RESUMO
Lipomas are common benign adipose tissue tumors but are infrequently found in the labia majora, especially at a large size. We report a case of a giant lipoma of the labia majora in a 37-year-old woman diagnosed by imaging methods and successfully treated by surgery. This case highlights the importance of considering lipoma in the differential diagnosis of labial masses and underscores the role of imaging in diagnosis. They need to be differentiated from liposarcoma or omental herniation into Nuck's canal. It also demonstrates the effectiveness of surgical management for large lipomas in sensitive areas, with attention to both medical and aesthetic outcomes.
Assuntos
Lipoma , Neoplasias Vulvares , Humanos , Feminino , Adulto , Lipoma/cirurgia , Lipoma/patologia , Lipoma/diagnóstico por imagem , Lipoma/diagnóstico , Neoplasias Vulvares/cirurgia , Neoplasias Vulvares/patologia , Neoplasias Vulvares/diagnóstico , Diagnóstico Diferencial , Vulva/patologia , Vulva/cirurgia , Imageamento por Ressonância MagnéticaRESUMO
BACKGROUND: Fibrolipoma of the lower lip is an uncommon condition with limited documentation in the literature. This paper provides updated insights into oral and maxillofacial lipomas through a detailed case report and comprehensive literature review, discussing clinical features, pathogenesis, diagnostic approaches, histopathology, and therapeutic strategies. CASE PRESENTATION: A 54-year-old female presented with a painless, enlarging mass on the inner aspect of her right lower lip, first noticed 2 years prior. The mass, now the size of a peanut, interfered with her eating and speech. Physical examination revealed a 2.0â ×â 2.5â ×â 1.0 cm mass beneath the mucous membrane of the right lower lip. It was firm, well-demarcated, and mobile. Surgical excision was performed, and histopathological analysis confirmed the diagnosis of a lower lip fibrolipoma. The lesion was successfully removed without recurrence. CONCLUSION: Lipomas in the oral and maxillofacial regions are rare, slow-growing benign tumors, particularly within the lips. Although their diagnosis is straightforward based on clinical presentation, histopathological confirmation is essential. Surgical resection remains the treatment of choice, with excellent prognostic outcomes.
Assuntos
Neoplasias Labiais , Lipoma , Humanos , Feminino , Pessoa de Meia-Idade , Lipoma/diagnóstico , Lipoma/cirurgia , Lipoma/patologia , Neoplasias Labiais/patologia , Neoplasias Labiais/cirurgia , Neoplasias Labiais/diagnóstico , Lábio/patologia , Lábio/cirurgiaRESUMO
BACKGROUND/AIMS: There is limited knowledge regarding the management of duodenal subepithelial lesions (SELs) owing to a lack of understanding of their natural course. This study aimed to assess the natural course of asymptomatic duodenal SELs and provide management recommendations. METHODS: Patients diagnosed with duodenal SELs and followed up for a minimum of 6 months were retrospectively investigated. RESULTS: Among the 443,533 patients who underwent esophagogastroduodenoscopy between 2008 and 2020, duodenal SELs were identified in 0.39% (1,713 patients). Among them, 396 duodenal SELs were monitored for a median period of 72.5 months (interquartile range, 37.7-111.3 mo). Of them, 16 SELs (4.0%) showed substantial changes in size or morphology at a median follow-up of 35.1 months (interquartile range, 21.7-51.4 mo). Of these SELs with substantial changes, tissues of two SELs were acquired using endoscopic ultrasound-guided fine needle aspiration biopsy: one was a lipoma and the other was non-diagnostic. Three SELs were surgically or endoscopically removed; two were diagnosed as gastrointestinal stromal tumors, and one was a lipoma. An initial size of 20 mm or larger was associated with substantial changes during follow-up (p = 0.016). CONCLUSION: While the majority of duodenal SELs may not exhibit substantial interval changes, regular follow-up with endoscopy may be necessary for cases with an initial size of 20 mm or larger, considering a possibility of malignancy.
