Fatty masses of the abdomen and pelvis and their complications.

There are numerous common and rare macroscopic fat-containing masses found in the abdomen and pelvis. These include benign masses, such as lipoleiomyoma, ovarian teratoma, mesenteric teratoma, and lipoma, as well as malignant masses, including liposarcoma and malignant transformation of benign entities. Any mass may become symptomatic due to the development of a complication which may range from ovarian torsion to intussusception to hemorrhage. Imaging plays a vital role in diagnosis and treatment planning when confronted with a symptomatic fat-containing mass.

A case of Trousseau syndrome associated with a mucosa-associated lymphoid tissue lymphoma disseminated to the mesenteric adipose tissue.

A 66-year-old man with recurrent stroke within a short period of time was referred to our department from the neurology department to rule out any malignancy. An endoscopic examination revealed a white depressed lesion in the body of the stomach, and computed tomography revealed a high-density area in the mesentery around the stomach. A mucosa-associated lymphoid tissue (MALT) lymphoma was detected from both the stomach biopsy and resected mesenteric specimen. Systemic chemotherapy was administered for the MALT lymphoma (Lugano classification stage IV). Cerebral infarction did not occur after the treatment. We concluded that Trousseau syndrome associated with the MALT lymphoma disseminated to the mesenteric adipose tissue. A MALT lymphoma has a small probability of occurring in Trousseau syndrome.

Tumor adiposo con síntomas de alarma / Adipose tumor with alarm signs

La presencia de una tumoración en tejidos blandos es un motivo de consulta frecuente en Atención Primaria. Una historia clínica completa y una adecuada exploración física son fundamentales para detectar posibles lesiones malignas. Aunque los sarcomas de tejidos blandos pueden aparecer en cualquier lugar del cuerpo, la mayoría se presenta en extremidades o el abdomen. Son un grupo heterogéneo, poco frecuente, de tumores mesenquimales malignos, siendo los liposarcomas los sarcomas más frecuentes del adulto. La cirugía habitualmente es curativa, sola o combinada con radioterapia, con o sin quimioterapia. Preservar la funcionalidad del miembro es el principal objetivo del tratamiento. La detección precoz puede evitar al paciente una cirugía mayor e importantes complicaciones, por lo que debemos estar atentos a los signos clínicos de alarma. Presentamos el caso de una mujer de 54 años con un liposarcoma bien diferenciado, en cara lateral externa del muslo izquierdo (AU)

The presence of a mass involving soft tissues is a frequent reason of consultation in primary health care. A complete clinical history and an appropriate physical examination are fundamental in order to detect possible malignant lesions. Although soft-tissue sarcomas can arise anywhere in the body, the majority appear in the limbs or within the abdomen. Soft-tissue sarcomas are a heterogeneous group of rare malignant mesenchymal tumors, and liposarcomas are the most common sarcoma in adult life. Surgery is often curative, alone or in combination with radiotherapy, with or without chemotherapy, and preserving limb functionality is the goal of treatment. The relevance of early detection could save patients major surgery and serious complications, that is why clinical awareness of the alarm signs should be kept in mind. We present the case of a 54-year-old female with a well-differentiated liposarcoma involving the lateral aspect of the left thigh (AU)

Identification of the methylation of p14ARF promoter as a novel non-invasive iomarker for early detection of lung cancer

BACKGROUND: Recent diagnostic procedure advances have greatly improved early lung cancer detection. However, the invasive, unpleasant and inconvenient nature of current diagnostic procedures limits their application. There is a great need of novel non-invasive biomarkers for early lung cancer diagnosis. In the present study, we intend to determine whether the blood signatures of p14ARF promoter methylation are suitable for early detection of lung cancer. METHODS: The study aimed to assess the probability of p14ARF promoter methylation in plasma samples to detect early lung cancer using nested methylation-specific PCR in the training set consisted of tumor tissues and paired blood. Besides, we were further to discuss the difference in time to progression between methylation and unmethylation of p14ARF promoter using univariate and multivariate analysis. RESULTS: The methylation of p14ARF promoter was detected in 33.6 % of tumor tissues, and 12.1 and 25.2 % in distant-cancer mucosa and matched plasma, respectively, and our study has also demonstrated the positive correlation between them by Pearson's test (r = 0.300). The tumor-free survival time of the unmethylation of p14ARF promoter is significantly longer than that of the methylation of p14ARF promoter in tumor tissues (χ (2) = 7.149, P = 0.008). CONCLUSION: The methylation of p14ARF promoter in plasma samples has strong potential as a novel non-invasive biomarker for early detection of lung cancer, and the methylation of p14ARF promoter was considered as prognostic factor in our study (AU)

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[Hemosiderotic fibrohistiocytic lipomatous lesion: a new entity you must remind]. / Tumeurs fibrolipomateuses hémosidérotiques: une nouvelle entité à ne pas méconnaître.

Fatty tissues lesions are the most frequent of both benign (lipoma) and malignant tumor (liposarcoma) of soft tissues in the adult. We here describe the case of female patient having a fatty tissue mass of the ankle corresponding to an hemosiderotic fibrohistiocytic lipomatous lesion (HFHLL). This very rare tumour of recent description is specific of the ankle/foot area of the middle age women. These lesions are always benign and frequently recur following incomplete resection. This tumor may have invasive local growth and metastases have not been described so far. We describe the anatomopathologist's key points of their diagnostic. We discuss the main differentials diagnosis and treatment.

Oncogenic osteomalacia: localization of underlying peripheral mesenchymal tumors with use of Tc 99m sestamibi scintigraphy.

