Synchronous Thyrolipoma and Papillary Thyroid Carcinoma: A Rare but Significant Event.

The presence of adipocytes within thyroid glands is a rare finding seen in thyrolipoma, diffuse lipomatosis, or thyroid teratoma. Although some cases present with multinodular goiter or autoimmune thyroiditis, the exact cause has not yet been elucidated. Among reported cases, thyrolipomas mainly occur in females and usually present as a solitary lesion. However, a few reported cases had coexisting papillary thyroid carcinomas. Herein, we present a 51-year-old female with synchronous thyrolipoma (2.0 × 1.5 × 1.3 cm) and papillary thyroid carcinoma (0.7 × 0.6 × 0.6 cm) within the same thyroid lobe. She had diabetes mellitus and hypertension and complained of anterior neck enlargement and discomfort for three months. Thyroid sonography showed multiple hypoechoic nodules, one of which was heterogeneous and ill-defined. Fine needle aspirate cytology for the ill-defined nodule was suspicious for papillary thyroid carcinoma. She subsequently received radical thyroidectomy and neck lymph node dissection. Histopathologically, one thyrolipoma and one papillary thyroid carcinoma were identified in the right lobe of the thyroid gland without metastases of lymph nodes, while other nodules were multinodular goiter. Notably, thyrolipoma may not be simply an incidental finding but might coexist with thyroid carcinomas. A brief review of the pertinent literature of prior reports is also provided.

Spontaneous adenolipoma of the mammary gland in the male F344 rat.

A 110-week-old male F344 rat from the high-dose group of a 104-week carcinogenicity study, exhibited a spontaneously occurring subcutaneous mass in the left axilla extending to the chest. Histologically, the mass was well-demarcated from the adjacent mammary tissue and slightly encapsulated without evidence of infiltration into the surrounding tissues. The mass contained both epithelial and adipose components. The epithelial component consisted of ductal structures of various sizes lined by a single layer of flattened to cuboidal epithelial cells with relatively clear or vacuolated cytoplasm. These ductal structures were well-intermingled with an adipose component that consisted of a uniform monomorphic cell population of mature adipocytes. Both cell types were well-differentiated and did not exhibit cellular atypia. Within the mass, fibrous connective tissue was found in the stroma with infiltration of numerous mast cells. Based on these findings, the mass was diagnosed as an adenolipoma of the mammary gland.

A case report of RccHanTM: WIST rat with multiple neoplastic and non-neoplastic proliferative lesions.

It is extremely rare to have multiple spontaneous proliferative lesions in young adult rats. Here, we report the occurrence of different proliferative lesions in multiple tissues of a 7-week-old female rat in a 1-week repeated toxicity study. Grossly, multiple white patches and nodules in the bilateral kidneys, femoral and subcutaneous masses, and a nodule in the liver were observed. Renal lesions were diagnosed as renal mesenchymal tumors. One of the femoral subcutaneous masses was diagnosed as an adenolipoma consisting of mammary epithelial cells and mature adipocytes. The other femoral and abdominal subcutaneous masses were diagnosed as lipomas consisting of mature adipocytes. The liver nodule was diagnosed as non-regenerative hepatocellular hyperplasia, which was characterized by the proliferation of slightly hypertrophic hepatocytes. In the cauda equina, the growth of enlarged Schwann cells around the axon was observed, and this lesion was diagnosed as a neuroma.

Ultrasound-guided fine-needle aspiration biopsy of thyroid neoplasms with lipomatous stroma: Report of two cases.

Thyroid tumors with abundant adipose tissue component are rare, reportedly accounting for 0.98-2.8% of all thyroid nodules, and include entities such as thyroid lipoadenoma and thyroid carcinoma with lipomatous stroma (TCLS). They may be encountered on fine-needle aspiration biopsy (FNAB), which is widely used in evaluation of thyroid nodules. However, due to their relative rarity, adipose elements rarely are recognized preoperatively in these tumors. Herein, we report two cases of thyroid tumors with abundant adipose tissue, along with cytologic, histologic, and ultrasonographic features. Although an intermixture of adipose tissue and thyroid follicular cells is the key cytologic feature of thyroid tumors with adipose stroma, other cytologic findings, such as abundant fat droplets or isolated fragments of adipose tissue, also should raise the possibility of a fat-containing tumor, particularly when a biopsy is performed by a cytopathologist under ultrasonographic guidance and adequate radiologic-pathologic correlation. Cytopathologists should be aware that overlooking lesional adipose tissue within a thyroid neoplasm might give the false impression of a non-diagnostic or sparsely cellular FNAB specimen.

