retinoblastoma (RB). We report another such example where multiple AC/DL occurred in the neck and back of a 30-year-old male who had germline RB1 gene deletion and bilateral RB in infancy. On excision, all tumors histologically showed similar morphology of adipocyte anisometry, focal single cell necrosis with surrounding binucleated or multinucleated histiocytes, hyperchromatic and minimally atypical lipocyte nuclei, vacuolated Lockhern change, rare foci of fibromyxoid change, occasional mononuclear cell clusters around capillaries, and loss of RB1 immunostaining. Unequivocal atypical cells, lipoblasts, floret-nucleated or multinucleated giant cells were absent. Molecular analysis of tumor cells showed monoallelic RB1 gene loss without amplification of MDM2 and CDK4 genes. Short-term follow up did not show tumor recurrence. AC/DLs in RB survivors are characterized by multiplicity, unifying histology, and benign course. Their biology appears distinct from ordinary lipomas, spindle cell lipomas, and atypical lipomatous tumors.
Collapse
Affiliation(s)
- Faizan Malik
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Kumarasen Cooper
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
26
|
Sauchelli-Faas G, Barragán-Acea A, Álvarez-Argüelles H, Montoto-López J, Jiménez-Rivera JJ, Martínez-Sanz R. Pulmonary valve spindle-cell lipoma: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231216544. [PMID: 38033915 PMCID: PMC10687942 DOI: 10.1177/2050313x231216544] [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: 05/09/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
Primary cardiac tumours are rare and most of them are benign. Myxomas, fibroelastomas and lipomas are common in adults. Primary valvular cardiac tumours are even more rare and affect all four valves in a similar proportion. Valvular lipomas are very rare. In the pulmonary valve there is only one described. Lipomas can be spindle-cell varieties. But of these, there is only one described in a valve, and it is placed in the aortic valve. Pulmonary valve lipomas can produce obstruction to the right ventricular outflow tract as well as pulmonary valve regurgitation, or pulmonary embolism. Symptoms may be dyspnoea, angina, arrhythmias, or syncope. We aim to illustrate with this case report how we came into this very rare pathology, so we present a 54-year-old woman with a giant spindle-cell lipoma located in the anterior pulmonary leaflet and severe dyspnoea. Total resection of the tumour was performed and restoration of valve function was obtained by means of bicuspidization of the remaining pulmonary leaflets. She had a good recovery after surgery and no complication during the postoperative evolution, being discharged from hospital after 7 days from surgery, with echocardiographic control showing good biventricular function, absence of tumour or obstruction, and minimal pulmonary valve regurgitation.
Collapse
Affiliation(s)
- Guadalupe Sauchelli-Faas
- Cardiovascular Surgery Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Antonio Barragán-Acea
- Echocardiography Unit, Cardiology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Hugo Álvarez-Argüelles
- Pathology Department, Hospital Universitario de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Javier Montoto-López
- Cardiovascular Surgery Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | | | - Rafael Martínez-Sanz
- Cardiovascular Surgery Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| |
Collapse
|
27
|
McDonald MG, Cunning DM. Large Sublingual Lipoma: A Case Report. Ear Nose Throat J 2023:1455613231212058. [PMID: 37970836 DOI: 10.1177/01455613231212058] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Lipomas are benign soft tissue tumors frequently observed throughout the body. Lipomas rarely cause health concerns; however, when symptomatic, it is often related to their location and size. A 65-year-old male patient presented with a non-tender, enlarging mass in the anterior floor of the mouth, which was otherwise asymptomatic. Computed tomography evaluation revealed an unusually large hypolucent mass, posterior to the inner table of the right anterior mandible. Surgical excision was uncomplicated. Upon follow-up, the right anterior floor of the mouth wound healed without compromise of the lingual or hypoglossal nerves or Wharton's duct. This discussion highlights the infrequent occurrence of lipomas in the oral cavity, particularly in the floor of the mouth, including patient presentation, preoperative evaluation, and surgical planning.
Collapse
Affiliation(s)
- Mason G McDonald
- Arizona Coast Ear, Nose, & Throat, LTD, Lake Havasu City, AZ, USA
| | - Devin M Cunning
- Arizona Coast Ear, Nose, & Throat, LTD, Lake Havasu City, AZ, USA
| |
Collapse
|
28
|
Lee SW, Youn SH, Park JK. Multiple Hepatic Lipoma: A Case Report of Captive Hill Mynah with Iron Storage Disease. Vet Sci 2023; 10:626. [PMID: 37888578 PMCID: PMC10611273 DOI: 10.3390/vetsci10100626] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/02/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
The present case describes multiple hepatic lipomas in a common hill mynah (Gracula religiosa). A 21-year-old female captive common hill mynah died without any notable clinical symptoms. An autopsy and histopathological examinations were conducted to determine the exact cause of death. On gross observation, the liver demonstrated a yellowish white surface color and multiple nodules indicating neoplastic lesions. Histopathological assessment found that the nodules purely comprised mature adipocytes. Furthermore, the liver exhibited an excessive accumulation of iron in hepatocytes and Kupffer cells and the infiltration of chronic inflammatory cells, suggesting iron storage disease (ISD). Based on the results, the present case was diagnosed as multiple hepatic lipomas with ISD. To the authors' best knowledge, multiple hepatic lipomas accompanying ISD lesions have not been reported previously. Hence, the present case is the first case report of hepatic multiple lipomas with ISD in veterinary medicine.