Assuntos
Doenças Assintomáticas , Neoplasias Duodenais , Endoscopia do Sistema Digestório , Humanos , Estudos Retrospectivos , Feminino , Masculino , Pessoa de Meia-Idade , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Idoso , Adulto , Lipoma/patologia , Lipoma/cirurgia , Lipoma/diagnóstico por imagem , Progressão da Doença , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/cirurgia , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Fatores de Tempo , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Duodenopatias/patologia , Duodenopatias/cirurgiaRESUMO
Tumours of adipose tissue origin are relatively rare in the head and neck. Here, we report a case of an unfamiliar lipomatous lesion that involved the neck and mediastinum. A nil-comorbid man in his 40s presented with a slowly progressive anterior neck swelling of 3 years, which was diagnosed as lipoma by histopathological sampling. Computed tomography demonstrated the lesion to be involving parapharyngeal and retropharyngeal spaces with mediastinal extension. The lesion was removed by the transcervical approach. The final histology of the excised specimen, with immunohistochemistry for mouse double minute 2 (MDM2) and p16, suggested an atypical lipomatous tumour (ALT). This report accentuates the occurrence of this rare neoplasm in the neck, which often mimics lipoma clinically. Although radiology can demonstrate suggestive features, histology with MDM2 and/or p16 positivity can confirm the diagnosis of ALT as against the lipoma. A successful transcervical excision, despite the deeper extension of the lesion between the critical structures of the neck and mediastinum, demonstrates the non-infiltrating nature of the tumour.
Assuntos
Neoplasias de Cabeça e Pescoço , Lipoma , Tomografia Computadorizada por Raios X , Humanos , Masculino , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Lipoma/cirurgia , Lipoma/diagnóstico por imagem , Lipoma/patologia , Lipoma/diagnóstico , Adulto , Neoplasias do Mediastino/cirurgia , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/patologia , Neoplasias do Mediastino/diagnóstico , Pescoço/patologia , Pescoço/diagnóstico por imagem , Diagnóstico Diferencial , Mediastino/patologia , Mediastino/diagnóstico por imagemRESUMO
This retrospective study aims to examine the characteristics and treatment approaches of colon lipomas, which are benign tumors found in the colon. We analyzed a cohort of 25 patients, focusing on demographic characteristics, clinical presentation, location and size of the lipoma, concomitant pathologies, and treatment methods. The average age of the patients was 67.3 years, with 36% being male and 64% female. The majority of lipomas were located in the ascending colon (52%), and their median size was 2 cm. The predominant presenting symptom was constipation, affecting 83.3% of the symptomatic patients. Surgical resection was undertaken in only 1 patient due to obstruction. Statistically significant differences were observed between symptomatic and asymptomatic patients regarding various parameters, including the size of the lipoma (Pâ =â .033). Colon lipomas are generally benign and frequently asymptomatic but may necessitate different treatment approaches depending on their size, location, and the presence of symptoms. Further studies are imperative to refine treatment strategies and enhance patient care outcomes.
Assuntos
Neoplasias do Colo , Lipoma , Humanos , Lipoma/cirurgia , Lipoma/diagnóstico , Masculino , Feminino , Estudos Retrospectivos , Idoso , Neoplasias do Colo/cirurgia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/patologia , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Constipação Intestinal/etiologia , Constipação Intestinal/terapia , Constipação Intestinal/diagnóstico , AdultoRESUMO
PURPOSE: Differentiating benign lipomas from malignant causes is challenging and preoperative investigative guidelines are not well-defined. The purpose of this study was to retrospectively identify cases of head and neck lipomas that were surgically resected over a 5-year period and to identify the radiological modality chosen and features discussed in the final report. Multidisciplinary outcomes and pathology reports were examined with a view to identifying high risk features of a lipoma to aid in future risk stratification. METHODS: Retrospective chart review of pathology characteristics, radiological features (modality, size, calcifications, septations, globular/nodular foci), multidisciplinary discussion and history of presenting complaint was performed. RESULTS: Two liposarcomas and 138 lipomas were identified. Twenty-two percent of all lipomas received radiological investigation. Twenty-two percent of imaging referrals were possibly inappropriate. Furthermore, radiological features suggestive of malignancy were not present in the final radiology report, X2 = 28.8, p < 0.0001. CONCLUSION: As expected, the incidence of liposarcoma is low. There is limited awareness of radiology referral guidelines superimposed with a tendency to over-investigate lipomas. Furthermore, radiological features suggestive of malignancy were inconsistently reported on and not documented in multidisciplinary discussions. Therefore, we propose a multidisciplinary checklist for referring physicians and radiologists to aid in diagnostic work-up.
Assuntos
Neoplasias de Cabeça e Pescoço , Lipoma , Humanos , Estudos Retrospectivos , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Masculino , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias de Cabeça e Pescoço/patologia , Pessoa de Meia-Idade , Idoso , Adulto , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Idoso de 80 Anos ou mais , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Lipossarcoma/patologia , Diagnóstico DiferencialRESUMO
Spindle cell lipomas are a rare type of lipoma usually presenting in middle-aged to older men, often located on the posterior neck or shoulder; presentation on the foot is exceptionally uncommon. We report a 24-year-old man with spindle cell lipomas on the hallux of his left foot. He experienced an uneventful recovery after excision of the mass. We discuss clinical, radiologic, and histopathologic features of spindle cell lipomas and we review the differential diagnosis at this anatomic site.
