Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.665
Filtrar
1.
Bull Cancer ; 107(11): 1186-1198, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33059872

RESUMO

Benign and malign tumors can affect the temporomandibular joint (TMJ) as any other articulation. Nevertheless, TMJ tumors are rare and mostly benign. Their clinical expression is varied including symptomatology similar to TMJ dysfunctional disorders, otologic or neurologic pathologies. In some cases, they remain totally asymptomatic. Hence, diagnosis is difficult since the symptomatology can be misleading with TMJ dysfunctional disorders or otologic disorders wrongly diagnosed. There is thus frequently a long delay between symptoms onset and diagnosis. The great variety of TMJ lesions explains the wide range of possible treatment modalities, mostly based on surgery. We provide here a review of the lesions originating from the TMJ. Tumoral or cystic mandibular lesion affecting the TMJ through local extension will not be discussed. Osteoma, osteoid osteoma, osteoblastoma, chondroma, osteochondroma, chondroblastoma, tenosynovial giant cell tumors, giant cell lesions, non-ossifying fibroma, hemangioma, lipoma or Langerhans cell histiocytosis are all possible diagnosis among the benign tumors found in the TMJ. Pseudotumors include synovial chondromatosis and aneurysmal bone cyst. Finally, malign tumors of the TMJ include mainly sarcomas (osteosarcoma, chondrosarcoma, synovial sarcoma, Ewing sarcoma, and fibrosarcoma), but also multiple myeloma and secondary metastases. We will review the clinical, radiological and histological aspects of each of these lesions. The treatment and the recurrence risk will also be discussed.


Assuntos
Neoplasias Ósseas , Articulação Temporomandibular , Cistos Ósseos Aneurismáticos/etiologia , Cistos Ósseos Aneurismáticos/patologia , Cistos Ósseos Aneurismáticos/terapia , Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Condroblastoma/complicações , Condroblastoma/diagnóstico por imagem , Condroblastoma/cirurgia , Condroma/diagnóstico por imagem , Condroma/patologia , Condroma/cirurgia , Condrossarcoma/patologia , Condrossarcoma/terapia , Diagnóstico Diferencial , Fibrossarcoma/diagnóstico por imagem , Fibrossarcoma/patologia , Fibrossarcoma/terapia , Tumor de Células Gigantes do Osso/diagnóstico por imagem , Tumor de Células Gigantes do Osso/terapia , Tumor de Células Gigantes de Bainha Tendinosa/complicações , Tumor de Células Gigantes de Bainha Tendinosa/diagnóstico por imagem , Tumor de Células Gigantes de Bainha Tendinosa/cirurgia , Hemangioma/diagnóstico por imagem , Hemangioma/terapia , Histiocitose de Células de Langerhans/patologia , Histiocitose de Células de Langerhans/cirurgia , Humanos , Lipoma/diagnóstico por imagem , Lipoma/patologia , Lipoma/cirurgia , Mieloma Múltiplo/patologia , Osteoblastoma/diagnóstico por imagem , Osteoblastoma/patologia , Osteoblastoma/cirurgia , Osteocondroma/diagnóstico por imagem , Osteocondroma/patologia , Osteocondroma/cirurgia , Osteoma/diagnóstico por imagem , Osteoma/patologia , Osteoma Osteoide/complicações , Osteoma Osteoide/diagnóstico por imagem , Osteoma Osteoide/patologia , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/patologia , Osteossarcoma/terapia , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/patologia , Sarcoma Sinovial/diagnóstico por imagem
4.
Pan Afr Med J ; 35: 101, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32636999

RESUMO

The lipoma of the corpus callosum is a very rare benign congenital lesion, which can be isolated or associated with varying degrees of dysgenesis of the corpus callosum. It can be asymptomatic or revealed by nonspecific signs such as epileptic seizures, headache, neurological deficit or dementia. Sectional imaging makes diagnosis easily. We report the case of an 18-year-old boy who had a seizure in which imaging revealed a lipoma of the corpus callosum.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Corpo Caloso/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Adolescente , Neoplasias Encefálicas/patologia , Corpo Caloso/patologia , Humanos , Lipoma/patologia , Imagem por Ressonância Magnética , Masculino , Convulsões/etiologia
5.
Artigo em Chinês | MEDLINE | ID: mdl-32668879