Collapse
Affiliation(s)
- Seoungw-Woo Lee
- Department of Veterinary Pathology, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Republic of Korea; (S.-W.L.); (S.-H.Y.)
- Division of Biotechnology, DGIST, Daegu 42988, Republic of Korea
| | - Soong-Hee Youn
- Department of Veterinary Pathology, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Republic of Korea; (S.-W.L.); (S.-H.Y.)
- Samsung Everland Zoological Garden, Yong-in 17023, Republic of Korea
| | - Jin-Kyu Park
- Department of Veterinary Pathology, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Republic of Korea; (S.-W.L.); (S.-H.Y.)
| |
Collapse
|
29
|
Frąk W, Gocel O, Sieniawski K, Sieniawska J, Włodarczyk M, Dziki L. Multiple symmetrical lipomatosis: A literature review and case report of a patient with Madelung's disease. Pol Przegl Chir 2023; 96:130-134. [PMID: 38348992 DOI: 10.5604/01.3001.0053.5997] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
<b><br>Introduction:</b> Madelung's disease is a rare condition characterised by the symmetric growth of fatty tumours (lipomas) around the neck, shoulders, upper arms and trunk.</br> <b><br>Case report:</b> We present a description of a male patient with extensive adipose tissue overgrowth around the neck. Once the possibility of malignancy was excluded, the patient's history and clinical and radiological findings led to the diagnosis of Madelung's disease. A two-stage surgery was planned and the patient underwent lipectomy of the lipomas around the neck.</br> <b><br>Conclusions:</b> This article analyses the clinical data with Madelung's disease; discusses its aetiology, clinical manifestations, diagnosis and treatment methods; and provides help with clinical diagnosis and treatment.</br>.
Collapse
Affiliation(s)
- Weronika Frąk
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
| | - Oliwia Gocel
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
| | - Karol Sieniawski
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
| | - Joanna Sieniawska
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, Poland
| | - Marcin Włodarczyk
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
| | - Lukasz Dziki
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
| |
Collapse
|
30
|
Alsaleh N. Chondroid lipoma that may mimic malignancy: A case report. Clin Case Rep 2023; 11:e8059. [PMID: 37867545 PMCID: PMC10587652 DOI: 10.1002/ccr3.8059] [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: 06/10/2023] [Revised: 08/08/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023] Open
Abstract
Chondroid lipoma is rare benign lipomatous lesion could mimic other soft tissue tumor.
Collapse
Affiliation(s)
- Nuha Alsaleh
- Department of SurgeryCollege of Medicine, King Saud UniversityRiyadhSaudi Arabia
| |
Collapse
|
31
|
Zhao X, Prather KY, Tavakol SA, Gernsback JE. Bilateral cerebellopontine angle lipomas in an infant with encephalocele: illustrative case. J Neurosurg Case Lessons 2023; 6:CASE23315. [PMID: 37773761 PMCID: PMC10555580 DOI: 10.3171/case23315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/15/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Bilateral cerebellopontine angle (CPA) lipomas are extremely rare. Herein the authors present a case of bilateral CPA lipomas in an infant along with a literature review of bilateral CPA lipomas. OBSERVATIONS A newborn girl was incidentally found to have bilateral CPA lipomas during the workup for an occipital encephalocele. The encephalocele was repaired primarily on day 2 after birth. The patient demonstrated no symptoms associated with the bilateral CPA lipomas. Eight cases of bilateral CPA lipomas were identified in the literature review and are summarized. Conservative management is the consensus strategy, given minimum growth of the tumor and the high risk of surgical intervention. LESSONS This is the first reported case of bilateral CPA lipomas in an infant as well as the first with a coexisting intracranial malformation. Intracranial lipomas share an extremely low growth rate and typically do not cause severe symptoms. The management of asymptomatic or mildly symptomatic bilateral CPA lipomas is usually conservative.
