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1.
Medicine (Baltimore) ; 99(21): e20248, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481302

RESUMO

RATIONALE: Lipomas are common benign tumors, constituting 16% of soft tissue mesenchymal tumors. They usually occur under the skin or in the large muscles of the thigh, shoulder, or upper arm. There are few reported cases of lipomas located in the forearm and hand muscles, accounting for less than 1% of all lipomas. PATIENT CONCERNS: A 47-year old man presented with a history of swelling and accompanying pain in the left wrist for 2 years. DIAGNOSES: The patient was diagnosed with intramuscular lipoma in the pronator quadratus. INTERVENTIONS: The mass was resected completely with wide-awake technique. OUTCOMES: The patient was followed up for 2 years with no recurrence. The symptoms of swelling and pain resolved within 3 weeks post-surgery, and there was no clear abnormality in wrist and finger movement and sensation. A satisfactory outcome was achieved. LESSONS: Intramuscular lipoma in the pronator quadratus is a rare benign tumor which should be distinguished from malignant tumors. Especially for patients with carpal tunnel syndrome presenting with wrist swelling, ultrasound, computed tomography, or magnetic resonance imaging can be used to assess deep tissue masses.


Assuntos
Lipoma/cirurgia , Músculo Esquelético/patologia , Neoplasias de Tecidos Moles/patologia , Antebraço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Resultado do Tratamento , Punho/patologia
2.
Medicine (Baltimore) ; 99(22): e20392, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481427

RESUMO

RATIONALE: Thyroglossal duct cyst (TGDC), the most common midline neck mass, has several histological diagnoses other than cyst in the literature. We present the first case of thyroglossal duct lipoma. PATIENT CONCERNS: A 63-year-old woman presented with a painless soft midline neck mass for more than 3 years, which enlarged in size and caused a lump sensation during swallowing. DIAGNOSES: Sonography revealed a 3.5 × 3.0 × 3.0-cm homogenous isoechoic oval lesion without an acoustic shadow beyond the thyroid glands. An ultrasound-guided biopsy revealed abundant sheets of fat cells with infiltration of some lymphocytes and histiocytes. Computed tomography revealed a 3.5 × 3.0 × 3.0-cm well-circumscribed ovoid mass with Hounsfield unit (HU) between -50 and -100 and a thyroglossal duct remnant. All these findings supported the diagnosis of thyroglossal duct lipoma. INTERVENTIONS: The patient underwent Sistrunk operation for excision of the neck tumor, and pathological examination revealed an adipose tumor surrounded by benign thyroid tissue, confirming the diagnosis of thyroglossal duct lipoma. OUTCOMES: Neither postoperative complication nor recurrence was noted at the 18-month follow-up. LESSONS: This is the first case of thyroglossal duct lipoma in the literature. Our study extends the disease spectrum of thyroglossal duct mass and suggests that clinicians should consider thyroglossal duct lipoma in the differential diagnosis of a midline neck mass.


Assuntos
Lipoma/diagnóstico , Cisto Tireoglosso/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Feminino , Humanos , Lipoma/patologia , Lipoma/cirurgia , Pessoa de Meia-Idade , Cisto Tireoglosso/patologia , Cisto Tireoglosso/cirurgia , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia
3.
Surg Clin North Am ; 100(3): 669-680, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32402308

RESUMO

Although the vast majority of soft tissue extremity masses are benign, approximately 13,000 people in the United States were diagnosed with soft tissue sarcoma in 2019. This article focuses on the optimal workup of soft tissue masses including the indications for ultrasound and MRI, as well as use of preoperative core needle biopsy. Current AJCC staging, surgical principles of soft tissue sarcoma management, and data regarding indications for radiation therapy and chemotherapy are reviewed. As up to 50% of patients with soft tissue sarcoma will develop recurrent disease, surgical management of locally recurrent and distant metastatic disease is discussed.