RESUMO

Objective: To explore the clinical manifestations, diagnosis, treatment and prognosis of maxillofacial adipocytic neoplasia in children. Methods: The clinical data of 8 children with maxillofacial adipocytic neoplasia admitted to Shanghai Children's Hospital from August 2014 to July 2019 were retrospectively analyzed, including 6 males and 2 females, aged from 8 months to 8 years 11 months, with an average age of 44 months. The clinical characteristics, imaging findings, treatment methods and effects of 8 patients were analyzed. Results: Among the 8 patients, 5 were lipomas and 3 were lipoblastomas; 4 were in the masseter muscle region of the parotid gland, 2 were in the parapharyngeal space and 1 was in the submandibular and nasal areas separately. The clinical manifestations were mainly painless maxillofacial masses, sleep snoring and pharyngeal foreign body sensation. All of 8 patients underwent surgical treatment without complications such as infection, facial paralysis, and salivary fistula. No recurrence was observed during a follow-up of 6 months to 5 years. Conclusions: Lipoma and lipoblastoma are the main tumors of maxillofacial adipocytic neoplasia in children. The appropriate surgical incision and surgical method can be selected according to the characteristics of the area of the tumor combined with preoperative imaging examination. The prognosis of the disease is good and recrudescence is rare.


Assuntos
Lipoma , Neoplasias Bucais , Recidiva Local de Neoplasia , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Lipoma/diagnóstico , Lipoma/patologia , Masculino , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Glândula Parótida , Estudos Retrospectivos
6.
Tokai J Exp Clin Med ; 45(2): 75-80, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32602105

RESUMO

CASE PRESENTATION: The patient was a 72-year-old man who consulted with his previous physician for chief complaints of palpitations, fatigue, and blackish feces persisting for 1 month. After confirming the presence of anemia, the patient was referred to our hospital. Blood test findings upon hospital arrival revealed a hemoglobin (Hb) level of 6.0 g/dL. Computed tomography revealed a tumor of 32 mm × 30 mm with a low-density area extending from the bulb to the second part of the duodenum. Magnetic resonance imaging revealed high signal intensity on T1- and T2-weighted imaging and low signal intensity on fat-suppressed T2-weighted imaging, findings consistent with lipoma. Upper gastrointestinal endoscopy revealed a yellowish submucosal tumor that had perforated into the intestinal tract from the external wall extending from the upper corner to the second part of the duodenum. After determining that the tumor was sessile, laparoscopic partial duodenectomy with Roux-en-Y reconstruction was planned and performed. Pathology revealed a yellowish tumor 4 cm × 4 cm in size extending from the pyloric area to the duodenal bulb arising from the tunica muscularis. The present case report details our experience involving a patient who underwent surgical resection for hemorrhagic duodenal lipoma.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Duodenopatias/cirurgia , Neoplasias Duodenais/cirurgia , Duodeno/cirurgia , Hemorragia Gastrointestinal/cirurgia , Laparoscopia/métodos , Lipoma/cirurgia , Idoso , Anastomose em-Y de Roux , Imagem de Difusão por Ressonância Magnética , Duodenopatias/patologia , Neoplasias Duodenais/diagnóstico por imagem , Neoplasias Duodenais/patologia , Duodeno/patologia , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/patologia , Humanos , Lipoma/diagnóstico por imagem , Lipoma/patologia , Masculino
7.
J Card Surg ; 35(7): 1740-1742, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32484973

RESUMO

BACKGROUND AND AIMS: Lipomatous hypertrophy of the interatrial septum is an uncommon type of cardiac adipose tumor. It is extremely rare for these lesions to be located in the interventricular septum. METHODS: We report this case of incidentally diagnosed lipomatous hypertrophy of the interventricular septum with right ventricular outflow obstruction which caused minimal symptoms and Wolff-Parkinson-White pattern on EKG. CONCLUSION: We also discuss the diagnosis and management of this condition.


Assuntos
Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirurgia , Lipoma/diagnóstico , Lipoma/cirurgia , Neoplasias Lipomatosas/diagnóstico , Neoplasias Lipomatosas/cirurgia , Septo Interventricular/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia Transesofagiana , Eletrocardiografia , Feminino , Neoplasias Cardíacas/patologia , Humanos , Hipertrofia , Lipoma/patologia , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Lipomatosas/patologia , Resultado do Tratamento , Septo Interventricular/patologia , Síndrome de Wolff-Parkinson-White
8.
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
9.
Am J Otolaryngol ; 41(5): 102572, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32518018

RESUMO

Lipomas are common benign mesenchymal tumors that originate from mature adipocytes throughout the body, with 13-20% occurring in the head and neck region, however only 1-4.4% affect the oral cavity, where they are found predominately in the cheek, followed by the tongue, lips, palatal mucosa, gingiva, and floor of the mouth. Herein, we present a multimedia analysis of transoral floor of mouth lipoma resection in a 58-year-old female. Learning points include (1) Identification and stenting of Wharton's ducts in order to facilitate their functional preservation and to minimize risk of postoperative sialocele; (2) postoperative observation with airway monitoring due to expected floor of mouth edema; (3) utilization of a midline incision to minimize injury to Wharton's ducts and maximize bilateral access to the floor of mouth.