Collapse
|
32
|
Ashrafian H. Differential diagnosis of the periorbital lump on "Young Woman with Unicorn" (1505-1506) by Raphael (1483-1520). Eur J Ophthalmol 2023; 33:NP144-NP145. [PMID: 37264587 DOI: 10.1177/11206721231179998] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Hutan Ashrafian
- Institute of Global Health Innovation, The Department of Surgery and Cancer, Imperial College London, London, UK
| |
Collapse
|
33
|
Zimmer V. Cold snare unmasking as a one-stop-shop procedure for an unequivocal (tissue) diagnosis of gastric lipomas lacking characteristic findings on standard endoscopy. Porto Biomed J 2023; 8:e229. [PMID: 37846305 PMCID: PMC10575347 DOI: 10.1097/j.pbj.0000000000000229] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 07/09/2023] [Accepted: 07/10/2023] [Indexed: 10/18/2023] Open
Affiliation(s)
- Vincent Zimmer
- Marienhausklinik St Josef Kohlhof, Department of Medicine, Neunkirchen, Germany
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| |
Collapse
|
34
|
Lee BH, Lee YM, Park SO, Chang LS, Kim YH. A Case Report of Madelung's Disease. Arch Plast Surg 2023; 50:463-467. [PMID: 37808325 PMCID: PMC10556315 DOI: 10.1055/a-2122-6121] [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: 01/26/2023] [Accepted: 06/30/2023] [Indexed: 10/10/2023] Open
Abstract
Madelung's disease (MD) is a rare disease characterized by diffuse, nonencapsulated, multiple fat masses in different areas of the body. In this case report, we present a case of MD in Asia and its management. A 66-year-old man with a history of hypertension presented with massive growth of soft tissue around the neck, breasts, upper back, and lower abdomen. Preoperative magnetic resonance imaging revealed remarkably hypertrophic fat tissue around the neck and anterior chest was wall, which consistent with the diagnosis of MD. Multiple linear incisions were made on the neck and 763, 186, 635 g of posterior, right, and left fat tissues were excised, respectively. A single wide, transverse incision was done to excise 1,072 g of fat from the upper back. Masses of both breasts were excised, preserving the inferior pedicle, weighing 1,086 (right) and 1,164 g (left). The recovery was optimal and the patient was discharged without complications. In this case, we excised the adipose masses as much as possible and improved contour and symmetry. However, the fat infiltrations in the patient were diffusely distributed, making total fat excision difficult. This rare case report may help in managing patients with MD.
Collapse
Affiliation(s)
- Bo Hyun Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Young Mann Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Seong Oh Park
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Lan Sook Chang
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Youn Hawn Kim
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| |
Collapse
|
35
|
Kang DH, Lew BL, Kwon SH. Do the Clinical Characteristics of Lipomas Influence the Incision Length During Minimal Incision Extraction? J Cutan Med Surg 2023; 27:461-465. [PMID: 37470263 DOI: 10.1177/12034754231188439] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Minimal incision extraction technique is widely accepted for the surgical removal of lipomas, but no consensus for the incision length has been made yet. OBJECTIVE To investigate the clinical characteristics of lipomas which affect the minimal incision length during the minimal incision extraction. METHODS We retrospectively analyzed 50 patients who underwent minimal incision extraction for 55 medium-sized (3-5 cm) or large lipomas (> 5 cm) between March 2020 and May 2022. If the mass is not fully dissected, or adequate visual field for hemostasis was not provided through the initial one-third incision, the incision was extended to the minimal extent. RESULTS There were 33 males and 17 females with a mean age of 53.5 ± 12.7 years. There was no statistical difference in the minimal % incision length, defined as [(incision length) / (tumor diameter)] x 100, between the medium-sized (n = 31) and large lipomas (n = 24). Lipomas of the long incision group (minimal % incision length ≥66.7%, n = 21) had a higher frequency of head and neck location than lipomas of the short incision group (minimal % incision length <66.7%, n = 34) (odds ratio = 14.5, P < .05). However, no association was found between the tumor diameter or depth and the minimal % incision length. The occurrence of postoperative complications was not associated also (P = .296). CONCLUSION The minimal % incision length for lipoma removal does not show statistical difference between medium-sized and large lipomas, and is affected by its anatomical location, but not by tumor diameter or depth.
Collapse
Affiliation(s)
- Da-Hyun Kang
- Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Bark-Lynn Lew
- Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Soon-Hyo Kwon
- Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, South Korea
| |
Collapse
|
36
|
Facanali CBG, Junior MRF, Junior CWS, Safatle-Ribeiro AV. A Sessile Serrated Lesion Overlying a Submucosal Colonic Lipoma: An Endoscopic Rarity Identified Using Artificial Intelligence. Am J Case Rep 2023; 24:e940499. [PMID: 37563824 PMCID: PMC10426383 DOI: 10.12659/ajcr.940499] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/07/2023] [Accepted: 06/28/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Lipomas are benign, slow-growing mesenchymal neoplasms, more prevalent in females, with a peak incidence in the fifth to sixth decades of life. Generally, due to their low clinical relevance, they receive little attention in the literature. Uncommon in the colon, lipomas are most often identified as an incidentaloma in asymptomatic patients during colonoscopy, and overlapping with epithelial lesions is a rare finding. Serrated polyps used to be considered as hyperplastic polyps without any malignant potential; however, currently, the serrated pathway accounts for one-third of all colorectal cancers. Here, we describe a rare case of a sessile serrated lesion on a submucosal lipoma identified with the aid of artificial intelligence. CASE REPORT A 60-year-old woman underwent screening colonoscopy for colorectal cancer after a positive fecal immunochemical test. A high-definition colonoscopy with the aid of artificial intelligence (Fujifilm CAD EYE) was performed. A flat lesion at the right colon was diagnosed with white-light endoscopy simultaneously identified by artificial intelligence, which classified the lesion as hyperplastic. Resection was performed through mucosectomy, and a sign of naked fat was observed at the base of the resected lesion. Histopathology of the specimen characterized a submucosal lipoma associated with a sessile serrated lesion. CONCLUSIONS We describe a rare case of sessile serrated lesion on a colon lipoma, identified with the aid of artificial intelligence. We carried out a brief literature review and discussed the main findings and aspects related to the literature.