Assuntos
Extremidades/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Biópsia por Agulha Fina , Quimiorradioterapia , Terapia Combinada , Extremidades/patologia , Humanos , Interpretação de Imagem Assistida por Computador , Lipoma/patologia , Lipoma/cirurgia , Imagem por Ressonância Magnética , Margens de Excisão , Estadiamento de Neoplasias , Prognóstico , Radioterapia Adjuvante , Sarcoma/patologia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/patologia
5.
J Clin Pediatr Dent ; 44(2): 107-111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32271663

RESUMO

Lipomas are common benign neoplasms of oral region which occur scarcely in the parapharyngeal space (PPS). The diversity observed in its histologic presentation classified it into many subtypes among which Spindle Cell Lipoma (SCL) is a rare entity. SCL is an uncommon benign tumor of adipose tissue usually located superficially in the neck, back and shoulder region but its presentation in oral and pharyngeal spaces is very rare. Exhaustive literature search for oral and pharyngeal space pleomorphic SCL till date revealed 45 cases of oral SCL with a mean age distribution of 55 years. Only one reported case of parapharyngeal occurrence of pleomorphic SCL was found. A rare case of pleomorphic variant of SCL in PPS extending into the buccal space is being presented. This case could be the first to report the multiple presentation and the youngest age of occurrence of SCL in PPS.


Assuntos
Lipoma , Diagnóstico Diferencial , Humanos , Pessoa de Meia-Idade
7.
Br J Radiol ; 93(1110): 20200063, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32271626

RESUMO

Multiparametric ultrasound (MPUS), combining conventional techniques (greyscale and colour Doppler ultrasound), ultrasound strain elastography, and contrast-enhanced ultrasound (CEUS), has been successfully used in the assessment of adult scrotal pathology. Contrast-enhanced ultrasound can confidently establish testicular tissue vascularity even in the small-volume paediatric testis. Elastography provides further assessment of tissue stiffness, potentially adding useful diagnostic information. In children, ultrasonography is particularly advantageous, being safe, radiation-free and negating the need for sedation or general anaesthesia during the imaging evaluation. In this review article, we aim to familiarise readers with the MPUS scanning protocol used for paediatric scrotal examination and provide an overview of scrotal MPUS features, with particular focus to clinical indications where MPUS may be advantageous over conventional ultrasonography.


Assuntos
Doenças dos Genitais Masculinos/diagnóstico por imagem , Escroto/diagnóstico por imagem , Ultrassonografia/métodos , Abscesso/diagnóstico por imagem , Adolescente , Fatores Etários , Criança , Contraindicações de Medicamentos , Meios de Contraste/administração & dosagem , Meios de Contraste/efeitos adversos , Cistos/diagnóstico por imagem , Ecocardiografia Doppler em Cores , Técnicas de Imagem por Elasticidade/métodos , Epididimite/diagnóstico por imagem , Humanos , Recém-Nascido , Infarto/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Masculino , Fosfolipídeos/administração & dosagem , Fosfolipídeos/efeitos adversos , Escroto/lesões , Torção do Cordão Espermático/diagnóstico por imagem , Hexafluoreto de Enxofre/administração & dosagem , Hexafluoreto de Enxofre/efeitos adversos , Neoplasias Testiculares/diagnóstico por imagem , Testículo/irrigação sanguínea , Testículo/diagnóstico por imagem , Testículo/lesões
8.
Medicine (Baltimore) ; 99(10): e19448, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150099

RESUMO

To investigate the accuracy of computed tomography (CT) in evaluating spinal epidural adipose tissue compared to magnetic resonance imaging (MRI).CT scan images and matched magnetic resonance images of total 368 patients between July 2014 and July 2016 were evaluated. Hounsfield units (HU) of epidural fat (EF), dural sac (DuS), ligamentum flavum, bone of facet joints, and paraspinal muscles were measured for comparison. Anteroposterior diameter of the EF, anteroposterior diameter of the DuS, transverse diameter of the DuS, cross-sectional area of the EF, and cross-sectional area of the DuS were measured at each disc level from L1-2 to L5-S1.Fat tissue showed exclusive negative HU significantly different from all other periphery tissues. Pearson correlation coefficient analyses showed significant positive correlations between CT and MRI measurements; Bland-Altman plots also depicted satisfied agreement. Overgrowth of spinal EF was more commonly found at L2-3 and L3-4 levels in present study, and body weight, age, and gender were significantly associated with amounts of EF both on CT and MRI.The CT scan is a satisfied alternative of MRI for the evaluation of spinal epidural adipose tissue.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Vértebras Lombares , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
9.
Rev Med Liege ; 75(3): 137-139, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32157835

RESUMO

Uterine lipoleiomyoma is a rare and benign pathology whose etiopathogenesis is still poorly understood. Benign cystic teratoma of the ovary constitutes its main and primordial differential diagnosis because of the different treatments. Pelvic MRI is the best imaging technique to confirm the diagnosis.


