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JAAD Case Reports Jun 2024
PubMed: 38774668
DOI: 10.1016/j.jdcr.2024.01.015 -
Cureus Mar 2024Lipoma 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...
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.
PubMed: 38681398
DOI: 10.7759/cureus.56999 -
International Journal of Surgery Case... May 2024Neural fibrolipoma, also known as fibrolipomatous hamartoma (FLH), is a rare benign tumor that usually affects the upper limb and tends to develop near the n. median....
INTRODUCTION
Neural fibrolipoma, also known as fibrolipomatous hamartoma (FLH), is a rare benign tumor that usually affects the upper limb and tends to develop near the n. median. FLH is a rare birth defect defined by the noncancerous growth of fibroadipose tissue around nerve bundles. These conditions are associated with abnormal bone growth, resulting in macrodactyly in about one-third of cases. The illness is medically referred to as macrodystrophia lipomatosa (MDL).
CASE PRESENTATION
A-4 years old girl presents with the index finger and thumb larger than the surrounding fingers and has been present since birth. Over time, the index finger and thumb continue to enlarge. This enlargement is accompanied by pain, a tingling sensation, and occasional bluish discoloration, especially at night. The patient is the third child out of four siblings, with a history of normal birth and no abnormalities in other parts of the body. The patient can grip objects in daily activities, but there is noticeable stiffness in the right hand.
DISCUSSION
FLH with macrodactyly is an uncommon abnormality that can manifest as either a minor lesion or a big mass affecting the entire extremity. Clinically, it is challenging to challenging to diagnose FLH in patient with macrodactyly.
CONCLUSION
It is crucial to possess a thorough understanding of the distinctive histology and radiological findings in order to accurately diagnose and treat the condition.
PubMed: 38669809
DOI: 10.1016/j.ijscr.2024.109680 -
Cureus Mar 2024Introduction Benign lipomatous tumors are soft tissue tumors that exhibit a predominant adipocytic phenotype. Lipomas are the archetype and are the most common benign...
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.
PubMed: 38646250
DOI: 10.7759/cureus.56618 -
Children (Basel, Switzerland) Dec 2023There are scarce papers about the use of fluorescence-guided surgery (FGS) in the open surgical field. This study aimed to assess the usefulness of FGS in an open...
INTRODUCTION
There are scarce papers about the use of fluorescence-guided surgery (FGS) in the open surgical field. This study aimed to assess the usefulness of FGS in an open setting in the pediatric population and to report our preliminary experience using the Rubina Lens system.
METHODS
All patients undergoing ICG fluorescence-assisted open surgery over the period September 2022-September 2023 were enrolled. Each surgical procedure was performed using the Rubina Lens for ICG fluorescence visualization.
RESULTS
A total of 25 patients, 14 boys and 11 girls with a median age at surgery of 5.8 years-old (range 0-15), were enrolled. Surgical indications were dermoid/epidermoid cysts of the head ( = 7), lymphangiomas of the head/neck ( = 2), thyroglossal duct cysts ( = 7), gynecomastia ( = 3), preauricular fistula ( = 2), second branchial cleft fistula ( = 1), fibrolipoma of the shoulder ( = 1) and myofibroma of the gluteal/perineal region ( = 2). In all procedures, an intralesional injection of 2.5 mg/mL ICG solution using a 30-gauge needle was administered. No adverse reactions to ICG occurred. Median operative time was 68.6 min (range 35-189). The visualization of ICG-NIRF with the Rubina Lens was achieved in all cases. No intraoperative complications were reported. Postoperative complications occurred in 3/25 patients (12%), with gynecomastia ( = 1), thyroglossal duct cyst ( = 1) and neck lymphangioma ( = 1), who developed a fluid collection in the surgical site, requiring needle aspiration in outpatient care (Clavien-Dindo 2). Complete mass excision was confirmed with pathology reports.
CONCLUSIONS
Based on this initial experience, FGS using the Rubina Lens was very helpful in open surgery, providing enhanced visualization of anatomy and identification of margins, real-time reliability and low complication rate. It was easy to use, time saving, feasible and clinically safe. Previous experience in MIS is necessary to adopt this technology. The accuracy of the injection phase is important to avoid diffusion of the ICG into the perilesional tissue.
PubMed: 38255367
DOI: 10.3390/children11010054 -
Journal of Oral and Maxillofacial... 2023Fibrolipoma, a subtype of lipoma, is a painless, well-circumscribed, slow-growing, submucosal benign adipocyte tumour. It is uncommon in the oral cavity and...
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.
PubMed: 38033946
DOI: 10.4103/jomfp.jomfp_105_23 -
Which one is the most accurate naming convention: cutaneous lipofibroma or pedunculated lipofibroma?Dermatology Reports Sep 2023This is a case of a large pedunculated lipofibroma on the left axilla in a 36-year-old woman. The lesion was excised completely with no recurrence after one year of...
This is a case of a large pedunculated lipofibroma on the left axilla in a 36-year-old woman. The lesion was excised completely with no recurrence after one year of follow-up. A new name for this rare entity is proposed to be more inclusive of all lesions of pedunculated lipofibroma and to differentiate it from another entity called fibrolipoma.
