Biópsia excisional de lipoma em fundo de vestíbulo mandibular: um relato de caso / Excisional biopsy of lipoma in the buccal mandibular vestibule: a case report

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)

Middle ear lipoma as a mimicker of other diseases: a review of an unusual presentation / Lipoma en el oído medio como un imitador de otras enfermedades: una revisión de una presentación inusual

The finding of a lipoma in the middle ear is much rarer than its occurrence in the external auditory canal or even the inner ear, with fewer than seven cases described in the literature and none of them in Spain or South America. Despite its benign nature, the location of the lipoma may compromise structures that play a significant role in auditory preservation or balance control, necessitating surgical removal as a curative treatment. The main objective of this article is to describe the presentation of lipomas in the middle ear as a possible, although rare, etiology to consider in patients presenting with hearing loss, instability, or both symptoms concurrently, seeking otorhinolaryngological evaluation.

El hallazgo de un lipoma en el oído medio es mucho más raro que su ocurrencia en el canal auditivo externo o incluso en el oído interno, con menos de siete casos descritos en la literatura y ninguno de ellos en España o Sudamérica. A pesar de su naturaleza benigna, la ubicación del lipoma puede comprometer estructuras que desempeñan un papel significativo en la preservación auditiva o en el control del equilibrio, lo que hace necesaria la extirpación quirúrgica como tratamiento curativo. El objetivo principal de este artículo es describir la presentación de los lipomas en el oído medio como una posible, aunque rara, etiología a considerar en pacientes que presentan pérdida de audición, inestabilidad o ambos síntomas simultáneamente, buscando evaluación otorrinolaringológica.

Taquicardia ventricular monomorfa sostenida secundaria a lipoma intramiocárdica / Sustained monomorphic ventricular tachycardia secondary to intramyocardial lipoma

[RESUMEN]. Introducción: A pesar de ser extremadamente raros, los tumores cardíacos conforman un importante desafío diagnóstico de la práctica cardiooncológica. Los lipomas son la segunda neoplasia primaria benigna en orden de frecuencia, representan entre un 8 a 12% de los tumores cardíacos primarios benignos en adultos. Materiales, métodos: Presentamos un caso clínico de una paciente estudiada y diagnosticada en nuestra institución. Descripción: Se presenta a una paciente de 21 años, de género femenino, sin factores de riesgo cardiovasculares, que fue referida a nuestra institución con diagnóstico de lipoma cardíaco. Su presentación inicial incluyó taquicardia ventricular sostenida con descompensación hemodinámica, que respondió favorablemente a la cardioversión eléctrica. Tras su ingreso, se llevaron a cabo estudios diagnósticos adicionales para obtener una caracterización más precisa de la masa y facilitar la toma de decisiones terapéuticas. El ecocardiograma transtorácico reveló la presencia de una masa en el septum interventricular basal, con extensión a la pared inferior de ambos ventrículos. La resonancia cardíaca posterior confirmó la naturaleza lipídica de la masa, que se presentaba de manera homogénea, con lí- mites definidos, sin realce en ninguna fase del contraste endovenoso y encapsulada, sin afectar estructuras adyacentes. La ausencia de realce precoz y tardío permitió descartar la vascularización y la presencia de tejido fibroso, respectivamente, consolidando así el diagnóstico de lipoma. Después de una evaluación exhaustiva por el equipo cardiovascular de nuestro hospital, se decidió de manera conjunta no proceder con una intervención quirúrgica debido a la ubicación anatómica del tumor y al elevado riesgo de morbimortalidad asociado. La alternativa consensuada fue la implantación de un cardiodesfibrilador, considerando el historial de arritmia severa y el riesgo de recurrencia en esta paciente. Conclusión: Se presenta un caso infrecuente de tumor cardíaco, que genera grandes desafíos diagnósticos y terapéuticos. Se optó por un tratamiento conservador con el propósito de prevenir la recurrencia de eventos arrítmicos.