OBJECTIVE: To highlight a strategy for potential detection of mesenchymal tumors in oncogenic malacia, as illustrated by 3 cases. METHODS: Three case reports are presented in which successful localization of the offending neoplasm was accomplished by using whole-body Tc 99m sestamibi scanning. Alternative localization techniques are also reviewed. RESULTS: Oncogenic osteomalacia occurs infrequently and is caused by neoplasms that secrete phosphatonins, substances that interfere with proximal tubular resorption of phosphorus and can result in phosphaturia, hypophosphatemia, reduced 1,25-dihydroxyvitamin D concentration, and osteomalacia. Removal of the underlying neoplasm results in complete resolution of all biochemical, pathologic, and physical manifestations of this disorder, as shown in our 3 patients. Because the neoplasms are small and can occur in any tissue compartment, they are difficult to localize, a feature that often results in therapeutic failure. CONCLUSION: We conclude that use of whole-body Tc 99m sestamibi scanning may be an appropriate and cost-effective initial strategy for the localization of peripheral phosphatonin-secreting tumors.

Obesity: an endocrine tumor?

Obesity is one of the most common disorders in clinical practice. The prevalance of obesity has increased by more than 60% since 1990. Adipose tissue acts as an endocrine organ secreting many factors into the blood, known as adipokines, including leptin, adipsin, acylation-stimulating protein, adiponectin, etc. This article examines the hypothesis that obesity may be evaluated as an endocrine tumor, regarding its genetic basis, hyperplasia and hypertrophy of adipocytes, neovascularisation within the adipose tissue associated with growth, and beneficisal metabolic effects of surgical removal of excess adipose tissue by liposuction. Assuming obesity as an endocrine tumor may bring out new treatment modalities. Liposuction as "cytoreductive surgery", antiangiogenic teraphy or anti-neoplastic drugs may be important components of obesity treatment in future.

Lipoblastomatosis of the neck causing hemiparesis: a case report and review of the literature.

BACKGROUND: Lipoblastoma and lipoblastomatosis are rare pediatric adipose tumors that sometimes affect the neck or spinal cord. This case is the third report of lipoblastoma extending into the spinal canal, the first report of intradural tumor extension, and the first report of hemiparesis resulting from lipoblastoma compressing the spinal cord. METHODS: A 13-month-old boy was seen by a pediatrician for a firm, supraclavicular neck mass on the left side. After being evaluated by CT and MRI scanning, the tumor was partially resected. RESULTS: Postoperative microscopic examination of the tumor showed adipose cells with mature nuclei and well-formed fat vacuoles interspersed with fibrovascular septa, a finding consistent with maturing lipoblastoma. CONCLUSIONS: Although lipoblastomatous tumors are treated with complete surgical resection when possible, location of these tumors in the neck may dictate partial resection to avoid intraoperative injury to the spinal cord.

Fibrolipoma en un paciente con la enfermedad de Von Recklinghausen / Fibrilipoma in a patient with Von Recklinghousen's disease

Se presenta el caso de un paciente, con antecedente de padecer de la enfermedad de Von Recklinghausen, el cual fue valorado y su conducta terapéutica fue diferida, por sospechar la presencia de un tumor neurofibromatoso. El paciente se remitió a la consulta externa de nuestro servicio y una vez concluido sus estudios, se realizó su tratamiento quirúrgco. El paciente no presentó complicaciones transoperatorias y posoperatorias; su estadía fue de 3 días. Anatomía patológica informó la presencia de un fibrolipoma (neoplasia mesodérmica). El control a los 3 años de operado mostró un paciente asintomático y sin recidiva local. En la literatura médica revisada no se informaron otros casos similares de pacientes con la presencia de un fibrolipoma en la enfermedad de Von Recklinghausen(AU)

Angiolipoma epidural: presentación de caso y revisión de literatura / Epidural angiolipoma: a case report and literature review

Se presenta el caso de una paciente de 54 años con paraparesia espática progresiva debido a comprensión de la médula espinal dorsal por tumor sólido con máximo diámetro sagital en D5-D6. La RM demostró una lesión expansiva posterior a la médula espinal sin invasión de la misma, con hiperintensidad de señal en T1 y T2, indicando se trataba de un proceso expansivo de estirpe adiposa. La resección quirúrgica y ulterior análisis histológico de la pieza confirmó un angiolipoma extradural. La recuperación neurológica a través de la descompresión quirúrgica resultó inmediata revirtiéndose los síntomas de la paciente (AU)

[Isolated trigeminal neuropathy associated with a fatty tumor of Meckel's cavum]. / Neuropatía aislada del nervio trigémino asociada a tumor graso en el cavum de Meckel.

INTRODUCTION: In recent years there has been increasing interest in isolated trigeminal sensory neuropathy. We present a case with an unusual association of this neuropathy and a fatty tumour of Meckel's cavum. CLINICAL CASE: A 24 year old man consulted for occasional episodes (during the previous two months) of dysesthesia of the right maxillary region. These were self-limiting and lasted only a few minutes. There was no lacrimation, apparent trigger factor, conjunctival injection or reduction in level of consciousness. There were no abnormal findings either on general or on full neurological examination. On cranial CT there was no signal from the tip of the right petrous temporal bone, but no space-occupying lesion nor pathological uptake of contrast material. On cranial MR there was an extra-axial lesion in the superior part of the tip of the right petrous temporal bone of 2 x 2 cm, localized to Meckel's cavum and right cavernous sinus, with a small lobule in the right lateral part of the prepontine cisterna. CONCLUSIONS: Trigeminal sensory neuropathy has been described in association with different connective tissue disorders, infections of the central nervous system, vascular dilatations and very varied types of tumours, particularly meningioma. The commonest site for lesions related to this clinical condition is the posterior fossa. A tumour in Meckel's cavum is rarely found in relation to this diagnosis, and from our review of the literature, involvement of fatty tumours seems to be rare.