Lipoma on the Sole of the Left Foot: Case Report.

Introduction: Lipomas are benign soft-tissue swelling commonly found on the neck, upper back, trunk, and shoulder but are rare in the foot and particularly in the sole. Case Report: This is a case of lipoma in a 49-year-old female teacher with 2 months history of painless swelling at the sole of the left foot which later became painful when it was traumatized. The patient was referred from a peripheral hospital to a teaching hospital in Ghana. Ultrasonography assessment revealed a hematoma, so our surgical team decided to do an excision biopsy under a popliteal block. Intraoperative findings revealed a lipoma and the mass was sent for histopathological assessment. The excised mass microscopically showed lobules of mature fat cells with areas of fibrous septae which have blood vessels and some nerves. The histopathological report revealed a diagnosis of fibro lipoma with no signs of malignancy. The surgery was uneventful and a 6-month follow-up period showed a healed wound and the patient can fully step on her left foot. Conclusion: The rare nature of a lipoma found at the plantar surface of the foot makes this case interesting and the creation of awareness can help heighten the index of skepticism among clinicians especially when patients present with a swelling on the sole which has been traumatized. The Doppler ultrasound findings were different from our surgical findings; therefore, lipoma should be a differential diagnosis of swelling on the sole of the feet associated with trauma.

Giant primary scrotal lipoma in a low-resource setting: challenges with diagnosis and review of literature.

Lipoma is the commonest benign mesenchymal tumor composed of matured adipocytes. A literature search revealed few reported cases of giant scrotal lipoma. This article aims to report a giant scrotal lipoma weighing 1100 g and illustrate our challenges with the diagnostic process in a low-resource setting. A 28-year-old male presented with a huge right scrotal mass. Examination revealed the mass had no cough impulse. It was firm, non-tender and lobulated, with definite edges. Scrotal sonography was suspicious of lipoma. Intraoperatively, there was an encapsulated scrotal wall mass and an incidental inguinoscrotal hernia, content being the omentum. The scrotal mass was excised, hernia sac was ligated, and excised and the posterior wall was repaired. Histology confirmed the scrotal mass as a lipoma. Primary scrotal lipomas are rare but should be considered in the differential diagnosis of unusual scrotal masses. Ultrasonography is a useful diagnostic tool in resource-limited settings.

Pediatric burns mortality risk factors in a developing country's tertiary burns intensive care unit.

AIM: This study aimed at identifying risk factors related to pediatric burns mortality in a middle income country such as Ghana. METHODS: The data for the three years retrospective study (May 2009 - April 2012) was obtained from the pediatric burn admissions records and patients' folders of the Reconstructive Plastic Surgery & Burns Unit (RPSBU), Komfo Anokye Teaching Hospital (KATH), Ghana. Data retrieved included: Demographic features, Total Burned Surface Area (TBSA) incurred; Aetiology of burns; Duration of the admission; Outcome of admission; Part of the body affected and Cost incurred. Ethical approval for this study was obtained from the KNUST-SMS/KATH Committee on Human Research, Publications and Ethics. Data analyses were performed with SPSS 17.0 version. RESULTS: Information on 197 patients was completely retrieved for the study. Burns mortality rate for the study was identified to be 21.3% (N=42). The mean age of the 42 dead patients was 3.7±0.3 years, ranging from 0-13 years, while, males (54.8%, N= 23) outnumbered females (45.2%, N=19). The TBSA burned interquartile range was 48%. In terms of etiology of burns Scald (73.8%, N=31) was the commonest cause of injury. Mortality risk factors identified were Age <6 years (P=0.028); Scald especially hot water and soup (P=0.016); TBSA >36% (P=0.028) and Inhalation injury (P=0.040). CONCLUSION: Age, scald, TBSA and Inhalation Injury were identified as pediatric burns mortality risk factors in a developing country such as Ghana's RPSBU. These identified factors will serve as a guideline for plastic surgeons and other health professionals practicing in countries such as Ghana.