Assuntos
Leiomioma , Lipoma , Neoplasias Ovarianas , Neoplasias Uterinas , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Imagem por Ressonância Magnética , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Uterinas/diagnóstico por imagem
10.
Bull Tokyo Dent Coll ; 61(1): 53-60, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32074588

RESUMO

An extremely rare case of fibrolipoma in the hard palate is presented and discussed with reference to the literature. An 85-year-old woman visited the Tokyo Dental College Chiba hospital in September 2016 with the chief complaint of a mass in the hard palate. The patient had first become aware of this mass several years earlier. An examination at another hospital in June 2009 resulted in a clinical diagnosis of lipoma. Regular examinations followed every 6 months until September 2014, at which time she stopped attending these appointments because there was no change. In August 2016, however, the patient realized that the tumor was increasing in size. Although there was no pain, awareness of a foreign body in the oral cavity when eating or talking was increasing, so she decided to visit our clinic for detailed examination and treatment. At this point, the mass extended from the center to the left side of the hard palate. It measured 15 mm along the major axis, and had a clear border; nearly spherical, its surface was smooth and glossy, and was of a slightly yellowish color. The mass was painless, elastic, and soft. Computed tomography and magnetic resonance imaging revealed a tumorous lesion. Based on a clinical diagnosis of lipoma, it was subsequently excised under general anesthesia in January 2017. The tumor lay under the palatal mucosa, extending from the center to the left side of the hard palate. It was surrounded by a single-layered membranous structure, and had not adhered to the surrounding tissues. Healthy palatal mucosa and periosteum were also removed en bloc with the tumor within a safety margin of approximately 5 mm. No pressure absorption of palatine bone was seen. Histopathologically, proliferation of mature adipose tissue was observed. This was surrounded by a thin, single-layer membrane within the subepithelial connective tissue, which was covered by stratified squamous epithelium. Proliferation of fibrotic connective tissue was seen between the adipocytes. The final diagnosis was fibrolipoma. To date, at 18 months postoperatively, no recurrence has been observed and progress has been satisfactory.


Assuntos
Lipoma , Palato Duro , Idoso de 80 Anos ou mais , Feminino , Humanos , Imagem por Ressonância Magnética , Tóquio , Tomografia Computadorizada por Raios X
11.
Medicine (Baltimore) ; 99(6): e18985, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028409

RESUMO

RATIONALE: Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign lesion because of its asymptomatic and indolent clinical course. we report a case of atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) of buccal mucosa, provisionally diagnosed as lipoma. PATIENT CONCERNS: A 97-year-old female was referred to dentistry and oral surgery department with an asymptomatic mass on the right buccal mucosa which had been present for an unknown period of time. DIAGNOSIS: Magnetic resonance imaging demonstrated a well-circumscribed lesion at the right buccal mucosa, and a lipoma was suspected. INTERVENTIONS: Surgical removal was performed, and a diagnosis of ALT/WDL was made. She and her family refused additional treatment due to her age. OUTCOMES: At the 10 months follow-up, the patient remained free of disease. LESSONS: The indolent clinical course and small size of oral liposarcoma can lead to provisional clinical diagnosis of benign lesion.