[ABSTRACT]. Introduction: Despite being extremely rare, cardiac tumors pose a significant diagnostic challenge in cardio-oncology practice. Lipomas rank as the second most common primary benign neoplasm, accounting for 8 to 12% of primary benign cardiac tumors in adults. Materials and Methods: We present a clinical case of a patient studied and diagnosed at our institution. Description: A 21-year-old female patient, without cardiovascular risk factors, was referred to our institution with a diagnosis of cardiac lipoma. Her initial presentation included sustained ventricular tachycardia with hemodynamic decompensation, successfully managed with electrical cardioversion. Following admission, additional diagnostic studies were conducted to achieve a more precise characterization of the mass and guide therapeutic decision-making. Transthoracic echocardiography revealed a mass in the basal interventricular septum, extending to the inferior wall of both ventricles. Subsequent cardiac resonance confirmed the lipid nature of the mass, presenting homogeneously with well-defined borders, no enhancement in any phase of intravenous contrast, encapsulated, and without involvement of adjacent structures. The absence of early and late enhancement ruled out tumor vascularization and fibrous tissue, respectively, confirming the diagnosis of a lipoma. Following a comprehensive evaluation by our hospital's cardiovascular team, a joint decision was made to refrain from surgical intervention due to the anatomical location of the tumor and the associated high risk of morbidity and mortality. The consensus alternative was the implantation of a cardioverter-defibrillator, considering the patient's history of severe arrhythmia and the risk of recurrence. Conclusion: An infrequent case of cardiac tumor, that is associated with diagnostic and therapeutic challenges, is described. A conservative treatment was chosen aiming to prevent the recurrence of arrhythmic events.

Sensory and Motor Median Nerve Neuropathy Due to a Deep Giant Hand Lipoma: A Case Report / Neuropatia sensorial e motora do nervo mediano por um lipoma gigante na mão: Relato de caso

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.

Resumo Os lipomas são os tumores de partes moles mais comuns no corpo humano, mas sua localização na mão é rara. Os lipomas de mão que causam sintomas por compressão do nervo são ainda mais raros. Apresentamos um caso de neuropatia do nervo mediano decorrente de um lipoma palmar gigante, localizado nas regiões tenar e hipotenar da mão. A paciente apresentava sintomas típicos de síndrome do túnel do carpo, além de comprometimento dos movimentos do polegar. Durante a cirurgia, o ramo motor recorrente do nervo mediano repousava sobre o lipoma sob grande tensão. Esta localização particular do ramo motor do nervo mediano em relação ao lipoma torna este caso único. O tumor foi extirpado, protegendo as estruturas neurovasculares e, poucas semanas depois, a paciente havia recuperado totalmente os movimentos do polegar e força de preensão, além de apresentar resolução da disestesia.

Clinical value of fluorescence in situ hybridization with MDM2 and DDIT3 probe in diagnosis of liposarcoma / 北京大学学报(医学版)

OBJECTIVE@#To investigate the value of using MDM2 amplification probe and DDIT3 dual-color, break-apart rearrangement probe fluorescence in situ hybridization (FISH) technique in the diagnosis of liposarcoma.@*METHODS@#In the study, 62 cases of liposarcoma diagnosed in Peking University First Hospital from January 2015 to December 2019 were analysed for clinicopathological information. Of these 62 cases of liposarcoma, all were analysed for MDM2 amplification and 48 cases were analysed for DDIT3 rearrangement using a FISH technique. Our study aimed to evaluate the status of MDM2 and DDIT3 by FISH in liposarcoma and correlate it with diagnosis of different subtypes of liposarcoma. The subtypes of liposarcoma were classified according to the FISH results, combined with the relevant clinicopathological features.@*RESULTS@#The patients aged 31-89 years (mean: 59 years) with a 1.75:1 male to female ratio. Histologically, there were 20 cases of atypical lipomatous tumour/well-differentiated liposarcoma (ALT/WDLPS), 26 cases of dedifferentiated liposarcoma (DDLPS), 13 myxoid liposarcoma (MLPS) and 3 pleomorphic liposarcoma (PLPS). Tumors with DDLPS (23/26) and WDLPS (8/20) were localized retroperitoneally, while both tumours of MLPS and PLPS were localized extra-retroperitoneally, and the difference of sites among the four subtypes of liposarcoma was statistically significant (P < 0.05). Histologically, varied mucoid matrix could be observed in the four subtypes of liposarcoma, and the difference was statistically significant (P < 0.05). MDM2 gene amplification was demonstrated in all cases of ALT/WDLPS and DDLPS (100%, 20/20 and 26/26 respectively); DDIT3 gene rearrangement was noted only in MLPS (100%, 13/13); most cases of DDLPS (96.2%, 25/26) and ALT/WDLPS (83.3%, 5/6, 6 cases selected for detection) demonstrated the picture of amplification of the DDIT3 telomeric tag. According to the instructions of DDIT3 break-apart rearrangement probe, the 5' telomere probe and 3' centromere probe spanned but did not cover the DDIT3 gene itself, on the contrary, the 5' telomere probe covered the CDK4 gene, while the DDIT3 and CDK4 gene were located adjacent to each other on chromosome, therefore, when the amplification signal appeared on the telomeric tag of the DDIT3 rearrangement probe, it indeed indicated the CDK4 gene amplification rather than the DDIT3 gene rearrangement. Then the 10 cases with DDIT3 telomeric tag amplification were selected for CDK4 and DDIT3 gene amplification probe FISH tests, and all the cases showed CDK4 gene amplification (100%, 10/10) and two of the 10 cases demonstrated co-amplification of CDK4 and DDIT3 (20%, 2/10); DDIT3 polysomy detected by DDIT3 gene rearrangement probe was found in 1 case of DDLPS and 2 cases of PLPS (66.7%, 2/3) with morphology of high-grade malignant tumour and poor prognosis.@*CONCLUSION@#Our results indicate that a diagnosis of different subtype liposarcoma could be confirmed based on the application of MDM2 and DDIT3 FISH, combined with clinicopathological findings. It is also noteworthy that atypical signals should be correctly interpreted to guide correct treatment of liposarcomas.