Assuntos
Lipoma/cirurgia , Neoplasias Bucais/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Edema , Feminino , Humanos , Lipoma/patologia , Pessoa de Meia-Idade , Doenças da Boca/prevenção & controle , Neoplasias Bucais/patologia , Complicações Pós-Operatórias/prevenção & controle , Doenças das Glândulas Salivares/prevenção & controle , Resultado do Tratamento
11.
World Neurosurg ; 140: 4-9, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32407922

RESUMO

BACKGROUND: Adipose lesions of nerve are generally distinguished as either extraneural or intraneural lipomas or, alternatively, lipomatosis of nerve. We present a patient with an unusual circumferential lipoma that completely encircles the right sciatic nerve and discuss a possible pathogenesis. CASE DESCRIPTION: A 44-year-old woman presented with progressive symptoms and signs of sciatic neuropathy for 1 year. Magnetic resonance imaging revealed a large lipomatous mass extending from the level of the lesser trochanter to the distal third of the femur. The sciatic nerve was completely enveloped by the lipoma in the proximal segment, partially enveloped in the mid-segment and was separate from the nerve in the distal segment. The lipoma was not covered by the epineurium. The tumor was completely resected and the patient's neurologic symptoms improved. CONCLUSIONS: The pathogenetic mechanism of the reported circumferential lipoma of the sciatic nerve is not known. Two possible mechanisms considered included 1) envelopment by an extraneural lipoma over time and 2) occurrence of a lipoma in the paraneurial compartment (and in this case, extension into an extraneural one). Based on the available literature, lipomas that circumferentially envelop the entire nerve seem to be underrecognized and poorly understood. Analogous cases of lipomas enveloping nerves or other structures than nerves have been reported in the literature. Our reported case highlights the complexity of adipose lesions affecting nerves.


Assuntos
Lipoma/patologia , Nervo Isquiático/patologia , Adulto , Feminino , Humanos , Lipoma/cirurgia , Nervo Isquiático/cirurgia
12.
Niger J Clin Pract ; 23(5): 626-630, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32367868

RESUMO

Background: Lipomas are rarely seen tumors of adipose tissue that are benign in character. Although mostly located to the subcutaneous region, specifically in the upper back, neck, and shoulder, they may also occur in thoracic cavity. Aim: They aim of the study was to analyse clinical features and outcome of treatment of intrathoracic pleural lipomas. Materials and Method: We retrospectively evaluated the clinicopathological records of seven patients with intrathoracic lipomas who had undergone surgery between 2005 and 2017. We made analyses in terms of age, gender, admission complaints, lesion locations and dimensions, diagnostic techniques, operative procedures, histopathological features, and prognosis. Results: Four women and three men with a mean age 62.7 (range, 48-75 years) were included. They had chest pain (n = 2), effort dyspnea (n = 1) as the admission symptom, whereas four patients were asymptomatic, whose lesions were detected on chest radiography on an incidental basis. The radiological features of the tumors were well-demarcated, homogenous lesions with fat density. Tumors of all cases were excised, which were located on the right side in two patients and left in five. We used video-assisted thoracoscopy in two patients, single-port video-assisted thoracoscopy in three patients, thoracotomy in two patients. All lesions were of parietal pleural origin and were located intrathoracically. They had a range of size between 4 and 10 cm, with an average of 6.7 cm. All cases were operated with complete resection. At a mean follow-up duration of 4.7 years no recurrence was noted. Conclusion: Intrathoracic lipomas are rare, benignly behaving tumors. As it may prove difficult to differentiate them from malignant lesions and they may grow in an invasive growth pattern, surgery should be pursued in all patients for both diagnosis and treatment.


Assuntos
Lipoma/cirurgia , Neoplasias Torácicas/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Toracoscopia/métodos , Toracotomia/métodos , Adulto , Idoso , Dor no Peito/etiologia , Dispneia/etiologia , Feminino , Humanos , Lipoma/patologia , Masculino , Pessoa de Meia-Idade , Lobo Parietal , Prognóstico , Estudos Retrospectivos , Neoplasias Torácicas/patologia , Resultado do Tratamento
13.
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
14.
J Card Surg ; 35(5): 1132-1134, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32237173