Collapse
|
37
|
Marzyńska D, Żaba R, Lacka K. Lipomas: genetic basis of common skin lesions and their occurrence in rare diseases. Postepy Dermatol Alergol 2023; 40:481-486. [PMID: 37692275 PMCID: PMC10485760 DOI: 10.5114/ada.2023.129529] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 02/17/2023] [Indexed: 09/12/2023] Open
Abstract
Lipomas are usually sporadic, asymptomatic lesions, and their clinical and histologic presentation does not pose diagnostic difficulties. In ambiguous cases, however, knowledge of genetics is necessary. HMGA2 expression in adipose cells enables the differentiation of normal adipose tissue from lipoma and liposarcoma. Moreover, lipomas can be associated with genetic diseases, such as multiple endocrine neoplasia type 1, neurofibromatosis type 1, Wilson's disease, or mitochondrial diseases. Lipomas can run in families (familial multiple lipomatosis) or be a part of genetic syndromes such as PTEN hamartoma tumor syndrome, Proteus syndrome, and Pai syndrome. This study aims to present the genetic basis of lipomas and diseases in which these lesions occur in the clinical picture.
Collapse
Affiliation(s)
- Dorota Marzyńska
- Student’s Scientific Circle at the Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Ryszard Żaba
- Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Lacka
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
38
|
Sakamoto A, Noguchi T, Matsuda S. Anatomic variations in retaining ligaments during minimally invasive resection of subcutaneous lipomas. GMS Interdiscip Plast Reconstr Surg DGPW 2023; 12:Doc02. [PMID: 37577726 PMCID: PMC10413276 DOI: 10.3205/iprs000172] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Objective Lipomas are common, benign tumors usually located in the subcutaneous tissue. The "one-inch method" is a minimally invasive technique for resecting large subcutaneous lipomas through a one-inch incision after blunt dissection of the lipoma from its peripheral retaining ligaments. The limitations of this method are currently unclear. Materials and methods We assessed twenty-five patients with large lipomas, defined as a tumor diameter greater than 5 cm. The location of the lipoma was at the shoulder in fifteen patients, the extremity in six patients, and the torso in four patients. Results The mean operative time for all lesions was 28.3 minutes, with a mean time of 25.9 minutes for lipomas at the shoulder, 21.8 minutes for the extremities, and 47.0 minutes for the torso. We classified patients into three groups according to operative time: the short group (10-29 min), middle group (30-49 min), and long group (50-70 min). For lipomas of the shoulder, there were eleven patients (73%) in the short group, three patients (20%) in the middle group, and one patient (7%) in the long group. For lipomas of the extremity, the groups contained five patients (83%), one patient (17%), and no patients (0%), respectively. For lipomas of the torso, the groups contained one patient (25%), no patients (0%), and three patients (75%), respectively. Conclusions Lipomas of the torso require a longer operative time than those of the shoulder or extremity; this difference could be due to the number of retaining ligaments present, which is reportedly higher in the back than in the anterior or side body. Lipomas of the back are less amenable to the one-inch method, and posterior shoulder lipomas may take more time than those at other parts of the shoulder or at the extremities.