Coexistence of three nevus lipomatosus cutaneus superficialis with typical, cutaneous adenolipoma-like, and dermal spindle cell lipoma-like histopathological features in a patient.

We report an unique case of a patient who showed coexistence of three nevus lipomatosus cutaneus superficialis (NLCS) with typical, cutaneous adenolipoma (AL)-like, and dermal spindle cell lipoma (SCL)-like histopathological features. A 53-year-old woman presented with a 20-year history of skin-colored and slightly elevated nodules. These lesions were separately located on the lateral side (lesion 1) and medial side (lesion 2) of her left buttock and on her right thigh (lesion 3). Microscopically, all were ill-defined dermal lesions with some subcutaneous involvement and were mostly composed of mature adipocytes. The adipocytes formed small aggregates around blood vessels in the upper dermis. Lesions 1, 2, and 3 were diagnosed as NLCS, and additional features were recognized in lesions 2 and 3. Lesion 2 revealed eccrine glands and ducts amongst the lipomatous component, as seen in cutaneous AL. Lesion 3 had scattered CD34-positive spindle cells, which is representative of dermal SCL. These appearances were considered to be on the morphological spectrum of NLCS. In all three lesions, CD34-positive cells proliferated between the upper dermal blood vessels and their peripheral mature adipocytes. This pathological finding could be principal in NLCS and might be associated with its pathogenesis.

Adenolipoma of the Breast: A Case Report.

Adenolipoma of the breast is a rare tumor classified as a hamartomatous lesion. It is a well-circumscribed lesion composed of adipocytes and other breast tissues. The characteristic feature is a well-circumscribed mass containing radiolucent fat admixed with dense fibrous connective tissue surrounded by a thin radiopaque pseudo capsule. Microscopically, there is a mixture of ducts and lobules with adipose tissue. Ductal hyperplasia, adenosis, calcification, and apocrine metaplasia may occur within the hamartoma. These are rarely associated with malignancies and excision is considered curative. If these lesions are not detected clinically or radiologically, these remain unrecognized. Awareness of this poorly recognized benign entity would help avoid an incorrect diagnosis and unnecessary intervention. Here we present a case of a 35-year-old female diagnosed histologically as adenolipoma of the breast.

An extremely rare case of giant oncocytic adenolipoma of the parotid gland.

Oncocytic adenolipoma is a rare tumor to occur in the salivary gland, which can present as a giant neck mass. Until now, <20 such cases are reported. We report this rare case for surgeons to consider it as one of the differential diagnoses.

Cutaneous spindle cell adenolipoma with eccrine and apocrine differentiation.

Cutaneous spindle cell adenolipoma (SCAL) is a recently described rare variant of lipoma with 11 cases reported to date. Here we report a consultation case of a 77-year-old male who presented with a nodule on the right nasolabial fold, diagnosed as apocrine fibroadenoma or sebaceous hyperplasia by an outside pathologist. The specimen revealed an ill-defined dermal tumor composed of mature adipocytes, bland spindle cells, ropey collagen, and dilated eccrine and apocrine glands and ducts in a fibromyxoid stroma. The spindle cells were positive for CD34 and negative for S100 protein and SOX10. These findings are consistent with those of cutaneous SCAL. The pathogenesis of this entity is controversial and includes a hamartomatous process, derivation from adipose tissue surrounding eccrine glands, or preexisting glands entrapment within a growing lipoma. In the present case, the glandular component is extensive and includes both eccrine and apocrine differentiation, which has not been previously described and further supports the hamartomatous nature. Awareness of this rare entity is helpful to prevent confusion with other look-alike primary and metastatic cutaneous lesions.

[Combined presentation of autoimmune thyroiditis, bilateral papillary thyroid carcinoma, cervical thyrolipoma and diabetes mellitus]. / Az autoimmun thyreoiditis, a kétoldali papillaris pajzsmirigy-carcinoma, a nyaki thyreolipoma és a diabetes mellitus együttes elofordulása.

Thyrolipoma or thyroid adenolipoma is an extremely rare form of thyroid adenoma, which also contains mature adipose tissue and follicles covered with fibrous capsule. We present the case of the growing cervical lesion of a 52-year-old female with diabetes, which was removed during total thyreoidectomy. Autoimmune thyroiditis, bilateral papillary carcinoma and cervical thyrolipoma have been identified by the histopathological examination of the thyroid gland. Orv Hetil. 2018; 159(25): 1024-1032.