Fibrocartilaginous lipoma: a clinicopathological analysis of six cases / 中华病理学杂志

Objective: To investigate the clinicopathological characteristics, immunophenotype, molecular genetics and differential diagnoses of fibrocartilaginous lipomas which consist of adipose tissue, fibrocartilage and fibrous elements. Methods: The clinicopathological features, immunohistochemical profiles and molecular profiles in six cases of fibrocartilaginous lipomas diagnosed at Foshan Traditional Chinese Medicine Hospital, Fudan University Shanghai Cancer Center, the Fifth Affiliated Hospital of Zhengzhou University and the Fourth Affiliated Hospital of Harbin Medical University from January 2017 to February 2022 were included. The follow-up information, diagnosis and differential diagnoses were evaluated. Results: There were three males and three females with a median age of 53 years (range 36-69 years) at presentation. Tumors were located in the extremities, the head and neck region and trunk; and presented as painless masses that were located in the subcutaneous tissue or deep soft tissue. Grossly, three cases were well defined with thin capsule, one case was well circumscribed without capsule, two cases were surrounded by some skeletal muscle. The tumors were composed of fatty tissue with intermingled gray-white area. The tumors ranged from 1.50-5.50 cm (mean 2.92 cm). Microscopically, the hallmark of these lesions was the complex admixture of mature adipocytes, fibrocartilage and fibrous element in varying proportions; the fibrocartilage arranged in a nodular, sheet pattern with some adipocytes inside. Tumor cells had a bland appearance without mitotic activity. Immunohistochemical analysis using antibodies to SMA, desmin, S-100, SOX9, HMGA2, RB1, CD34, adipopholin was performed in six cases; the fibrocartilage was positive for S-100 and SOX9, adipocytes were positive for S-100, adipopholin and HMGA2; CD34 was expressed in the fibroblastic cells, while desmin and SMA were negative. Loss of nuclear RB1 expression was not observed. Other genetic abnormalities had not been found yet in four cases. Follow-up information was available in six cases; there was no recurrence in five, and one patient only underwent biopsy of the mass. Conclusions: Fibrocartilaginous lipoma is a benign lipomatous tumor with mature adipocytes, fibrocartilage and fibrous elements. By immunohistochemistry, they show the expression of fat and cartilage markers. No specific molecular genetics changes have been identified so far. Familiarity with its clinicopathological features helps the distinction from its morphologic mimics.

Giant lipofibromatous hamartoma of median nerve in a child

Lipofibromatous hamartoma (LFH) is a rare fibrofatty tumor of adipocytes within peripheral nerves, affecting mainly children. It typically presents as a palpable mass surrounding the nerves of the upper limbs, causing pain and neurological deficits in the affected nerve distribution. We report the case of a child with a 2-years presentation of a mass in the right wrist associated with pain and paresthesia, who underwent investigation with magnetic resonance imaging (MRI). It showed thickening of the median nerve with spaghetti-like appearance associated with lipomatous tissue in a coaxial cable-like pattern, both features characteristic of LFH. This case illustrates the importance of MRI in the differential diagnosis of limb masses in the pediatric population.