Collapse
Affiliation(s)
- Akio Sakamoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Japan
| | - Takashi Noguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Japan
| |
Collapse
|
39
|
Pierotti L, Pardi E, Dinoi E, Piaggi P, Borsari S, Della Valentina S, Sardella C, Michelucci A, Caligo MA, Bogazzi F, Marcocci C, Cetani F. Cutaneous lesions and other non-endocrine manifestations of Multiple Endocrine Neoplasia type 1 syndrome. Front Endocrinol (Lausanne) 2023; 14:1191040. [PMID: 37484956 PMCID: PMC10360178 DOI: 10.3389/fendo.2023.1191040] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
Background Multiple Endocrine Neoplasia type 1 is a rare genetic syndrome mainly caused by mutations of MEN1 gene and characterized by a combination of several endocrine and non-endocrine manifestations. The objective of this study was to describe cutaneous lesions and other non-endocrine manifestations of MEN1 in a cohort of patients with familial (F) and sporadic (S) MEN1, compare the prevalence of these manifestations between the two cohorts, and investigate the correlation with MEN1 mutation status. Methods We collected phenotypic and genotypic data of 185 patients with F-MEN1 and S-MEN1 followed from 1997 to 2022. The associations between F-MEN1 and S-MEN1 or MEN1 mutation-positive and mutation-negative patients and non-endocrine manifestations were determined using chi-square or Fisher's exact tests or multivariate exact logistic regression analyses. Results The prevalence of angiofibromas was significantly higher in F-MEN1 than in S-MEN1 in both the whole (p < 0.001) and index case (p = 0.003) cohorts. The prevalence of lipomas was also significantly higher in F-MEN1 than in S-MEN1 (p = 0.009) and in MEN1 mutation-positive than in MEN1 mutation-negative (p = 0.01) index cases. In the whole cohort, the prevalence of lipomas was significantly higher in MEN1 mutation-positive compared to MEN1 mutation-negative patients (OR = 2.7, p = 0.02) and in F-MEN1 than in S-MEN1 (p = 0.03), only after adjustment for age. No significant differences were observed for the other non-endocrine manifestations between the two cohorts. Hibernoma and collagenoma were each present in one patient (0.5%) and meningioma and neuroblastoma in 2.7% and 0.5%, respectively. Gastric leiomyoma was present in 1.1% of the patients and uterine leiomyoma in 14% of women. Thyroid cancer, breast cancer, lung cancer, basal cell carcinoma, melanoma, and colorectal cancer were present in 4.9%, 2.7%, 1.6%, 1.6%, 2.2%, and 0.5% of the whole series, respectively. Conclusions We found a significantly higher prevalence of angiofibromas and lipomas in F-MEN1 compared with S-MEN1 and in MEN1 mutation-positive compared to MEN1 mutation-negative patients. In patients with one major endocrine manifestation of MEN1 , the presence of cutaneous lesions might suggest the diagnosis of MEN1 and a possible indication for genetic screening.
Collapse
Affiliation(s)
- Laura Pierotti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elena Pardi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Dinoi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paolo Piaggi
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Simona Borsari
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Chiara Sardella
- Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - Angela Michelucci
- Laboratory of Molecular Genetics, University Hospital of Pisa, Pisa, Italy
| | | | - Fausto Bogazzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - Filomena Cetani
- Unit of Endocrinology, University Hospital of Pisa, Pisa, Italy
| |
Collapse
|
40
|
AlSuwaydani SA, Alfehaid M, Alshamikh AS, Almaiman WA. Spindle Cell Lipoma of the Shoulder: A Case Report. Cureus 2023; 15:e41961. [PMID: 37588301 PMCID: PMC10427026 DOI: 10.7759/cureus.41961] [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: 07/16/2023] [Indexed: 08/18/2023] Open
Abstract
Spindle cell lipoma (SCL), an uncommon variant of benign lipomatous tumor, occurs predominantly in the posterior neck or the shoulders. Patients usually present a well-circumscribed and non-aggressive subcutaneous mass. Histopathologically, the mass comprises fat, CD34-positive spindle cells, and ropey collagen on a myxoid matrix. We report a case of left-shoulder SCL in a 45-year-old Saudi male nonsmoker with no known trauma. A soft tissue mass was seen on MRI near the posterior shoulder. It was a 4.5 cm x 3 cm subcutaneous rounded lump with heterogeneous signal intensity. There is no aggressive or invasive feature, and there is no significant fatty content. The mass was surgically excised with no complication. Histological examination revealed a neoplastic lesion constituted of mature adipocyte lobules and proliferation of loosely held bland spindle-shaped cells against a myxoid background. These cells exhibit neither increased mitoses nor nuclear pleomorphism. There were intervening rope collagen bundles. Lipoblasts and atypical stromal cells are also unidentified. At the periphery, a thin capsule was identified. There is no evidence of malignancy. To the best of our knowledge, this is the first reported case in Unaizah, Al Qassim. The correct diagnosis of SCL without a lipogenic component may be made by paying close attention to the clinical setting, histologic characteristics, immunohistochemical profile, and chromosomal abnormalities.
Collapse
Affiliation(s)
- Saleh A AlSuwaydani
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Mohammed Alfehaid
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Abdulaziz S Alshamikh
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Waleed A Almaiman
- Department of Emergency Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| |
Collapse
|
41
|
Santoso S, Rizqiawan A, Mulyawan I, Wihandono A, Amir MS. Lipoma in Parotid Gland: A Rare Case Report. Eur J Dent 2023; 17:929-934. [PMID: 36599447 PMCID: PMC10569883 DOI: 10.1055/s-0042-1758795] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Lipoma is a benign, rare, mesenchymal tumor found in the head and neck region, especially in the parotid gland. It thus requires a careful and precise examination to establish a diagnosis. A surgical procedure of the parotid gland is challenging due to the associated risk factor of facial nerve injury. We report a rare case of head and neck region lipoma between the superficial and deep lobe of the parotid gland. A 44-year-old female patient was presented with the chief complaint of a painless lump on the left front ear to the left cheek for about 1 year. There were no complaints of tooth pain before the lump appeared, and there were no lumps in other regions. A fine-needle aspiration biopsy, ultrasonography, and magnetic resonance imaging were all performed to establish the preoperative diagnosis and to plan the correct surgical approach. Lipoma was the initial clinical diagnosis, and a surgical excision with superficial parotidectomy and facialis nerve preservation was performed. Follow-up examinations were conducted to assess any facial nerve injury complications. Conclusion Lipoma rarely grows in the parotid gland. Careful diagnosis should be performed to establish a precise surgery for parotid dissection and facial nerve preservation.