RESUMO

BACKGROUND AND AIM: Lipomatous hypertrophy of the interatrial septum (LHIS), a fatty tumor, is usually diagnosed on both echo and CT/MRI imaging. Cases of LHIS located outside of the interatrial septum are extremely rare and rarer still are these cases large enough to cause symptoms. The clinical literature demonstrates a misunderstanding that fatty tumors outside the intra-atrial area represent lipomas. However, pathologic understanding of these fatty tumors is clear and is based on microscopic findings. METHODS: The tumor was removed by diving the base of attachment at the left ventricular apex via a median sternotomy on cardiopulmonary bypass. RESULTS: The patient made an uneventful recovery and remains well at 6 months postoperatively. CONCLUSIONS: On rare occasions, LHIS can arise from outside the interatrial septum. An LHIS can be differentiated from a lipoma by the presence of entrapped cardiac myocytes in LHIS, making it a pathological, rather than an anatomic, diagnosis.


Assuntos
Septo Interatrial/patologia , Átrios do Coração/patologia , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/patologia , Septos Cardíacos/patologia , Lipoma/diagnóstico , Lipoma/patologia , Adulto , Procedimentos Cirúrgicos Cardíacos , Ponte Cardiopulmonar , Neoplasias Cardíacas/cirurgia , Humanos , Hipertrofia , Lipoma/cirurgia , Imagem por Ressonância Magnética , Masculino , Esternotomia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
15.
BMJ Case Rep ; 13(4)2020 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-32295795

RESUMO

Lipomas are benign soft tissue neoplasm which rarely occur in the oral cavity. Of the total reported cases of lipoma, only about 15% to 20% of cases have occurred in the head and neck region and the tongue is an even rarer site with only about 4% of the reported cases occurring in that region. They are slow growing and usually asymptomatic in nature. When it grows to a large size, it can hinder the physiological processes that are associated with the area. This case report describes the diagnostic features of tongue lipoma with a brief review of literature.


Assuntos
Lipoma/diagnóstico , Neoplasias da Língua/diagnóstico , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Lipoma/patologia , Lipoma/cirurgia , Pessoa de Meia-Idade , Neoplasias da Língua/patologia , Neoplasias da Língua/cirurgia , Resultado do Tratamento
16.
Am J Case Rep ; 21: e921447, 2020 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-32332693

RESUMO

BACKGROUND Subcutaneous lipomatous lesions are commonly encountered in clinical practice. Hibernoma is a rare subtype of the benign lipomatous tumor, representing 1% of all types. It poses a challenge due to the difficulty of differentiating it from atypical lipomatous lesions and liposarcomas, which may lead to possible inappropriate diagnosis and management. CASE REPORT We report a case of a 33-year-old male who presented with a right upper thigh swelling noticed some time prior to presentation that had started increasing in size prior to his presentation. The magnetic resonance imaging (MRI) was unable to rule out atypical lipomatous tumor and liposarcoma. An ultrasound-guided biopsy gave a diagnosis of hibernoma. The patient underwent a wide local excision, which confirmed the diagnosis of hibernoma. At the 3-year follow-up, there was no evidence of local recurrence. CONCLUSIONS Hibernoma has been reported in the literature to be discovered incidentally by radiological imaging done for other causes. However, hibernomas raise a diagnostic challenge because in most imaging modalities they are indistinguishable from other malignant tumors. A wide local excision with negative margins is key to resolving the diagnostic dilemma that a hibernoma presents, as it will provide a definitive diagnosis differentiating it from other lipomatous lesions and prevent any future recurrence. Caution is advised when dealing with lipomatous lesions, as they often overlap with malignancy. Furthermore, an MRI should be done for any subcutaneous lesion that is larger than 5 cm or shows recent growth. A biopsy can resolve the diagnostic dilemma with caution to the hypervascularity of such tumors.


Assuntos
Lipoma/diagnóstico , Neoplasias Lipomatosas/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Biópsia Guiada por Imagem , Lipoma/patologia , Lipoma/cirurgia , Lipossarcoma , Masculino , Neoplasias Lipomatosas/patologia , Neoplasias Lipomatosas/cirurgia , Tela Subcutânea/patologia , Tela Subcutânea/cirurgia
18.
Dig Dis Sci ; 65(7): 1951-1953, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32157495

RESUMO

INTRODUCTION: Lipomas are the most common non-epithelial benign tumors of the gastrointestinal tract with a reported incidence in the colon of 0.2-4.4%. These lesions are usually asymptomatic with a typical endoscopic finding of a smooth, slightly yellow, circular, polyp that is sessile in most cases, covered with normal colonic mucosa. AREAS COVERED: There are rare reported cases of alterations of the overlying mucosa such as hyperplasia, atrophy, adenomatous changes, and necrosis. EXPERT COMMENTARY: We report a rare case of pedunculated colonic lipoma of the transverse colon covered with hyperplastic and ulcerated epithelium easily misdiagnosed as an adenomatous lesion.