Assuntos
Hallux , Lipoma , Humanos , Lipoma/patologia , Lipoma/diagnóstico , Lipoma/cirurgia , Masculino , Hallux/patologia , Adulto Jovem , Diagnóstico Diferencial , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgiaRESUMO
BACKGROUND: Lip infantile hemangiomas tend to show less volumetric regression and are more susceptible to visible sequelae in the involuted stage. Some of them still require surgical management after propranolol therapy. This study aimed to evaluate the efficacy and safety of the Stepwise, Multi-Incisional, and Single-Stage (SMISS) approach applied to lip reduction for those with involuted lip hemangiomas. METHODS: A retrospective review was performed to evaluate patients with lip hemangioma who received previous propranolol treatment and underwent the aforementioned procedure. Demographic characteristics, lesion morphology, and medical history were reviewed. The Visual Analog Scale was applied to assess the postoperative appearance. Complications within 12 months postoperatively were recorded. RESULTS: A total of 18 patients with lip hemangioma were eligible. All patients received oral propranolol therapy before surgery, with treatment duration ranging from 6.0 to 23.0 months. Their age at surgery ranged from 2.5 to 9.0 years. The median Visual Analog Scale scores were 8.0, ranging from 4.0 to 10.0. No severe complications were reported. CONCLUSIONS: This modified technique based on the SMISS approach has proven reliable and effective in improving the aesthetic outcome for involuted lip infantile hemangiomas. Practical surgical techniques still play an important part in the propranolol era.
Assuntos
Hemangioma , Neoplasias Labiais , Propranolol , Humanos , Estudos Retrospectivos , Masculino , Feminino , Hemangioma/cirurgia , Neoplasias Labiais/cirurgia , Propranolol/uso terapêutico , Pré-Escolar , Criança , Lactente , Lábio/cirurgia , Resultado do Tratamento , Lipoma/cirurgiaRESUMO
INTRODUCTION: Lipomas arising in the parietal peritoneum are rare, and some of them cause abdominal pain due to torsion of the pedunculated peritoneum. We encountered a case of parietal peritoneal lipoma arising upper peritoneum. In this report, we describe the detail of clinical presentation and discuss its potential pathogenesis and treatment strategy. CASE PRESENTATION: 45 year-old Japanese female patient presented with long-lasting intermittent pain in the left upper abdominal region. Abdominal imaging showed a well-defined fatty mass measuring 40 mm in size, suggesting a parietal peritoneal lipoma. Laparoscopy revealed a tumor with a twisted peduncle; however, no adhesion of the surrounding tissues and ischemic changes were visible. The tumor was easily removed by dissection of the tumor pedicle. CONCLUSION: Parietal peritoneal lipoma often shows pedunculated form and it causes abdominal pain by the torsion of tumor pedicle. Therefore, this type of lipoma should be considered a more aggressive surgery.
Assuntos
Dor Abdominal , Laparoscopia , Lipoma , Neoplasias Peritoneais , Humanos , Feminino , Lipoma/cirurgia , Lipoma/complicações , Lipoma/diagnóstico por imagem , Pessoa de Meia-Idade , Dor Abdominal/etiologia , Neoplasias Peritoneais/cirurgia , Neoplasias Peritoneais/complicações , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
A 14-year-old intact male Chihuahua dog was presented with masses located between the biceps femoris and adductor muscles in both hind limbs. Based on histopathological, immunohistochemical, and ultrastructural findings, we diagnosed these masses as bilateral hibernomas in the femoral regions. The dog had no evidence of recurrence or metastasis of the hibernomas through a 4-month postoperative follow-up. This is apparently the first report of bilateral hibernomas in the femoral regions of a dog. Key clinical message: Bilateral hibernomas should be considered as a differential diagnosis for masses occurring in the femoral regions of dogs.