Lipoma de recto prolapsado e incarcerado: caso clínico y análisis de la literatura / Prolapsed and incarcerated rectal lipoma: case report and literature review / Prolapso e encarceramento de lipoma do reto: caso clínico e análise da literatura

Los lipomas colónicos son tumores benignos poco frecuentes, extremadamente raros a nivel rectal. A pesar de ello, ocupan el segundo lugar en frecuencia detrás de los pólipos adenomatosos. Aunque la mayoría de los lipomas colorrectales son asintomáticos y se descubren incidentalmente, en ocasiones pueden ser sintomáticos y determinar complicaciones agudas que requieren tratamiento quirúrgico de urgencia. Estas formas de presentación pueden confundirse con las del cáncer colorrectal, constituyendo un desafío diagnóstico y terapéutico. Presentamos el caso de una paciente que consultó en emergencia por una gran masa dolorosa de aparición aguda a nivel del ano, resultando ser un lipoma rectal prolapsado a través del canal anal.

Colonic lipomas are infrequent benign tumors, extremely rare at the rectum. Nevertheless, they follow in frequency polyp adenomas. Even though most colorectal lipomas are asymptomatic and incidental, they can occasionally be symptomatic and develop acute complications that require urgent surgical treatment. This form of presentation can be confounded with colorectal cancer, therefore impairing diagnosis and treatment. We present the case of a female patient who came to the emergency room with an acute painful mass through the anus, that resulted in a prolapsed rectal lipoma.

Os lipomas colônicos são tumores benignos pouco frequentes, extremamente raros no nível retal. Apesar disso, ocupam o segundo lugar em frequência atrás dos pólipos adenomatosos. Embora a maioria dos lipomas colorretais sejam assintomáticos e descobertos incidentalmente, às vezes eles podem ser sintomáticos e levar a complicações agudas que requerem tratamento cirúrgico de emergência. Essas formas de apresentação podem ser confundidas com as do câncer colorretal, constituindo um desafio diagnóstico e terapêutico. Apresentamos o caso de um paciente que consultou na sala de emergência por uma grande massa dolorosa de início agudo ao nível do ânus, que acabou por ser um lipoma retal prolapsado pelo canal anal.

Tratamiento quirúrgico de fibrolipoma gigante de espalda / Surgical treatment of giant fibrolipoma of the back

Introducción: Los lipomas son los tumores más numerosos de tejidos blandos. Se presenta un caso con enfermedad de Hoffman-Zurhelle asociado a lipoma gigante en región toracodorsal y lipomatosis tratado quirúrgicamente de conjunto con las especialidades de cirugía plástica y cirugía general del Hospital Ameijeiras. Objetivo: Mostrar los resultados del tratamiento quirúrgico de exéresis de tumor gigante de espalda. Caso clínico: Paciente masculino de 34 años de edad que se le realizó bajo anestesia general disección del colgajo dermograso en sentido cefálico hasta línea paravertebral y cuello. Se respetó un centímetro de grosor, abordaje a nivel de la interfase del músculo trapecio y dorsal ancho. Se identificó la cápsula del lipoma que se independizó de las fibras musculares y del plano profundo hasta realizar su exéresis y de la piel excedente con nevo lipomatoso cutáneo superficial. Cierre por planos sin tensión. Conclusiones: Se logró la resección de un fibrolipoma gigante en espalda con una planificación cuidadosa que respetó el aporte vascular de los colgajos, la cobertura cutánea sin tensión y conservó la función muscular en ausencia de complicaciones(AU)

Introduction: Lipomas are the most numerous soft tissue tumors. We present a case of Hoffman-Zurhelle disease associated with giant lipoma in the thoracodorsal region and lipomatosis treated surgically in conjunction with the plastic surgery and general surgery specialties of the Ameijeiras Hospital. Objective: To show the results of surgical treatment of excision of a giant tumor of the back. Clinical case: A 34-year-old male patient underwent dissection of the dermographic flap in cephalic direction up to the paravertebral line and neck under general anesthesia. One centimeter thickness was respected, approaching at the level of the trapezius and latissimus dorsi muscle interface. The lipoma capsule was identified and became independent of the muscle fibers and the deep plane until it was excised, as well as the excess skin with superficial cutaneous lipomatous nevus. Closure by planes without tension. Conclusions: Resection of a giant fibrolipoma on the back was achieved with careful planning that respected the vascular supply of the flaps, the skin coverage without tension and preserved muscle function in the absence of complications(AU)