Assuntos
Lipossarcoma/diagnóstico , Neoplasias Bucais/diagnóstico , Idoso de 80 Anos ou mais , Feminino , Humanos , Lipoma/diagnóstico , Lipossarcoma/patologia , Lipossarcoma/cirurgia , Imagem por Ressonância Magnética , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia
12.
Can Assoc Radiol J ; 71(2): 161-173, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32063006

RESUMO

Imaging studies of the hands and fingers are common, and radiologists are generally comfortable with traumatic and degenerative conditions which arise frequently in daily practice. However, a variety of common and uncommon soft-tissue tumors also occur in the hand, the appropriate diagnosis of which can be a source of confusion for both clinicians and radiologists. These lesions often have overlapping imaging characteristics; however, a structured approach can help provide a focused differential diagnosis and impact further workup and management. We discuss several such tumors, categorizing them as cystic-appearing, noncystic masses along tendons and aponeuroses, adipocytic tumors, vascular lesions, and miscellaneous lesions with imaging features that can aid diagnosis.


Assuntos
Fibroma/diagnóstico por imagem , Tumor de Células Gigantes de Bainha Tendinosa/diagnóstico por imagem , Tumor Glômico/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Neurilemoma/diagnóstico por imagem , Neurofibroma/diagnóstico por imagem , Sarcoma Sinovial/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem , Malformações Arteriovenosas/diagnóstico por imagem , Diagnóstico Diferencial , Cisto Epidérmico/diagnóstico por imagem , Fasciite/diagnóstico por imagem , Cistos Glanglionares/diagnóstico por imagem , Mãos , Humanos , Imagem por Ressonância Magnética , Radiografia , Cisto Sinovial/diagnóstico por imagem , Ultrassonografia
13.
Can Assoc Radiol J ; 71(2): 186-194, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32063011

RESUMO

The tectal plate comprises the posterior portion of the midbrain, borders the quadrigeminal cistern, and includes the superior and inferior colliculi. Benign and malignant pathologies occurring in this location may lead to aqueductal stenosis, obstructive hydrocephalus, and Parinaud syndrome. Both computed tomography and magnetic resonance imaging can be used to further characterize lesions involving the tectal plate. In this pictorial essay, we review various tectal plate lesions and their imaging features.


Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Neoplasias do Tronco Encefálico/diagnóstico por imagem , Cistos/diagnóstico por imagem , Glioma/diagnóstico por imagem , Hemangioma Cavernoso do Sistema Nervoso Central/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Teto do Mesencéfalo/diagnóstico por imagem , Abscesso Encefálico/diagnóstico por imagem , Infartos do Tronco Encefálico/diagnóstico por imagem , Neoplasias do Tronco Encefálico/secundário , Lipoma/diagnóstico por imagem , Esclerose Múltipla/diagnóstico por imagem
14.
Br J Radiol ; 93(1110): 20191037, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32108489

RESUMO

OBJECTIVE: To determine whether the location of a small, indeterminate soft tissue mass within the subcutaneous compartment is related to its histological grade. METHODS: All Sarcoma Service referrals over a 12 month period of small (<3 cm) superficial soft tissue masses, indeterminate by MRI evaluation which subsequently underwent primary excision biopsy were included. Lesions were categorised by their anatomical location in the subcutaneous compartment. Histopathological diagnoses were categorized according to12 WHO 2013. χ2 statistical analysis was performed to determine the relationship between lesion depth and histological grade. RESULTS: The study included 43 patients, mean age 42 years (range 15-71 years). Within the subcutaneous compartment, 16 lesions were categorized as superficial, 9 lesions central and 18 lesions deep, of which 9 were non-neoplastic, 29 benign, 1 intermediate-grade and 4 malignant. Location in the deep aspect of the subcutaneous compartment was associated with a higher risk of intermediate or malignant histology (p = 0.02). CONCLUSION: The location of a small, indeterminate soft tissue mass within the subcutaneous compartment may be an indicator of histological aggressiveness. Lesions in the deep subcutaneous compartment are more likely to be intermediate-grade/malignant lesions. Therefore, if considering excision biopsy as definitive treatment, a wider margin may be appropriate. ADVANCES IN KNOWLEDGE: Small, indeterminate soft tissue masses can be aggressive and the anatomical depth within the subcutaneous tissue may be a potential indicator of histological aggressiveness.