Adenolipoma of the Skin: A Report of 11 Cases.

INTRODUCTION: Adenolipoma is a relatively recently described lesion representing a rare variant of lipoma in which eccrine glands and ducts are found interspersed amongst mature adipose tissue. This benign lesion was first described by Hitchcock et al. in 1993 [J Am Acad Dermatol 1993; 29: 82-85]. The next case series was written by Ait-Ourhrouil and Grosshans [Ann Dermatol Venerol 1997; 124: 845-848] in which they deemed adenolipoma a misnomer based on the pathophysiology of the lesion and suggested the name peri-sudoral lipoma instead. According to our knowledge, this case series would be the third in the literature to report cases of adenolipoma in an attempt to increase awareness of this entity. METHODS: We performed a retrospective review of adenolipoma cases from 2004 to 2014 at our institute. RESULTS AND CONCLUSIONS: Upon review of all adenolipomas diagnosed at our institute between 2004 and 2014, 11 cases in total were identified. Histologically, these lesions consisted of an admixture of adult-like adipose tissue and scattered eccrine glands and ducts. 4 cases also showed areas of myxoid changes; 2 showed scattered mast cells amongst the adipose tissue, and only 1 showed the presence of apocrine glands in addition to the eccrine glands and ducts. The female to male ratio was 6: 5. The typical age ranged from 41 to 53 years. Adenolipomas were seen arising from various locations including the thighs, gluteal region, lower leg, shoulder, chest, and trunk. The majority of cases were not fully encapsulated and the size varied from 0.7 to 5.8 cm.

Thyroid adenolipoma: a case report.

Generally, small quantities of adipose tissue is present in the thyroid gland. The adenolipoma of the thyroid gland is considered a rare finding. It consists in a benign, encapsulated neoplasm composed of mature adipose tissue and glandular elements. We report a case of a 71 year-old female patient presenting with swelling of the anterior neck and history of airway obstruction. Ultrasound (US) examination showed a bulky multinodular goiter which caused dislocation and compression of the trachea. The scans performed at the level of the isthmic region showed the presence of a hyperechoic oval formation with a homogeneous echostructure and regular contours; these characteristics suggested the lipomatous nature of the nodule. The patient was subsequently subjected to a Computer Tomography (CT) of the neck for a pre-operative balance of the goitre and to exclude extra-thyroid pathologies. The CT scan confirmed the sonographic findings, and the probable adipose nature of the isthmic formation. After the patient has been subjected to total thyroidectomy and histological examination confirmed the diagnosis of adenolipoma.

Prominent Cold Nodule in Multinodular Goiter Revealed to Be Thyrolipoma: A Case Report.

The presence of adipose tissue in the thyroid gland is a rare finding. Thyrolipoma or adenolipoma of the thyroid is a benign, encapsulated lesion of the thyroid composed of variable amounts of fat and glandular elements. This report presents a case of thyrolipoma in a 69-yr-old female presenting with neck swelling and respiratory distress. Differential diagnosis of the fat-containing thyroid lesion is also presented. Differentiation of the condition from similar lesions is necessary for accurate diagnosis of thyrolipoma.

Thyroid Pathology Findings in Cowden Syndrome: A Clue for the Diagnosis of the PTEN Hamartoma Tumor Syndrome.

OBJECTIVES: PTEN hamartoma tumor syndrome (PHTS) is a hereditary disorder caused by germline inactivating mutations of the PTEN gene. PHTS includes Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome. We describe how the peculiar pathologic and immunohistochemical thyroid features lead pathologists to suggest PHTS. METHODS: A 28-year-old white Spanish woman had a multinodular goiter. Total thyroidectomy was performed after fine-needle aspiration biopsy. Microscopic, immunohistochemical, and molecular analyses of the thyroid lesions were realized. RESULTS: The thyroid was multinodular, showing one papillary microcarcinoma, five follicular adenomas, three adenolipomas, 46 tiny adenomatous nodules (microadenomas), scattered foci of adipose tissue, and lymphocytic thyroiditis. Tumors were positive for thyroglobulin, thyroperoxidase, pendrin, cyclin D1, and p27 but negative for calcitonin and PTEN. A germline heterozygous deletion of one adenine at nucleotide 827 in exon 8 of the PTEN gene was confirmed. No BRAF, NRAS, or KRAS somatic mutations were detected in the papillary microcarcinoma, follicular adenoma, adenolipomas, or microadenomas. Negativity for PTEN was also found in the colonic tubulovillous adenoma and the storiform collagenoma. CONCLUSIONS: Pathologists play a crucial role in recognizing pathologic thyroid findings associated with PHTS for selecting patients for genetic testing.