Collapse
Affiliation(s)
- Sergio Santoso
- Oral and Maxillofacial Surgery Specialist Program, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| | - Andra Rizqiawan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| | - Indra Mulyawan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| | - Asdi Wihandono
- Oncology Division, Department of Surgery, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Muhammad Subhan Amir
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| |
Collapse
|
42
|
Tandon A, Srivastava A, Jaiswal R, Gaur A. Oral fibro lipoma: A rare clinicopathological entity. J Oral Maxillofac Pathol 2023; 27:537-539. [PMID: 38033946 PMCID: PMC10683883 DOI: 10.4103/jomfp.jomfp_105_23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/19/2023] [Accepted: 06/20/2023] [Indexed: 12/02/2023] Open
Abstract
Fibrolipoma, a subtype of lipoma, is a painless, well-circumscribed, slow-growing, submucosal benign adipocyte tumour. It is uncommon in the oral cavity and oropharyngeal region. It accounts for 1.6% of all facial lipomas. Fibrolipomas mostly affect the buccal mucosa and buccal vestibule and cause functional and cosmetic disabilities. The diagnosis and differentiation of fibrolipoma with clinically similar lesions such as fibroma and pleomorphic adenoma are very essential for a correct treatment plan and complete follow-up. Here, we present fibrolipoma, a very rare subtype of lipoma involving the buccal mucosa of the left premolar region in a 44-year-old male patient.
Collapse
Affiliation(s)
- Aanchal Tandon
- Department of Oral Pathology and Microbiology, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Abhinav Srivastava
- Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rohit Jaiswal
- Department of Oral Pathology and Microbiology, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Amit Gaur
- Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| |
Collapse
|
43
|
Ashika BK, Bagchi A, Chawla R, Kumar N, Sowmya K, Shetty RR. Intraoral Lipoma: A Case Report. J Pharm Bioallied Sci 2023; 15:S1338-S1340. [PMID: 37693971 PMCID: PMC10485496 DOI: 10.4103/jpbs.jpbs_143_23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 09/12/2023] Open
Abstract
The soft tissue tumor lipoma is quite frequent. Although it is the most mesenchymal tumor of the trunk and proximal regions of the extremities, it is quite uncommon to find it on the oral mucosa, accounting for just 1% to 5% of benign oral tumors. There is no specific location that is more prone to lipoma development in the mouth. Some frequent sites are the tongue, buccal mucosa, and the mouth's floor. A Yellowish mass with no symptoms is the normal clinical appearance. In most cases, the overlaying epithelium is unharmed, and superficial blood vessels may be seen passing through and around the tumor. The differential diagnosis might also include granular cell tumors, neurofibroma, traumatic fibroma, and diseases of the salivary glands (mucocele and mixed tumor). Herein a detailed case of a 28-year-old woman with a right-sided lower-lip oral lipoma is presented in this paper.
Collapse
Affiliation(s)
- BK Ashika
- Department of Prosthodontics, Crown and Bridge and Implantology, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
| | - Anandamoy Bagchi
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Riddhi Chawla
- School of Dentistry, Akfa University, Tashkent, Uzbekistan
| | - Nithin Kumar
- School of Dentistry, Akfa University, Tashkent, Uzbekistan
| | - Kona Sowmya
- Pedodontics and Preventive Dentistry, Machilipatnam, Andhra Pradesh, India
| | - Rahul R. Shetty
- Department of Oral Medicine and Radiology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Maharashtra, India
| |
Collapse
|
44
|
He X, Ge X, Chen J, Tang X. Cerebellopontine Angle Lipoma with Contralateral Sudden Deafness: A Case Report and Review of Literature. Curr Med Imaging 2023:CMIR-EPUB-132586. [PMID: 37340741 DOI: 10.2174/1573405620666230620115358] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/18/2023] [Accepted: 05/25/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Cerebellopontine angle lipoma is a rare tumor that composes less than 1% of all CPA tumors. There has been no recorded case of unilateral CPA/IAC lipoma with sudden contralateral deafness yet. CASE PRESENTATION We report a 52-year-old man diagnosed with right cerebellopontine angle lipoma and combined left total deafness. Pure-tone audiometry revealed total sensorineural deafness in his left ear and moderate sensorineural deafness in the right ear. The patient was treated with glucocorticoids, batroxobin, and other symptomatic treatments. There was no substantial improvement in hearing after 14 days' treatment. DISCUSSION We chose conservative treatment for him. It is advised to wear hearing aids in the right ear and to undergo regular imaging monitoring. CONCLUSION Treatment options for such patients should be chosen by taking into account the degree of bilateral hearing loss, the size and location of the tumor, the possibility of preserving hearing during surgery, the functional level of the patient's facial nerve, and other factors.