Assuntos
Neoplasias de Tecidos Moles/diagnóstico por imagem , Tela Subcutânea/diagnóstico por imagem , Adolescente , Adulto , Idoso , Distribuição de Qui-Quadrado , Feminino , Tumor Glômico/diagnóstico por imagem , Tumor Glômico/patologia , Humanos , Lipoma/diagnóstico por imagem , Lipoma/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Neoplasias da Bainha Neural/diagnóstico por imagem , Neoplasias da Bainha Neural/patologia , Neoplasias de Tecidos Moles/patologia , Tela Subcutânea/patologia , Adulto Jovem
15.
Isr Med Assoc J ; 22(1): 53-59, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31927807

RESUMO

BACKGROUND: Primary retroperitoneal neoplasms (PRN) arise from diverse retroperitoneal tissues. Soft tissue sarcomas (STS) comprise the majority and are well studied. Other non-sarcomatous PRN are very rare and less familiar. OBJECTIVES: To evaluate the clinicopathologic and radiologic features of non-sarcomatous PRN, as well as the outcome of complete tumor resection (TR). METHODS: Retrospective data were collected on consecutive patients (June 2006 to January 2015) who underwent resection of retroperitoneal lesions at our department. Final pathology of non-sarcomatous PRN was included. RESULTS: The study population included 36 patients (26% with PRN). PRN were neurogenic (17%), fat-containing (3%), and cystic (6%). The preoperative diagnosis was correct in only 28%. All patients underwent TR via laparotomy (72%) or laparoscopy (28%), for mean operative time of 120 ± 46 minutes. En bloc organ resection was performed in 11%. Complete TR was achieved in 97%. Intra-operative spillage occurred in 8%. Intra-operative, 90-day postoperative complications, and mortality rates were 11%, 36%, and 0%, respectively. The mean length of stay was 6.5 ± 5.5 days. The median overall survival was 53 ± 4.9 months. CONCLUSIONS: Familiarity with radiologic characteristics of PRN is important for appropriate management. Counter to STS, other PRN are mostly benign and have an indolent course. Radical surgery is not required, as complete TR confers good prognosis. Expectant management is reserved for small, asymptomatic, benign neoplasms.


Assuntos
Neoplasias Retroperitoneais/diagnóstico , Idoso , Feminino , Ganglioneuroma/diagnóstico , Ganglioneuroma/diagnóstico por imagem , Ganglioneuroma/patologia , Ganglioneuroma/cirurgia , Humanos , Lipoma/diagnóstico , Lipoma/diagnóstico por imagem , Lipoma/patologia , Lipoma/cirurgia , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Neurilemoma/cirurgia , Neurofibroma/diagnóstico , Neurofibroma/diagnóstico por imagem , Neurofibroma/patologia , Neurofibroma/cirurgia , Paraganglioma/diagnóstico , Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Paraganglioma/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
16.
World Neurosurg ; 133: 275-277, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31629145

RESUMO

We report a rare case of cervicothoracic intramedullary and extramedullary lipoma. Complete resection of the extramedullary lipoma and almost complete resection of the intramedullary lipoma were performed using a microscope, followed by posterior fusion and internal fixation from C4-T2 to maintain the stability of the cervicothoracic junction. Despite the high risk, it was still necessary to perform the decompression surgery and the surgical results were favorable.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Neoplasias da Medula Espinal/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem , Adulto , Vértebras Cervicais/cirurgia , Humanos , Laminectomia , Lipoma/cirurgia , Imagem por Ressonância Magnética , Masculino , Neoplasias da Medula Espinal/cirurgia , Fusão Vertebral , Vértebras Torácicas/cirurgia , Resultado do Tratamento
18.
World Neurosurg ; 134: 635-640.e1, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31704362