Sialolipoma of minor salivary glands: presentation of five cases and review of the literature with an epidemiological analyze.

UNLABELLED: Sialolipoma is rare benign neoplasm arise from salivary glands (majors and minors) characterized by neoplastic adipose tissue with scattered non-neoplastic salivary gland acinus. To date 60 cases (including 5 cases reported in the present paper) have been reported in scientific literature. This article presents 5 new cases of sialolipoma affecting minor salivary glands (MiSG) and additionally reviews and analyzes the previously published cases to assess possible demographical differences between sialolipoma from minor and from major salivary glands. CASE REPORTS: 5 cases (3 females; 2 males; age means 63.8 years), of sialolipoma from MiSG, are reported. 2 of them were located in buccal mucosa, 1 in upper lip mucosa, 1 in floor of the mouth and 1 in retromolar area. All tumors were composed by neoplastic adipocytes cells interlaced with normal salivary gland acinus cover it by a fibrous tissue capsule. Analyzes of literature showed that MiSG sialolipoma is most frequent in females over 60 years old, therefore and in conclusion this article assess different demographical profile of sialolipoma in respect to their topography.

Virilizing lipoadenoma of the adrenal gland in a pre-pubertal girl: A rare case.

We report a case of a 12-year-old girl who presented with the history of hirsutism. On evaluation, she was found to have testosterone secreting adrenal gland tumor. Histopathological examination of the adrenalectomy specimen revealed a lipoadenoma.

Hamartoma of the breast in two patients: A case report.

Breast hamartomas are rare, benign, tumor-like nodules composed of glandular, adipose and fibrous tissue. The hamartoma was first described in 1971 as a lipofibroadenoma, fibroadenolipoma or adenolipoma, based on the predominant component of the breast tissue. Clinical findings resemble fibroadenoma and if there is a palpable mass, the patients may receive an immediate diagnosis. Ductal hyperplasia, apocrine metaplasia, calcification and adenosis may occur within the hamartoma, with rarer instances of lobular or ductal intraepithelial neoplasms. Although hamartoma is usually benign, a malignant transformation is possible. An excision and histological examination is necessary for the differential diagnosis and also for any epithelial lesions of the hamartoma. Simple excision is enough for treatment if there is no coincidental epithelial malignant lesion. The patients in the present study were treated by simple excision as there were no proliferative changes in the lesions. No recurrence or other problems were detected in the 18-month follow-up. The current study presents two cases of breast hamartoma that were diagnosed as an adenolipoma and a fibroadenolipoma, and then describes the macroscopic and microscopic observations of these lesions.

Adenolipoma da glândula tireoide: relato de caso / Adenolipoma of the thyroid gland: a case report

Os adenolipomas tireoidianos são neoplasias raras e benignas, compostas de tecido adiposo maduro e folículos tireoidianos, de histogênese ainda indefinida, que acometem geralmente pacientes adultas do sexo feminino. Relata-se um caso de adenolipoma tireoidiano em paciente feminina de 65 anos de idade, discutindo-se os aspectos clínicos e laboratoriais e o diagnóstico diferencial.

Adenolipomas of the thyroid gland are rare and benign neoplasms composed of mature adipose tissue and thyroid follicles, with histogenesis still unknown. It commonly affects adult female patients. We report a case of adenolipoma of the thyroid gland in a 65 year-old female patient and discuss its clinical and laboratorial aspects and differential diagnosis.

Adenolipoma of the skin arising at neck region.

We report here a case of adenolipoma of the skin, an unusual variant of lipoma, arising on the neck. A 56-year-old man visited our hospital due to an anterior neck mass. An excisional biopsy was performed. The mass revealed a tan-yellow soft cut surface. We could not find any difference from other lipoma on gross inspection. Microscopically, the mass showed proliferation of mature adipocytes admixed with several eccrine units. The eccrine units were demonstrated by periodic acid-Schiff-positive granules in the secretory portions and by positivity of smooth muscle actin in the myoepithelial cells surrounding the eccrine glands. The tumor was completely excised, and the patient has been followed up without any evidence of recurrence so far.