Collapse
Affiliation(s)
- Xiao He
- Department of Otolaryngology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Xinting Ge
- Department of Otolaryngology, First Clinical Medical College of Zhejiang Chinese Medical University
| | - Jingjing Chen
- Department of Otolaryngology, The First Affiliated Hospital of Zhejiang Chinese Medicine University
| | - Xuxia Tang
- Department of Otolaryngology, The First Affiliated Hospital of Zhejiang Chinese Medicine University
| |
Collapse
|
45
|
Butt E, Zamora E, Shabot JM. An Unusual Cause of Intractable Hiccups. ACG Case Rep J 2023; 10:e01073. [PMID: 37312753 PMCID: PMC10259643 DOI: 10.14309/crj.0000000000001073] [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] [Received: 01/16/2023] [Accepted: 05/11/2023] [Indexed: 06/15/2023] Open
Abstract
Hiccups are a minor nuisance for most people and usually resolve within minutes. However, for some, they can persist for years and result in severe symptoms and even death. This case report describes a patient found to have a mediastinal lipoma resulting in intractable hiccups. The discussion highlights the pathophysiology, etiologies, and treatments of hiccups.
Collapse
Affiliation(s)
- Edward Butt
- Department of Internal Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX
| | - Ernesto Zamora
- Department of Gastroenterology and Hepatology, The University of Texas Medical Branch at Galveston, Galveston, TX
| | - J. Marc Shabot
- Department of Gastroenterology and Hepatology, The University of Texas Medical Branch at Galveston, Galveston, TX
| |
Collapse
|
46
|
Furuta A, Omoto S, Inoue T, Yanai M, Iwabe H, Takihara H, Ishibashi K, Tanaka H, Matsuura K, Ogata S, Yokomura A, Hoshikawa M, Kono M, Koriyama T, Tazawa T, Tsuyuguchi E, Yamasaki Y, Esumi S, Tsuruta Y, Shishimoto T, Yamamoto M, Ono W. Successful endoscopic submucosal dissection of colorectal lipoma with an overlying adenoma. JGH Open 2023; 7:456-457. [PMID: 37359118 PMCID: PMC10290265 DOI: 10.1002/jgh3.12901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/07/2023] [Accepted: 03/26/2023] [Indexed: 06/28/2023]
Abstract
We report the case of a 65-year-old woman whose colonoscopy revealed a soft submucosal tumor approximately 7 cm in diameter in the ascending colon with an overlying flat lesion. The tumor was diagnosed as a lipoma with an overlying adenoma. Endoscopic submucosal dissection (ESD) was performed. Pathological examination revealed that the epithelium was a low-grade tubulovillous adenoma, while the submucosal yellow tumor was a lipoma. ESD appears to be a safe and effective treatment for colorectal lipomas overlying lipomas with colorectal adenomas.
Collapse
Affiliation(s)
- Akito Furuta
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Shunsuke Omoto
- Department of GastroenterologyKindai University Faculty of MedicineOsaka‐sayamaJapan
| | - Taro Inoue
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Mitsuru Yanai
- Department of PathologySapporo Tokushukai HospitalSapporoJapan
| | - Hideo Iwabe
- Department of internal medicineKamagaya General HospitalKamagayaJapan
| | | | - Kohei Ishibashi
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Hironori Tanaka
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Ko Matsuura
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Shunsuke Ogata
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Akitaka Yokomura
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Masato Hoshikawa
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Michihito Kono
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Takasi Koriyama
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Tomohiko Tazawa
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Eri Tsuyuguchi
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Yasuo Yamasaki
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Shun Esumi
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Yoshimasa Tsuruta
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | | | - Masaki Yamamoto
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| | - Wataru Ono
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
| |
Collapse
|
47
|
Aydin S, Elgamal M, Aydin Y. Successful Resection of Gastric Subepithelial Lipoma Using the Bite-on-Bite Approach: Reviving Old Techniques in a Peripheral Hospital. Cureus 2023; 15:e40151. [PMID: 37425504 PMCID: PMC10329538 DOI: 10.7759/cureus.40151] [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: 06/08/2023] [Indexed: 07/11/2023] Open
Abstract
Subepithelial lesions (SELs) are common findings in the gastrointestinal (GI) tract. They are often benign and asymptomatic but can cause symptoms in some cases. The approach to endoscopic management of these lesions depends on various factors, including associated symptoms, location, available equipment, and operator expertise. In this case report, we present a 50-year-old male with long-standing dyspepsia who was found to have a submucosal lesion in the stomach. The lesion was successfully treated using the bite-on-bite method with cold biopsy forceps. This report aims to discuss gastric subepithelial lesions and current management options, and highlight an old technique for endoscopists in the era of advanced endoscopy.