Assuntos
Adenoma/diagnóstico , Neoplasias do Colo/patologia , Pólipos do Colo/patologia , Mucosa Intestinal/patologia , Lipoma/patologia , Úlcera/patologia , Idoso , Colo Transverso , Neoplasias do Colo/diagnóstico , Pólipos do Colo/diagnóstico , Colonoscopia , Diagnóstico Diferencial , Feminino , Humanos , Hiperplasia , Lipoma/diagnóstico , Sangue Oculto
19.
Clin Imaging ; 64: 18-23, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32208179

RESUMO

Solitary plasmacytoma is a rare form of plasma cell neoplasm defined by local neoplastic accumulation of monoclonal plasma cells in the absence of systemic proliferative plasma cell disease. In this case report, a 65-year-old female with remote past medical history of papillary thyroid cancer presented with shoulder pain and radiographs showing an aggressive osteolytic lesion presumed to represent an osseous metastasis. The subsequent MRI and CT examinations demonstrated diffuse intralesional macroscopic fat without a nonlipogenic soft tissue component or focal, nodular mass-like enhancement. The presence of macroscopic fat in an untreated osseous lesion suggested a benign lesion with the favored diagnosis an intraosseous lipoma with non-displaced pathological fracture. Therefore, the decision was made to forego image-guided percutaneous biopsy and instead proceed directly to open surgical biopsy and partial distal claviculectomy. Pathology of the resected specimen showed focally dense infiltration of plasma cells within the marrow space and scant hematopoiesis compatible with a plasma cell neoplasm. To the best of our knowledge, this is first case report of solitary plasmacytoma of bone, or any untreated plasma cell neoplasm, containing macroscopic fat upon imaging. The decision to forego image-guided percutaneous biopsy had significant treatment implications as the primary therapy for patients with SPB is not surgical, but localized radiation therapy. Based on this case, solitary plasmacytoma of bone may be included as one of the rare fat containing malignant bone lesions and imaging guided percutaneous biopsy should be considered in symptomatic fat-containing bone lesions.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Plasmocitoma/diagnóstico por imagem , Idoso , Neoplasias Ósseas/patologia , Osso e Ossos/patologia , Doenças das Cartilagens , Feminino , Humanos , Biópsia Guiada por Imagem , Lipoma/patologia , Imagem por Ressonância Magnética , Mieloma Múltiplo , Plasmocitoma/patologia
20.
Acta Orthop Traumatol Turc ; 54(1): 59-65, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32175898

RESUMO

OBJECTIVE: The aim of this study was to investigate the immunohistochemical stain profiling of adipocytic tumors. METHODS: From our archive files between the years of 2012-2018, excised, formalin-fixed and paraffin-embedded adipocytic tumors were retrospectively screened and 61 subjects were selected. The gender, age, tumor location and tumor diameter were evaluated. The cases were investigated in terms of p16, CD34, MDM2 expression and clinicopathological information. RESULTS: Of the 61 patients included in the study, we found that 2 had hibernoma, 4 had lipoblastoma, 14 had spindle cell lipoma (SCL), 10 had lipoma, 20 had atypical lipomatous tumor/well differentiated liposarcoma (ALT/WDL), and 11 had dedifferentiated liposarcoma (DDL). In terms of diameter, ALT/WDL and DDL were significantly different from the others (p=0.001, p=0.001, respectively). There was a significant difference between the groups according to the location (p=0.001). 35% (7/20) of ALT/WDLs were in the lower extremities (thighs) and 35% (7/20) were located in the retroperitoneal region. 70% of DDLs (7/11) were located in the retroperitoneum. When CD34 expression was evaluated among the groups, a significant difference was observed (p=0.001). CD34 was positive in 92.9% of SCL cases. p16 immunoreactivity was significantly different between the groups (p=0.001). p16 expression was observed in 50.5% of ALT / WDL cases and 79% of DDL cases. CONCLUSION: p16 and CD34 expression are valuable in the differential diagnosis of lipomatous tumors when radiological and clinical considerations do not help to differential diagnosis of adipocytic tumors. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.


Assuntos
Antígenos CD34/metabolismo , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Lipoma , Lipossarcoma , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Adipócitos/patologia , Adulto , Diagnóstico Diferencial , Feminino , Expressão Gênica , Humanos , Imuno-Histoquímica , Lipoma/metabolismo , Lipoma/patologia , Lipossarcoma/classificação , Lipossarcoma/metabolismo , Lipossarcoma/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA