Demographic and clinical data of patients with spinal epidural angiolipomas.

Spinal epidural angiolipomas are rare, benign, mesenchymal tumors. It remains unclear whether spinal epidural angiolipomas are genuinely rare or merely underreported. Herein, we assessed the demographic and clinical characteristics of patients with spinal epidural angiolipoma. We collected data from patients with spinal epidural angiolipoma from three sources. First, we retrospectively analyzed data from patients diagnosed with spinal epidural angiolipoma in our hospital between January 1, 2014, and December 31, 2023. Second, we performed a literature review of studies retrieved from PubMed. Third, we retrieved detailed data of patients with spinal angiolipoma from the Surveillance, Epidemiology, and End Results (SEER) database. We conducted a descriptive analysis to investigate the demographic and clinical characteristics of patients with spinal epidural angiolipoma. At our institution, three patients were diagnosed with spinal epidural angiolipoma. Additionally, we identified 116 patients from the literature review and 15 patients from the SEER database. We reviewed the treatment history and imaging features of the three patients from our institution. The descriptive analysis of the data collected from the literature review was consistent with previous reports. For example, 63.0% of lesions were located at the thoracic level. 31.9% of these lesions involved two vertebral bodies, while 75.6% involved 2-4 vertebral bodies. The most common symptoms experienced by patients were back pain, paraparesis, and numbness in the legs. Surgery was the primary treatment option for most patients, and complete tumor resection was achieved in the majority of patients. The male:female ratio was 1:1.4, the median age at diagnosis for the patients from the literature was 49 years old, and the median follow-up was 24 months. Notably, most of the reports came from Asia and there were few reports from Africa. The findings from the SEER database indicated a male:female ratio of 2:1. The peak incidence, which is typically reported in the fifth decade of life, was not observed. We presented three cases of spinal epidural angiolipoma and supplemented our findings with a literature review and population-based analysis according to the SEER database for the United States population. We believe that our research will enhance clinicians' comprehension of this uncommon tumor.

Angiolipoma de región maxilofacial en paciente pediátrico: presentación de un caso con revisión de la literatura / Angiolipoma of the maxillofacial region in a pediatric patient: a case report with literature review

El angiolipoma es una neoplasia del tejido adiposo maduro, acompañado de vasos sanguíneos y clasificándose en dos categorías, infiltrantes y no infiltrantes. La localización de esta lesión en la región maxilofacial es poco frecuente en la edad adulta y más aún en los niños. La tomografía computarizada y la resonancia magnética permiten establecer su diagnóstico. El tratamiento de elección es la escisión quirúrgica. Presentamos un caso de angiolipoma de región maxilofacial en una paciente de 4 años de edad, con afectación de la estética facial que, tras su valoración clínica e imagenológica, fue tratada mediante escisión quirúrgica intraoral en el Servicio de Cirugía Máxilofacial del Hospital del Niño Dr. Ovidio Aliaga Uría

Angiolipoma is a neoplasia composed of mature adipose tissue accompanied by blood vessels. It is classified into two categories: infiltrating and non-infiltrating. The occurrence of this lesion in the maxillofacial region is uncommon in adults and even rarer in children. Diagnostic tools such as computed tomography (CT) and magnetic resonance imaging (MRI) aid to stablish the diagnosis. Surgical excision is the treatment to be choice. We present a case of angiolipoma in the maxillofacial region of a 4-yearold patient, with facial aesthetic involvement. After clinical evaluation and imaging assessment, the lesion was successfully treated via intraoral surgical excision at the Pediatric Maxillofacial Surgery Service of the Dr. Ovidio Aliaga Uría Children's Hospital

Angiolipoma associated with antiretroviral switch therapy: a case report.

BACKGROUND: Angiolipomas have been well described in patients with HIV exposed to protease inhibitors with possible resolution after switching to non-nucleoside reverse transcriptase inhibitor-based regimens. Resolution of symptoms have occurred with switches to non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens; however, little is known regarding the development of angiolipomas when switching from NNRTI- to modern, integrase strand transfer inhibitor-based regimens. We describe a patient who underwent switch therapy from tenofovir disoproxil fumarate/emtricitabine/efavirenz (TDF/FTC/EFV) to tenofovir alafenamide/FTC/bictegravir (TAF/FTC/BIC) who later developed angiolipomas. CASE PRESENTATION: A 55-year-old male had been on TDF/FTC/EFV for 8 years before switching to TAF/FTC/BIC. Nineteen months after antiretroviral switch, the patient presented with multiple lesions in the upper extremities and abdomen. Diagnostic biopsies revealed non-encapsulated angiolipomas and HHV-8 and non-alcoholic fatty liver disease was ruled out. New lesions continued to appear 29 months after ART switch, after which now lesions appeared and prior lesions remained stable with no increase in size noted. No surgical intervention or change in antiretroviral therapy was needed. CONCLUSIONS: Angiogenesis may have been suppressed with TDF/FTC/EFV treatment, however when switched to TAF/FTC/BIC, promoted the growth of angiolipomas. Clinicians should be aware of the impact of switching to modern ART therapies resulting in possible adipogenesis.

Angiolipoma an Uncommon Breast Mass in Men: A Case Series.

Angiolipomas are uncommon benign masses of the breast which are rarely described in the male breast. They do not have a typical mammographic appearance and can present with concerning features such as microcalcifications or irregular borders. Ultrasound is helpful in evaluating these masses most commonly appearing as oval, circumscribed, and hyperechoic. Clinical, radiological, and pathological information needs to be carefully evaluated as angiolipomas can be confused with malignant pathology. Three cases of angiolipomas of the male breast are reported in this study with mammographic, sonographic, and pathologic correlation.

A rare case report of infratentorial cisternal angiolipoma with review of literature.

Angiolipomas are slow-growing benign mesenchymal-derived tumors consisting of mature adipocytes and thin-walled blood vessels. While the majority of angiolipomas are found in subcutaneous tissues, rarely there are case reports of intracranial lesions. We present a case of cisternal angiolipoma in a 10-year-old female. She presented with vague symptoms like dizziness without neurological deficits and radiological evaluation confirmed a left-sided infratentorial cisternal partially enhancing mass. She underwent craniotomy and had complete resection of the mass, which was histologically composed of mature adipocytes and blood vessels, consistent with angiolipoma. A review of the literature found only 18 cases of intracranial angiolipoma ever reported with our case representing the first case of infratentorial cisternal region.

Cellular angiolipoma: a case report and review of the literature.

Cellular angiolipoma is a rare subtype of angiolipoma, with vascular density approaching 95%. This case report describes a 55-year-old female that presented for treatment of a mass in her left breast that had been tender to slightly painful on palpation for nearly 2 years The patient underwent surgical excision of the mass, which was pathologically confirmed as a cellular angiolipoma. As of the 3-year follow-up, the patient reported no recurrence of the lesion. It is important to report this case and refresh knowledge of this and similar lesions to raise awareness of this diagnosis and treatment and improve future management of cellular angiolipoma cases.

Presentation of multiple painful subcutaneous nodules: Dercum's disease, a rare variant of lipoma.

A woman in her 50s presented to her general practitioner (GP) with an 8-month history of multiple painful subcutaneous nodules of various sizes in her trunk and limbs. Her previous GP made the clinical diagnosis of lipoma when they presented as non-painful nodules 2 years ago. Initial ultrasound demonstrated multiple lipomata with the largest size in the left upper thighs displaying features of subtle internal vascularity, entirely contained within the subcutaneous layer. MRI scan of thigh lesions showed multiple angiolipomas consistent with the entity of Dercum's disease. Subsequent biopsy histology confirmed the image diagnosis of angiolipoma. She was referred to a musculoskeletal oncological surgeon for evaluation and reassurance regarding optimising medical management of her associated obesity. Her angiolipoma and obesity are well managed by her GP. This case highlights the diagnostic workup of a rare variant of lipoma, Dercum's disease. The differential diagnosis of multiple painful lipomas was reviewed and discussed, consequently leading to the discussion of managing the associated obesity in this case.

[Esophageal Angiolipoma:Report of One Case and Literature Review].

Esophageal angiolipoma is a rare disease with unspecific clinical manifestations.This paper reported a case of esophageal angiolipoma confirmed by upper gastrointestinal endoscopy and summarized the clinical manifestations,endoscopic and pathological features,treatment and prognosis of the patients by reviewing the relevant literature,aiming to provide references for clinical diagnosis and treatment of this disease in the future.

Duodenal angiolipoma: a rare tumor causing recurrent upper gastrointestinal bleeding.

Duodenal angiolipoma is a rare adipocytic tumor, with non-specific symptoms precluding an early diagnosis. We present a case of a 67-year-old female admitted due to upper gastrointestinal bleeding. The upper endoscopy and endoscopic ultrasound evaluation showed a subepithelial lesion in the third portion of the duodenum. Endoscopic excision was performed using a standard polypectomy technique after endoloop placement. Histopathology was compatible with duodenal angiolipoma. The authors highlight duodenal angiolipoma as a rare adipocytic tumor potentially causing gastrointestinal bleeding, which can be safely treated with endoscopic excision.

A rare cause of upper gastrointestinal bleeding in an elderly female: gastric angiolipoma.

A 83-year-old woman with previous history of gallstone was hospitalized with intermittent melena of 1-week duration. Gastroscopy showed a protuberant mass with thick pedicle and superficial ulcer measuring 3.0 × 4.0-cm in the lower gastric body (Fig. 1. A). Biopsy of the ulcer indicated chronic inflammation without evidence of malignancy. Abdominal contrast-enhanced computed tomography demonstrated a well-defined and mixed density mass with heterogeneous enhancement in the gastric body. The final diagnosis was gastric angiolipoma.

Intussusceptive angiogenesis facilitated by microthrombosis has an important example in angiolipoma. An ultrastructural and immunohistochemical study.

The microvasculature of angiolipoma frequently presents thrombi. Our objectives are to assess whether intussusceptive angiogenesis (IA) participates in vasculature formation in non-infiltrating angiolipoma and, if so, to explore how thrombi are involved in the IA process. For this purpose, we studied angiolipoma specimens (n: 52), using immunohistochemistry, and confocal and electron microscopy. The results showed the presence of folds and pillars, hallmarks of IA, dividing the vessel lumen. Folds showed a cover formed by reoriented endothelial cells from the vessel wall, or from newly formed folds, and a core initially formed by thrombus fragments (clot components as transitional core), which was replaced by extracellular matrix and invaginating pericytes establishing numerous peg-and-socket junctions with endothelial cells (mature core). A condensed plasmatic electron-dense material surrounded and connected folds and pillars with each other and with the vascular wall, which suggests a clot role in fold/pillar arrangement. In conclusion, we contribute to IA participation in capillary network formation in angiolipoma and the immunohistochemical and ultrastructural events by which microthrombosis facilitates IA. Therefore, in addition to the histogenesis of angiolipoma, we provide an easily obtainable substrate for future studies on clot component action in IA, of clinical and therapeutic interest.

Clinical features and surgical outcomes of spinal epidural angiolipomas.