RESUMO

BACKGROUND: Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare clinical entity. We report an unusual case of intraparenchymal bifrontal CAPNON coexisting with interhemispheric lipoma and agenesis of the corpus callosum. CASE DESCRIPTION: A 64-year-old woman presented with slight weakness of her left leg. Computed tomography and magnetic resonance imaging showed massive nodular intraparenchymal calcifications at both sides of the interhemispheric lipoma associated with partial agenesis of the corpus callosum. Enhancement was observed at the periphery and within the calcification. Massive perifocal edema was also demonstrated. The enhanced lesion with calcification was partially resected. Histologic analysis of the resected specimen disclosed nodular calcification with fibro-osseous components and histiocytic reaction, consistent with CAPNON. A high ratio of M2 macrophages was observed among the infiltrating macrophages. 11C-methionine positron emission tomography demonstrated high uptake of the tracer at the lesion corresponding to the calcified lesion on computed tomography. Postoperatively, massive perifocal edema was decreased and maintained without progression for a year. CONCLUSIONS: The high M2 macrophage activity verified by histopathologic analysis suggests that CAPNON is not a silent but a more active, tumefactive disease involving the immune response. This hypothesis may be supported by the high uptake of 11C-methionine positron emission tomography.


Assuntos
Encefalopatias/cirurgia , Corpo Caloso/cirurgia , Lipoma/cirurgia , Macrófagos/patologia , Encefalopatias/diagnóstico , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Sistema Nervoso Central/cirurgia , Corpo Caloso/patologia , Humanos , Lipoma/complicações , Lipoma/diagnóstico , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
19.
Virchows Arch ; 476(1): 29-39, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31501988

RESUMO

Adipocytic tumors are frequently encountered in routine practice, and while the vast majority represent commonly encountered tumor types (e.g., benign lipoma), the heterogeneity and rarity of other adipocytic neoplasms can pose diagnostic challenges. Atypical and malignant adipocytic tumors account for approximately 20% of all sarcomas. The 2013 World Health Organization (WHO) classification of soft tissue and bone tumors recognizes four major liposarcoma subtypes, characterized by distinct clinical behavior, distinctive morphologies, as well as unique genetic findings: atypical lipomatous tumor/well-differentiated liposarcoma, dedifferentiated liposarcoma, myxoid liposarcoma, and pleomorphic liposarcoma. Since the publication of the 2013 WHO classification of soft tissue and bone tumors, the most notable change in the category of adipocytic tumors has been made in the clinicopathologic and molecular characterization of the heterogeneous but distinct group of "atypical low-grade adipocytic neoplasms with spindle cell features," for which the term atypical spindle cell/pleomorphic lipomatous tumor has been proposed. Another substantive change in the group of adipocytic tumors is the introduction of pleomorphic myxoid liposarcoma (myxoid pleomorphic liposarcoma) as an apparently novel subtype of aggressive liposarcoma, especially occurring in children and young adults with a predilection for the mediastinum. This review will further focus upon the diagnostic criteria of these novel emerging entities in the group of adipocytic tumors.


Assuntos
Adipócitos/patologia , Lipoma/patologia , Lipossarcoma/patologia , Humanos , Lipoma/genética , Lipossarcoma/genética , Prognóstico
20.
World Neurosurg ; 135: 156-159, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31843721

RESUMO

BACKGROUND: Internal auditory canal (IAC) lipomas are rare intracranial lesions. Consequently, preoperative imaging is essential in differentiating IAC lipomas from more common tumors such as vestibular schwannomas. The hallmark of lipomas on magnetic resonance imaging (MRI) is hyperintensity on T1-weighted images that suppresses on fat-suppressed sequences and does not enhance with gadolinium administration. CASE DESCRIPTION: The present case describes a 53-year-old woman who was misdiagnosed with a vestibular schwannoma because of the lack of appropriate MRI sequences. CONCLUSIONS: This case demonstrates the importance of ensuring that both fat-suppressed and non-fat-suppressed T1-weighted pregadolinium images are obtained in the diagnostic process of IAC lesions. It is therefore recommended that imaging centers ensure that such sequences are included in their MRI protocols.


Assuntos
Meato Acústico Externo/diagnóstico por imagem , Neoplasias da Orelha/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Erros de Diagnóstico , Meato Acústico Externo/patologia , Meato Acústico Externo/cirurgia , Neoplasias da Orelha/patologia , Neoplasias da Orelha/cirurgia , Feminino , Humanos , Lipoma/patologia , Lipoma/cirurgia , Imagem por Ressonância Magnética , Pessoa de Meia-Idade
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