PubMed: 37908607
DOI: 10.4081/dr.2023.9675 -
Frontiers in Medicine 2023Common kinds of soft tissue sarcomas (STS) include well-differentiated liposarcoma (WDLPS) and dedifferentiated liposarcoma (DDLPS). In this case, we present a...
BACKGROUND
Common kinds of soft tissue sarcomas (STS) include well-differentiated liposarcoma (WDLPS) and dedifferentiated liposarcoma (DDLPS). In this case, we present a comprehensive clinical profile of a patient who underwent multiple recurrences during the progression from WDLPS to DDLPS.
CASE PRESENTATION
A 62-year-old Asian female underwent retroperitoneal resection of a large tumor 11 years ago, the initial pathology revealed a fibrolipoma-like lesion. Over the next six years, the patient underwent three resections for recurrence of abdominal tumors. Postoperative histology shows mature adipose tissue with scattered "adipoblast"-like cells with moderate-to-severe heterogeneous spindle cells, pleomorphic cells, or tumor giant cells. Immunohistochemistry (IHC) demonstrated positive staining for MDM2 and CDK4, confirming that the abdominal tumor was WDLPS and gradually progressing to DDLPS. Post-operative targeted sequencing and IHC confirmed the POC1B::ROS1 fusion gene in DDLPS. Whole-exome sequencing (WES) revealed that WDLPS and DDLPS shared similar somatic mutations and copy number variations (CNVs), whereas DDLPS had more mutated genes and a higher and more concentrated amplification of the chromosome 12q region. Furthermore, somatic mutations in DDLPS were significantly reduced after treatment with CDK4 inhibitors, while CNVs remained elevated.
CONCLUSION
Due to the high likelihood of recurrence of liposarcoma, various effective treatments should be taken into consideration even if surgery is the primary treatment for recurrent liposarcoma. To effectively control the course of the disease following surgery, combination targeted therapy may be a viable alternative to chemotherapy and radiotherapy in the treatment of liposarcoma.
PubMed: 37649981
DOI: 10.3389/fmed.2023.1237246 -
International Journal of Surgery Case... Aug 2023Spinal tumors constitute 15 % of all tumors in the central nervous system. Pain is often the initial symptom, which can be localized, nocturnal, or radiated to the arms...
INTRODUCTION
Spinal tumors constitute 15 % of all tumors in the central nervous system. Pain is often the initial symptom, which can be localized, nocturnal, or radiated to the arms and/or limbs. We report a rare case with a subpial lipoma in the cervicothoracic spine and review the current literature.
CASE PRESENTATION
A 22-year-old female presented with the chief complaint of tetraparesis for three months before admission. Magnetic resonance imaging revealed an intradural tumor on the fifth cervical to fourth thoracic vertebrae. She underwent a laminectomy to remove the tumor completely. Histopathological examination revealed a proliferation of mature fat cells amongst fibrous connective tissue. Surrounding nerve fibers and erythrocyte-filled blood vessels were also found, suggesting a subpial fibrolipoma. Postoperatively, there was an improvement in muscle strength six weeks after surgery. Motoric strength was grade 5 for the upper extremities and grade 4 for the lower extremities.
DISCUSSION
In this patient, cervicothoracic laminectomy and tumor removal were performed without instrumentation. Total tumor resection is the primary goal when removing a pathological lesion. However, this depends on the lesion's adhesion to the surrounding tissue. Therefore, partial tumor resection may be possible, given the neurological complications that can occur.
CONCLUSION
Because subpial lipomas are rare, their treatment is highly specialized. An assessment of the patient's physical condition and imaging assessments can provide information about potential treatment strategies and outcomes.
PubMed: 37544094
DOI: 10.1016/j.ijscr.2023.108616 -
Revista Espanola de Enfermedades... Jun 2024A 54-year-old man was hospitalized with intermittent periumbilical pain for 1-month duration. Abdominal contrast-enhanced computed tomography (CT) revealed target-sign...
A 54-year-old man was hospitalized with intermittent periumbilical pain for 1-month duration. Abdominal contrast-enhanced computed tomography (CT) revealed target-sign and a fat density mass measuring 2.0 × 2.5-cm in the distal ileum. Part mesenteric tissues and blood vessels were embedded and the wall of the affected intestinal tube was thickened and edematous. His symptom was alleviated after conservative treatment and he refused further management. The patient was hospitalized again with the same symptoms and abdominal CT findings 4 years later. Exploratory laparotomy was performed. A palpable mass in the ileum was found measuring 3.0 × 3.0-cm and partial enterectomy was performed. Postoperative histopathology revealed the resected mass was composed of proliferating mature adipocytes surrounded by few fibrous connective tissue. Hyperplastic fibroblast and inflammatory exudative necrotic tissue were found on the surface of the mass. The patient was diagnosed as ileum fibrolipoma with intussusception. He was discharged home uneventfully and no symptoms was observed in 12 months follow-up.
Topics: Humans; Male; Middle Aged; Abdominal Pain; Tomography, X-Ray Computed; Recurrence; Intussusception; Lipoma; Ileal Neoplasms
PubMed: 37539545
DOI: 10.17235/reed.2023.9879/2023