To discuss the clinical features and surgical outcomes of spinal epidural angiolipomas. We retrospectively analyzed the medical records of patients with spinal epidural angiolipomas who were performed microsurgery between January 2003 and December 2017. The diagnosis of spinal angiolipomas was based on pathological criteria. Modified McCormick classification was applied to evaluate neurological function. There were 11 females and 9 males with ages ranged from 38 to 74 years. Fourteen lesions were located in the thoracic region, 4 in the lumbar, 1 in the lumbosacral, and 1 in the thoracolumbar region. Patients presented with nonspecific symptoms and the duration of symptoms ranged from 1 to 168 months with a mean 21.3 months. 11 cases exhibited isointense on T1-weighted imaging(T1WI) and hyperintense on T2-weighted imaging(T2WI). The other 9 cases exhibited hyperintense on T1WI and T2WI imaging. Gross total resection (GTR) was performed in 19 patients, and subtotal resection (STR) was performed in 1 patient. Postoperatively, all patients showed a recovery or improvement of neurological functions except the STR patient. There was no recurrence or regrowth of the residual lesions observed on magnetic resonance images (MRI). Usually, spinal epidural angiolipomas have two types of MRI manifestations depending on the ratio of fat to vessels. Total resection of spinal epidural angiolipoma is possible regardless of it is infiltrative or not. Postoperative radiotherapy is not recommended for subtotal resection patients. A favorable functional outcome can be expected if the patient performed early surgery.

A Huge Gastric Angiolipoma Presenting with Acute Upper Gastrointestinal Hemorrhage: A Case Report.

BACKGROUND: Angiolipoma is a benign neoplasm mainly composed of adipose tissue and proliferating blood vessels and is relatively rare in the gastrointestinal tract. And among them, gastric angiolipomas are extremely rare and tend to be small. CASE PRESENTATION: We report the clinical and imaging features of a patient with a huge angiolipoma in the stomach and an episode of hematemesis and melena, caused by the ulceration of the gastric mucosa overlying the gastric subepithelial angiolipoma revealed by the endoscopic evaluation. The patient was anemic, and the anemia resolved after local surgical resection of the tumor. We also reviewed the imaging and histological features of the presenting gastric angiolipoma. CONCLUSION: Radiologists should be aware of this rare benign gastric tumor that may present with gastrointestinal hemorrhage.

Intraosseous angiolipoma of the mandible.

INTRODUCTION: The angiolipoma is an uncommon histologic variant of lipomas, accounts for 5-17% of lipomas. Intraosseous lipomas of the jaws are extremely rare. The aim of the present article is to report and discuss another case of intramandibular angiolipoma. CASE REPORT: A 66-year-old man was referred to the Dentistry Department for the diagnosis and treatment of a lesion in the mandible. Past medical history included HIV positivity. The patient was asymptomatic. A CT scan revealed the incidental finding of a well-defined radiolucent image in the right body of the mandible, in the edentulous first molar / second premolar region, with sclerotic margins, and in contact with the mandibular canal, that was preserved. A conservative enucleation under local anesthesia was decided, together with the patient. Histopathological findings were consistent with the diagnosis of angiolipoma. DISCUSSION: Clinically, most intraosseous lipomas are asymptomatic, including the present case. Histological findings are essential for the diagnosis of intraosseous angiolipoma: mature neoplastic adipocytes streaked with numerous interspersed vascular spaces / blood vessels surrounded by mast cells and filled with red cells and several fibrous microthrombi are characteristics of angiolipomas. CONCLUSIONS: The diagnosis of intraosseous angiolipomas of the jaws may be difficult due to their rarity and it requires a histopathological examination.

Endoscopic resection of a rare duodenal polypoid mass: duodenal angiolipoma.

A 73-year-old man was hospitalized with upper abdominal pain of 1-month duration. Gastroscopy revealed a pedunculated polypoid mass with smooth surface and slightly yellowish color in the duodenal bulb. A long strip shaped mass with very low density in the duodenal was found in abdominal computed tomography . The mass was removed successful by endoscopic mucosal resection. The resected specimen measured 1.5 × 3.0-cm. Histopathology examination revealed a tumor in the submucosa which composed of mature adipose tissue and proliferative blood vessels. The final diagnosis was duodenal angiolipoma. The patient was discharged home uneventfully and no symptoms was observed in 6 months follow-up.None.