Insular carcinoma arising on a background of follicular carcinoma, thyrolipomatosis and amyloid goitre.

A 67-year-old man was referred with a history of a right-sided neck lump and dysphonia, secondary to a lesion in the thyroid gland. After undergoing a total thyroidectomy, he was found to have an exceedingly rare combination of follicular carcinoma, insular carcinoma, thyrolipomatosis and an amyloid goitre in his thyroid gland. He subsequently underwent further radioactive iodine ablation and has been in remission. He was also later incidentally diagnosed with systemic amyloidosis, which explained the amyloid deposition in his thyroid gland.

Nutritional status in children with Shwachman-diamond syndrome.

OBJECTIVE: In Shwachman-Diamond syndrome (SDS), pancreatic insufficiency can lead to malabsorption of fat-soluble vitamins and trace elements. The aim of this study was to assess the serum concentrations of vitamins A and E, zinc, copper, and selenium and their deficiencies. METHODS: This retrospective review was performed in 21 children (12 were male; median age, 7.8 years) with genetically confirmed SDS at a tertiary pediatric hospital. Pancreatic enzyme replacement therapy (PERT) and vitamin or trace elements supplements were documented. RESULTS: Twenty patients (95%) had pancreatic insufficiency receiving PERT, 10 (47%) had a combined vitamin and trace element deficiency, 6 (29%) had an isolated vitamin deficiency, and 4 (19%) had an isolated trace element deficiency. Vitamins A and E deficiency occurred in 16 (76%) and 4 (19%) of 21, respectively. Low serum selenium was found in 10 (47%), zinc deficiency in 7 (33%), and copper deficiency in 5 (24%). Eleven patients (52%) were on multivitamin supplementation, and 2 (10%) on zinc and selenium supplements. No statistical differences were found between repeated measurements for all micronutrients. CONCLUSIONS: More than 50% of the children had vitamin A and selenium deficiencies despite adequate supplementation of PERT and supplements. Micronutrients should be routinely measured in SDS patients to prevent significant complications.

[A case of intestinal intussusception caused by multiple lipoma diagnosed preoperatively].

A 45-year-old man presented with intermittent abdominal pain for a month. Intestinal intussusception was diagnosed by the findings of abdominal ultrasonography and computed tomography. Intussusception was reduced by barium enema. Based on magnetic resonance imaging, we diagnosed intestinal intussusception due to multiple lipoma. At laparotomy, after successful reduction of the intussusception with Hutchinson's maneuver, an ileoceal resection was performed. Intussusception in adults is relatively rare and may be difficult to diagnose preoperatively. In the diagnosis of this disease, abdominal echo, CT, and MRI are useful.

Lipohiperplasia de la válvula de bauhin / Lipoid hyperplasia of Bauhin's valve

Se presentan en este trabajo 2 casos clínicos relacionados con una afección poco frecuente como es la lipohiperplasia de la válvula ileocecal, con interés adicional en el diagnóstico diferencial con tumores malignos de la región cecal. Se ilustra con iconografía excepcional, aportando el interés de la TAC para el diagnóstico. A continuación se hace una revisión bibliográfica sobre el tema (AU)

Small bowel schwannoma with diffuse subcutaneous lipomatosis. Case report and literature review.

A case of a small-bowel schwannoma with diffuse familiar lipomatosis is described. This case underlines the rarity of the neoplasm and its probably chance association with subcutaneous lipomatosis. The intestinal neoplasm was diagnosed preoperatively by upper gastrointestinal endoscopy and a small-bowel enema; computed tomography scan confirmed the intestinal lesion. Attention is focused on the morphological features of intestinal schwannomas and their biological behaviour.

Lipomatosis of the ileocecal valve leading to episodes of partial small bowel obstruction.

The cases of two female patients with lipomatosis of the ileocecal valve inducing episodes of intestinal obstruction are presented. A barium enema with air contrast was performed in patient 1; patient 2 was operated on to treat ileus. Resection of the fatty tissue from the ileocecal valve was performed at operation, after histologic diagnosis on frozen section. These cases suggest that limited resection removing fatty tissue is effective and preferable to more radical resection.

[Pelvic lipomatosis. A case with ureteral and venous obstruction]. / Lipomatose pelvienne. A propos d'un cas avec obstruction urétérale et veineuse.

The authors report a case of pelvic lipomatosis in a 62 year old man associated with venous obstruction (third case reported in the literature), diagnosed after bilateral ureteric obstruction, and review of the literature on this subject. The diagnosis was suggested by the radiological triad of hyperlucency of the pelvis on plain abdominal X-ray, "hot air balloon" appearance of the bladder on IVU and a rigid and ascended rectosigmoid on barium enema, and was confirmed by CT and MRI. Treatment combining corticosteroids and urinary tract disinfection was partially effective. A double J ureteric stent resolved the problem of persistent right ureteric obstruction.

Lipomatosis of the ileocecal valve causing recurrent small bowel obstruction.

A case of lipomatosis of the ileocecal valve causing recurrent intestinal obstruction is described. Barium enema with air contrast provides an important diagnostic tool. If confirmed intraoperatively and by histopathologic examination on frozen section, limited resection of the ileum and cecum is advocated rather than blind right hemicolectomy.

Pelvic lipomatosis: diagnosis by computerized tomography scan.

Pelvic lipomatosis is a rare, relatively self-limiting disease characterized by the overgrowth of unencapsulated lipomatous tissue within the pelvis. The diagnosis is suggested, but not substantiated, by the striking roentgenographic changes noted on barium enema and intravenous pyelogram. Previously, pelvic laparotomy with tissue diagnosis was essential for documenting the disease. We report three cases in which computerized tomography was utilized as a safe, noninvasive and accurate method of diagnosis. The role played by partial venous obstruction is discussed in addition to rectal bleeding as a mode of presentation.