Hibernomes bilatéraux dans les régions fémorales d'un chien. Un chien Chihuahua mâle intact de 14 ans a été présenté avec des masses situées entre le biceps fémoral et les muscles adducteurs des deux membres postérieurs. Sur la base des résultats histopathologiques, immunohistochimiques et ultrastructuraux, nous avons diagnostiqué ces masses comme des hibernomes bilatéraux dans les régions fémorales. Le chien n'avait aucun signe de récidive ou de métastases des hibernomes au cours d'un suivi postopératoire de 4 mois. Il s'agit apparemment du premier rapport d'hibernome bilatéral dans les régions fémorales d'un chien.Message clinique clé:Les hibernomes bilatéraux doivent être considérés comme un diagnostic différentiel pour les masses survenant dans les régions fémorales des chiens.(Traduit par Dr Serge Messier).
Assuntos
Doenças do Cão , Lipoma , Masculino , Cães , Animais , Lipoma/diagnóstico , Lipoma/cirurgia , Lipoma/veterinária , Músculo Esquelético/patologia , Diagnóstico Diferencial , Membro Posterior/patologia , Doenças do Cão/diagnóstico , Doenças do Cão/cirurgia , Doenças do Cão/patologiaRESUMO
Madelung's disease is characterized by the presence of multiple symmetric and nonencapsulated facial, neck, and upper trunk lipomas. Depending on the location and size of lipomas, there may be concerns for difficult airway management and cardiovascular collapse. We present the anesthetic management case of a patient with cervical and mediastinal lipomas who underwent elective cervical lipoma resection.
Assuntos
Anestésicos , Lipoma , Lipomatose Simétrica Múltipla , Neoplasias do Mediastino , Humanos , Lipomatose Simétrica Múltipla/cirurgia , Lipoma/cirurgia , Pescoço/cirurgiaRESUMO
A colonic lipoma is an uncommon lesion that is linked with clinical symptoms in only a small portion of patients. Patients with large lipomas are often referred for major surgery, which is associated with significant morbidity and mortality. In this case, we described a female patient with recurrent episodes of gastrointestinal blood loss, abdominal pain and colocolic intussusceptions due to a large, lumen-filling, obstructive lipoma in the splenic flexure. On abdominal CT, a lesion of 3.6 cm was visualised with a fat-like density without solid components. Considering its benign nature, we intended to preserve the colon by deroofing the upper part of the lesion and then performing a colonoscopy-assisted laparoscopic wedge resection. During reassessment, auto-amputation of part of the lesion was observed, most likely as a result of long-lasting mechanical effects, which made it possible to perform solely a wedge resection with an excellent outcome.
Assuntos
Neoplasias do Colo , Colonoscopia , Laparoscopia , Lipoma , Humanos , Lipoma/cirurgia , Lipoma/diagnóstico por imagem , Feminino , Neoplasias do Colo/cirurgia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/diagnóstico por imagem , Laparoscopia/métodos , Colonoscopia/métodos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Dor Abdominal/etiologia , Intussuscepção/cirurgia , Intussuscepção/diagnóstico por imagem , Intussuscepção/diagnóstico , Resultado do TratamentoAssuntos
Neoplasias Esofágicas , Lipoma , Humanos , Lipoma/cirurgia , Lipoma/diagnóstico por imagem , Lipoma/patologia , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Masculino , Pessoa de Meia-Idade , Feminino , Esofagectomia/métodosRESUMO
Introdução: os lipomas são as neoplasias benignas de origem mesenquimal mais comum, podendo acometer diversas partes do corpo, sendo a região maxilofacial, de fato, uma das menos frequentes. Clinicamente, manifestam-se como aumentos de volume de crescimento lento e circunscrito, de base séssil ou pediculada, superfície lisa e consistência macia e coloração amarelada. Os sítios intra-orais mais acometidos são a mucosa jugal e o vestíbulo bucal.Dentre suas variantes microscópicas mais comuns, estão o fibrolipoma, composto de um componente fibroso. No entanto, tais variações não afetam o prognóstico do seu tratamento, que deve ser realizado através da excisão conservadora da lesão. OBJETIVO: O presente trabalho tem como objetivo relatar um caso atípico de lipoma intra-oral. DESCRIÇÃO DO CASO: Paciente do sexo feminino, 67 anos, apresentou-se com aumento de volume em região de fundo de vestíbulo mandibular com evolução de, aproximadamente, 10 meses, indolor, com queixas de dificuldade no posicionamento da prótese dentária inferior. O diagnóstico inicial foi de lipoma, confirmado por análise anatomopatológica através de biópsia excisional da peça. Considerações finais: O tratamento de lipomas intra-orais preconizado pela literatura é a excisão local, obtida por meio da biópsia excisional, sendo uma solução eficaz e de baixa morbidade ao paciente(AU)