Collapse
Affiliation(s)
| | | | - Yucel Aydin
- Department of Medicine, St. Mary's Hospital, Waterbury, USA
| |
Collapse
|
48
|
Cheruvu VPR, Khan MM, Arora M, Chaudary V. Nasopalpebral Lipoma sine Coloboma Syndrome-First Case Report. Indian J Plast Surg 2023; 56:276-279. [PMID: 37435343 PMCID: PMC10332910 DOI: 10.1055/s-0043-1768796] [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] [Indexed: 07/13/2023] Open
Abstract
The nasopalpebral lipoma-coloboma syndrome was described for the first time in 1982. It is an autosomal dominant syndrome with complete penetrance and is characterized by features like congenital symmetric upper eyelid and nasopalpebral lipomas, bilateral symmetric upper and lower eyelid colobomas, broad forehead, widow's peak, abnormal eyebrow pattern, telecanthus, broad nasal bridge, maxillary hypoplasia, and ophthalmological abnormalities. We report a case of a milder variant of the nasopalpebral lipoma-coloboma syndrome that we have termed "nasopalpebral lipoma sine coloboma syndrome." Such a milder variant is not reported hitherto in the literature. We also describe the surgical correction of the deformity in a case that presented in adulthood, with a satisfactory and pleasing aesthetic outcome.
Collapse
Affiliation(s)
- Ved Prakash Rao Cheruvu
- Department of Burns and Plastic Surgery, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India
| | - Manal M. Khan
- Department of Burns and Plastic Surgery, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India
| | - Madhuri Arora
- Department of Burns and Plastic Surgery, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India
| | - Vikas Chaudary
- Department of Burns and Plastic Surgery, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India
| |
Collapse
|
49
|
Kumar KK, Toland A, Fischbein N, Morrell M, Heit JJ, Born DE, Steinberg GK. Vascular anomaly, lipoma, and polymicrogyria associated with schizencephaly: developmental and diagnostic insights. Illustrative case. J Neurosurg Case Lessons 2023; 5:CASE2388. [PMID: 37218736 PMCID: PMC10550650 DOI: 10.3171/case2388] [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] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/24/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Schizencephaly is an uncommon central nervous system malformation. Intracranial lipomas are also rare, accounting for approximately 0.1% of brain "tumors." They are believed to be derived from a persistent meninx primitiva, a neural crest-derived mesenchyme that develops into the dura and leptomeninges. OBSERVATIONS The authors present a case of heterotopic adipose tissue and a nonshunting arterial vascular malformation arising within a schizencephalic cleft in a 22-year-old male. Imaging showed right frontal gray matter abnormality and an associated suspected arteriovenous malformation with evidence of hemorrhage. Brain magnetic resonance imaging revealed right frontal polymicrogyria lining an open-lip schizencephaly, periventricular heterotopic gray matter, fat within the schizencephalic cleft, and gradient echo hypointensity concerning for prior hemorrhage. Histological assessment demonstrated mature adipose tissue with large-bore, thick-walled, irregular arteries. Mural calcifications and subendothelial cushions suggesting nonlaminar blood flow were observed. There were no arterialized veins or direct transitions from the arteries to veins. Hemosiderin deposition was scant, and hemorrhage was not present. The final diagnosis was consistent with ectopic mature adipose tissue and arteries with meningocerebral cicatrix. LESSONS This example of a complex maldevelopment of derivatives of the meninx primitiva in association with cortical maldevelopment highlights the unique challenges from both a radiological and histological perspective during diagnostic workup.
Collapse
Affiliation(s)
| | - Angus Toland
- Department of Pathology, Texas Children’s Hospital, Houston, Texas
| | | | | | | | - Donald E. Born
- Pathology, Stanford University School of Medicine, Stanford, California; and
| | | |
Collapse
|
50
|
Ait M'barek Y, Benantar L, Hamadi H, Aniba K. Deep Frontal Lipoma With Frontal Bone Invasion: Report of a Rare Case. Cureus 2023; 15:e38546. [PMID: 37273399 PMCID: PMC10239272 DOI: 10.7759/cureus.38546] [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: 05/04/2023] [Indexed: 06/06/2023] Open
Abstract
Lipomas are benign masses of fatty tissue, and in the forehead, they may develop in the subcutaneous or deep fat tissue. While subcutaneous lipomas are common, deep forehead lipomas are unusual and rarely invade the underlying bone. Only a few cases have been reported in the literature, and even fewer cases are reported in children. We present a case of a slowly growing frontal mass corresponding to a deep lipoma responsible for frontal bone invasion, resulting in a bony defect reaching the dural space. Through this case, we aim to emphasize forehead lipomas' clinical and surgical characteristics.
Collapse
Affiliation(s)
- Yassine Ait M'barek
- Neurological Surgery, Ibn Tofail Hospital, Mohammed VI University Hospital, Marrakech, MAR
| | - Lamia Benantar
- Neurological Surgery, Ibn Tofail Hospital, Mohammed VI University Hospital, Marrakech, MAR
| | - Hajar Hamadi
- Neurological Surgery, Ibn Tofail Hospital, Mohammed VI University Hospital, Marrakech, MAR
| | - Khalid Aniba
- Neurological Surgery, Ibn Tofail Hospital, Mohammed VI University Hospital, Marrakech, MAR
| |
Collapse
|