Fibrolipoma of the hard palate: an uncommon location. Case report / Fibrolipoma del paladar duro: una ubicación poco frecuente. Reporte de caso

Abstract Fibrolipoma, a benign soft tissue adipose tumor, is a histological variant of lipoma. Clinically, it presents as a painless slow-growing mass, indistinguishable from other benign soft tissue tumors. In the oral cavity, it is mainly encountered in the buccal mucosa. Involvement of the palate is very rare; it accounts for around 7-14% of all oral fibrolipomas. In this article, we describe a case of fibrolipoma in the hard palate of a 70-year-old female, who presented with an asymptomatic pedunculated mass, characterized by a normal-colored and smooth surface, which have been present for 20 years. The lesion was excised, and histopathological study revealed a fibrolipoma. To the best of our knowledge, only 17 cases occurring in the palate have been reported in the literature. Since fibrolipoma presents clinical similarities with other benign soft tissue neoplasms, a thorough clinical examination and histopathological analysis are essential for obtaining diagnosis.

Resumen El fibrolipoma es una neoplasia benigna de tejido adiposo, variante histológica del lipoma. Clínicamente se presenta como una tumoración de crecimiento lento, asintomática, indistinguible de otras neoplasias benignas de tejidos blandos. En cavidad oral se presenta principalmente en la mucosa yugal. El paladar es un sitio infrecuente, comprende del 7 al 14% de todos los fibrolipomas. En este reporte, describimos un caso de fibrolipoma de paladar duro en una mujer de 70 años de edad, que presentó una tumoración pediculada, asintomática, de superficie lisa, del mismo color de la mucosa adyacente, con un tiempo de evolución de 20 años. La lesión fue extirpada, y el estudio histopatológico reveló un fibrolipoma. En nuestro conocimiento, se han reportado en la literatura únicamente 17 casos de fibrolipoma de paladar. Siendo que el fibrolipoma presenta similitud clínica con otras neoplasias benignas de tejidos blandos, un examen clínico detallado, así como el estudio histopatológico son esenciales en la obtención del diagnóstico.

Lipomielomeningocele y médula anclada en un neonato: a propósito de un hallazgo cutáneo / Lipomyelomeningocele and tethered cord in neonate: a cutaneous finding / Lipomielomeningocele e medula ancorada em rescem nacido: um achado cutâneo

Introducción: el disrafismo espinal oculto comprende las anomalías congénitas caracterizadas por la fusión incompleta del tubo neural, en las que la lesión se encuentra cubierta por piel sin observarse exposición del tejido nervioso. Existen estigmas cutáneos que se asocian a su presencia, siendo los lipomas congénitos en la línea media posterior altamente sugerentes de lesión espinal. Su principal complicación es la asociación con el síndrome de médula anclada, que puede causar un daño neurológico irreversible. Caso clínico: recién nacida de sexo femenino, durante la exploración en Maternidad detectamos un estigma cutáneo del tipo lipoma en la región sacra sospechoso de disrafismo espinal oculto, confirmándose posteriormente, mediante estudio con ecografía y resonancia magnética, la presencia de lipomielomeningocele y médula anclada. Conclusiones: el reconocimiento de los marcadores cutáneos, que constituyen a veces la única manifestación de la enfermedad en pacientes asintomáticos, posibilitaría un diagnóstico precoz y manejo individualizado con posible corrección quirúrgica según el caso, que podría prevenir el daño neurológico irreversible asociado a la médula anclada.

Introduction: hidden spinal dysraphism involves congenital anomalies characterized by an incomplete fusion of the neural tube, where the lesion is covered by skin and the nervous tissue is not exposed. Some skin stigmas are linked with this spinal injury, mainly congenital lipomas in the posterior midline of the lesion. Hidden spinal dysraphism's main complication could be tethered cord syndrome, which can cause irreversible neurological damage. Clinical case: female newborn showing a lipoma-like skin stigma in the sacral region, looking like hidden spinal dysraphism, which was later confirmed through ultrasound and magnetic resonance imaging, which showed lipomyelomeningocele and a tethered cord. Conclusions: early detection of these skin markers is sometimes the only tool to early diagnosis and personalized treatment in asymptomatic patients. It enables a possible surgical remediation and may prevent the irreversible neurological damage linked to the tethered cord.