Introduction: lipomas are the most common benign neoplasms of mesenchymal origin, which can affect different parts of the body, with the maxillofacial region, in fact, one of the least frequent. Clinically, they manifest as slow-growing, circumscribed swellings, with a sessile or pedunculated base, smooth surface, soft consistency and yellowish color. The most affected intraoral sites are the buccal mucosa and the buccal vestibule. Among its most common microscopic variants are the fibrolipoma, composed of a fibrous component. However, such variations do not affect the prognosis of its treatment, which must be carried out through conservative excision of the lesion. OBJECTIVE: This study aims to report an atypical case of intraoral lipoma. CASE DESCRIPTION: A 67-yearold female patient presented with swelling in the bottom region of the mandibular vestibule with an evolution of approximately 10 months, painless, with complaints of difficulty in positioning the lower dental prosthesis. The initial diagnosis was lipoma, confirmed by anatomopathological analysis through excisional biopsy of the specimen. Final considerations: The treatment of intraoral lipomas recommended by the literature is local excision, obtained through excisional biopsy, being an effective solution with low morbidity for the patient(AU)
Assuntos
Humanos , Feminino , Idoso , Neoplasias Bucais , Lipoma/cirurgia , Lipoma/terapiaAssuntos
Adenoma , Hiperparatireoidismo Primário , Achados Incidentais , Neoplasias das Paratireoides , Paratireoidectomia , Humanos , Paratireoidectomia/métodos , Neoplasias das Paratireoides/cirurgia , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/diagnóstico por imagem , Hiperparatireoidismo Primário/cirurgia , Hiperparatireoidismo Primário/diagnóstico , Adenoma/cirurgia , Adenoma/diagnóstico , Adenoma/patologia , Diagnóstico Diferencial , Neoplasias do Timo/cirurgia , Neoplasias do Timo/diagnóstico , Neoplasias do Timo/complicações , Feminino , Lipoma/cirurgia , Lipoma/diagnóstico , Lipoma/complicações , Pessoa de Meia-Idade , MasculinoRESUMO
A man in his 40s presented with an incidental finding of an osteolytic bone lesion. He sustained an ankle injury while inline skating, fracturing his lateral malleolus. Besides the fracture, radiographic imaging on the day of the injury incidentally revealed a well-defined solitary osteolytic lesion with a sclerotic rim within the right calcaneus. MRI showed an intraosseous, fat-containing lesion with focal contrast enhancement, assessed as an intraosseous lipoma with central necrosis. In the pathological analysis of a sample of the lesion an intraosseous myolipoma of the calcaneus was found-an unexpected and extraordinary finding. To prevent pathological fracturing, curettage and bone grafting were performed using autologous iliac crest bone in combination with allogenous bone chips.
Assuntos
Neoplasias Ósseas , Calcâneo , Lipoma , Masculino , Humanos , Calcâneo/diagnóstico por imagem , Calcâneo/cirurgia , Calcâneo/patologia , Extremidade Inferior/patologia , Imageamento por Ressonância Magnética , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/patologia , Lipoma/diagnóstico por imagem , Lipoma/cirurgiaAssuntos
Neoplasias Laríngeas , Lipoma , Humanos , Lipoma/cirurgia , Lipoma/diagnóstico por imagem , Lipoma/patologia , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Faríngeas/cirurgia , Neoplasias Faríngeas/diagnóstico por imagem , Neoplasias Faríngeas/patologia , Tomografia Computadorizada por Raios X , Masculino , Feminino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Piriformis muscle mass is rare, which is particular for intrapiriformis lipoma. Thus far, only 11 cases of piriformis muscle mass have been reported in the English literature. Herein, we encountered one patient with intrapiriformis lipoma who was initially misdiagnosed. CASE PRESENTATION: The patient is a 50-year-old Chinese man. He complained of osphyalgia, right buttock pain, and radiating pain from the right buttock to the back of the right leg. Both ultrasound and magnetic resonance imaging demonstrated a cyst-like mass in the right piriformis muscle. Ultrasonography-guided aspiration was performed on this patient first, but failed. He was then recommended to undergo mass resection and neurolysis of sciatic nerve. Surprisingly, final histology revealed the diagnosis of intrapiriformis lipoma. The patient exhibited significant relief of symptoms 3 days post-surgery. CONCLUSION: Diagnosis and differential diagnosis of radicular pain are potentially challenging but necessary. Atypical lipoma is prone to be misdiagnosed, especially in rare sites. It is notable for clinicians to be aware of the presence of intrapiriformis lipoma to avoid misdiagnosis and inappropriate treatment.