Introdução: o disrafismo espinhal oculto envolve anomalias congênitas caracterizadas por uma fusão incompleta do tubo neural, onde a lesão é coberta por pele e o tecido nervoso não fica exposto. Alguns estigmas de pele estão relacionados a essa lesão espinhal, principalmente lipomas congênitos na linha média posterior da lesão. A principal complicação do disrafismo espinhal oculto pode ser a síndrome da medula ancorada, a qual pode causar danos neurológicos irreversíveis. Caso clínico: recém-nascida apresenta estigma cutâneo semelhante a lipoma na região sacral, semelhante a disrafismo espinhal oculto, posteriormente confirmado por ultrassonografia e ressonância magnética, o que evidenciou lipomielomeningocele e medula ancorada. Conclusões: a detecção precoce desses marcadores cutâneos às vezes é a única ferramenta para o diagnóstico precoce e tratamento personalizado em pacientes assintomáticos. Permite uma possível correção cirúrgica e pode prevenir os danos neurológicos irreversíveis ligados à medula ancorada.

Hallazgos por imagen de lipoma pericárdico. Revisión de la literatura / Imaging findings of pericardial lipoma. Review of the literature

Introducción: El lipoma pericárdico es un tumor benigno infrecuente cuya presentación clínica es variada. Se revisaron los hallazgos por imagen descritos en la literatura en las modalidades de radiografía, ecocardiografía, tomografía axial computarizada (TAC) y resonancia magnética (RM). Metodología:Se identificaron reportes de caso, presentaciones en congreso y estudios observacionales de lipomas pericárdicos en PubMed, Scopus, Web of Science, Embase y Cochrane hasta el 01 de junio de 2022. Resultados: El lipoma pericárdico se ha descrito proporcionalmente en hombres y mujeres, en promedio a los 51 años de edad. Por lo general, los pacientes no presentan comorbilidades y de presentarlas, corresponden a factores de riesgo cardiovascular. Los síntomas más comunes son el dolor torácico y las palpitaciones. Hasta el 15 % de los casos son hallazgos incidentales en pacientes asintomáticos. Los métodos de imagen más frecuentemente descritos son la ecografía y la TAC, seguidos de la radiografía y la RM. Las descripciones incluyen masas ecogénicas, cardiomegalia, masas con densidad grasa menor a las 0 UH y por RM hiperintensas en T1 y T2 con saturación grasa y sin realce del medio de contraste. Un hallazgo frecuente es el derrame pericárdico. Conclusión: El rendimiento de las imágenes para el diagnóstico de lipomas pericárdicos no se ha calculado. Sin embargo, los hallazgos multimodales son altamente confiables para el diagnóstico no invasivo.

Introduction: Pericardial lipomas are benign and infrequent cardiac tumors with variable clinical presentation. We reviewed the imaging findings reported in the literature in radiography, echocardiography, computed tomography, and magnetic resonance. Methodology: We identified case reports, congress presentations and observational studies published in PubMed, Scopus, Web of Science, Embase and Cochrane until June 1st, 2022. Results: Pericardial lipoma occurs proportionally in women and men, at a mean age of 51 years. Past medical history is unremarkable and if present, cardiovascular risk factors are the most common comorbidity. The most common symptoms are chest pain and palpitations. Up to 15% of cases are incidental findings in asymptomatic patients. The most frequent imaging methods are echocardiography and computed tomography followed by radiography and magnetic resonance. Descriptions include echogenic masses, cardiomegaly, densities below 0 UH, T1 and T2 hyperintensity, fat saturation and lack of contrast enhancement. A frequent finding was pericardial effusion. Conclusions: The accuracy of the different imaging methods for lipomas has not been estimated. However, multimodal imaging is highly reliable for non-invasive diagnosis.

Omental lipoma in pediatric age group: clinical presentation, image findings and management

ABSTRACT A 2-year-old female patient, admitted in the emergency room, presented diarrhea for 5 days and bloody stools in the last 24 hours. Physical examination revealed no significant findings. Ultrasound was initially performed, showing an elongated, well delimited and solid mass occupying since right hypocondrium until left iliac fossa, displacing adjacent structures. In sequence, magnetic resonance imaging was performed for confirmation of findings suggestive of omentum lipoma. After 1 week, the surgical resection was performed by videolaparoscopic acess. During 2-year follow-up, there was no sign of recurrence.

Lipoma de la cavidad oral: descripción de casos / Lipoma of the oral cavity: cases description

El lipoma es un tumor benigno derivado de tejido adiposo maduro que se presenta con poca frecuencia en la cavidad oral, pero de interés para el clínico estomatológico por su distintiva presentación en esta región. A continuación se reportan dos casos clínicos de lipoma simple localizados en la mucosa vestibular y piso de boca que fueron tratados mediante eliminación quirúrgica (AU)

Lipoma is a benign neoplasm derived of mature adipose tissue that occurs infrequently in the oral cavity, but of interest to the stomatologic clinician for its distinctive presentation in this region. Next, two cases of simple lipoma located in the vestibular mucosa and floor of the mouth that were treated by surgical excision are presented (AU)

Hibernoma intramuscular en el muslo izquierdo de una fémina / Intramuscular lipoma in the left thigh of a woman

Se describe el caso clínico de una paciente de 32 años de edad, con antecedentes de esquizofrenia paranoide, atendida en la consulta de Ortopedia y Traumatología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, por presentar aumento de volumen en la cara interna del muslo izquierdo que le dificultaba la marcha. Al examen físico se observó un tumor de aproximadamente 20 cm, no doloroso a la palpación, así como blando y pastoso, con límites imprecisos y adherido a planos profundos. Según los estudios imagenológicos efectuados se trataba de tejido graso, por lo que no existía correlación con los elementos aportados al examen físico. Teniendo en cuenta lo anterior se discutió el caso con los imagenólogos y se decidió realizar la exéresis del tumor. Se tomó muestra para biopsia cuyo resultado informó la presencia de un hibernoma. La fémina evolucionó satisfactoriamente y se reincorporó a sus actividades habituales a los 2 meses.

The case report of a 32 years patient with history of paranoid schizophrenia is described. She was assisted in the Orthopedics and Traumatology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, due to an increase of volume in the internal face of the left thigh that difficulted her from walking. A tumor of approximately 20 cm was observed with the physical exam, that was not painful to the palpation, but soft and doughy, with imprecise limits and adhered to deep planes. According to the imaging studies it was an adipose tissue, reason why there was no correlation with the elements obtained with the physical exam. Taking into account the above-mentioned the case was discussed with the imaging specialists and the decision was removing the tumor. A sample for biopsy was taken whose result informed the presence of a lipoma. The woman had a favorable clinical course and she returned to her usual activities 2 months later.

Lipoma Cervicofacial Gigante: Reporte de un caso / Giant Cervicofacial Lipoma: A Case Report

RESUMEN: Los lipomas son neoplasias benignas formadas por tejido adiposo maduro y que representan los tumores mesenquimales más frecuentes. Los lipomas gigantes se definen en relación a un tamaño mayor de 10 centímetros o un peso mayor a 1 kilogramo. Su presentación a nivel de cabeza y el cuello es infrecuente. Se caracterizan por tener un crecimiento lento, progresivo, deformante y asintomático. Es necesaria la realización de pruebas de imagen para su correcta localización anatómica y establecer relaciones con las estructuras vecinas. El tratamiento de elección es la escisión quirúrgica de la masa. La planificación pre-quirúrgica en este tipo de casos debe ser minuciosa para garantizar la conservación tanto de la función como de la estética cervicofacial. Se reporta el caso de una mujer de 50 años que presenta una tumoración gigante cervicofacial de 9 años de evolución, diagnosticada como lipoma, con sus características clínicas, imageneológicas, histopatológicas y su manejo terapéutico.

ABSTRACT: Lipomas are benign neoplasms formed by mature adipose tissue and represent the most frequent mesenchymal tumors. Giant lipomas are defined in relation to a size greater than 10 centimeters or a weight greater than 1 kilogram. Their presentation at head and neck level is infrequent. They are characterized by having a slow, progressive, deforming and asymptomatic growth. Imaging tests are necessary for their correct anatomical location and the establishment of relationships with neighboring structures. The treatment of choice is surgical excision of the mass. Pre-surgical planning in this type of case must be meticulous to guarantee the preservation of both function and cervicofacial aesthetics. The case of a 50-year-old woman with a giant cervicofacial tumor of 9 years of evolution, diagnosed as lipoma, with its clinical, imaging, histopathological characteristics, and therapeutic management is reported.