Neural fibrolipoma in pharyngeal mucosal space: A rare occurrence

Neural fibrolipoma is a rare lesion presenting in early childhood, as a slow-growing fusiform swelling of a nerve, usually in the forearm or wrist (median nerve), associated with symptoms of compression neuropathy. There are only few case reports of neural fibrolipoma in neck and no such case has been reported in pharyngeal mucosal space.

A case of lipoma of lateral anterior neck treated with surgical enucleation

Lipoma arise in almost 50% of all soft tumours. The neck lipomas are rare tumours that may present as painless masses with slow growth, in the lateral portions of the neck. Some lipomas, such as the one studied in our case, grow deep in the subcutaneous tissue, in close contact with muscles. Here, we report a case of lipoma extending from pre-tragal region up to the ascending branch of the mandible in a 62 year old man, treated with enucleation. The inferior margin of lipoma involved the pharyngeal and the superior margin was achieved by the top of the skull base. The mass of lipoma caused breathing difficulties in the patient, preventing regular sleep. No complication was recorded in the post-operative period and no further surgery was performed. The complete resolution after one year's follow-up, together with the rarity of the anatomical site, makes this case worthy of description. A correct diagnosis facilitated removal of this lesion with a surgical method.

Fat-containing salivary gland tumors: a review

Fat-containing tumors of the salivary glands are uncommon. Their wide histological spectrum varies from pure lipomatous neoplasms similar to their cutaneous and soft tissue counterparts to mixed lipoepithelial lesions specific to the salivary glands. With few exceptions, these uncommon lesions affect mainly the elderly, with a mean age at presentation of ≥ 50 years and show a predilection for males. A few cases occur in childhood; some of them represent congenital lesions. In decreasing order of frequency, ordinary (soft-tissue type) lipoma, oncocytic lipoadenoma, non-oncocytic sialolipoma, and pleomorphic adenoma/myoepithelioma with extensive lipometaplasia are the main variants of fat containing tumors encountered in the salivary glands. While pleomorphic adenoma/myoepithelioma with lipometaplasia behave in the same way as their non-fat-containing counterparts, other lipomatous salivary gland tumors listed above are cured with simple excision and do not carry a risk of recurrence. Other lipoma variants (spindle cell lipoma, osteolipoma, fibrolipoma, angiolipoma, pleomorphic lipoma, lipoblastoma and hibernoma) are exceptionally rare in the salivary gland. Atypical lipomatous tumors/liposarcoma have been only rarely reported in the salivary gland and they behave in a similar fashion to their soft-tissue counterparts. Diffuse lipomatosis and lobular fatty atrophy are the two tumor-like lesions that might closely mimic sialolipoma, particularly in limited biopsy material without knowledge of the gross findings. This review summarizes the clinicopathological features of the main types of salivary fat-containing lesions and discusses their differential diagnoses.

Gastric outlet obstruction from duodenal lipoma in an adult

The duodenum is a rare site for gastrointestinal lipoma with less than 230 cases reported in the literature. Although, peptic ulcer disease remains the most common benign cause of gastric outlet obstruction (GOO), duodenal lipomas remain a rare, but possible cause of GOO and could pose a diagnostic challenge, especially in countries where access to endoscopy and modern imaging techniques poses a challenge. The authors present a case of GOO in a 40-year-old male, secondary to a duodenal lipoma. It was successfully treated by a transduodenal resection through a midline laparotomy. The histology report confirmed it was a submucosal lipoma.

Carotid sheath lipoma: first case report in the English literature

Lipomas are the most commonly encountered benign mesenchymal tumour, arising in any location where fat is normally present. Lipomas in the head and neck are rare in all age groups. Cases of vascular sheath lipomas in the femoral region have only been reported in adults. In children, vascular sheath lipomas have not been described to date. We report the first case of a carotid sheath lipoma in a seven-year-old boy. He had a non-tender soft mass with ill defined borders occupying the left upper part of the neck. Magnetic resonance imaging showed a mass at the bifurcation of the left common carotid artery without involving the same. The mass was hyperintense on T1 and T2 weighted sequences, suggestive of a lipoma. The lipoma was enucleated after incising the carotid sheath, safeguarding its contents. Histopathology confirmed it as a lipoma.

An unusual case of an intramuscular lipoma of the biceps brachii

Lipomas are common benign neoplasms consisting of mature fatty tissue. They are usually of roundish or ovoid shape and are situated in a single anatomical region. They most frequently occur on the back and in the extremities. Most lipomas are subcutaneous and require no imaging evaluation. When deep, large and unusual in location, MRI can identify and localise these tumours and is the best exploration to differentiate lipoma and lipo-sarcoma. We describe a case of a patient with an intramuscular lipoma of the biceps brachii.

Successful lumbar epidural catheter placement through a lower back lipoma

Structural abnormalities of the lumbar spine or the overlying structures may represent a relative contraindication or technical difficulty to neuraxial anesthesia. We report a case of successful epidural catheter placement through a lower back lipoma for vascular bypass surgery of the lower extremity.

Role of intraoperative squash smear cytology as a diagnostic modality in lipoma of quadrigeminal cistern

Quadrigeminal lipoma is a rare tumor that has been categorized as developmental malformation rather than a hamartoma or true neoplasm, due to its origin from abnormal persistence and mal-differentiation of meninx primitiva during the development of the subarachnoid cisterns. Reported admixture of adipose tissue with heterotopic elements also supports a developmental origin. Quadrigeminal lipomas are frequently asymptomatic and detected incidentally. Though a favorable clinical course is usually expected, recurrences may occur due to partial removal of lesions in close relation to vital structure. We describe the role of intraoperative squash smear cytology as a diagnostic aid in quadrigeminal cistern lipoma and an alternative to frozen sections that are technically difficult to obtain due to presence of lobules of fibro-adipose tissue. With radiological correlation, squash cytology can be an economical method for intraoperative diagnosis, pending subsequent histopathological confirmation.

Lipoma involving the masticator space

The lipoma is a common tumor of mesenchymal origin, usually seen on the trunk and lower limbs. In the head and neck region, it is usually seen in the posterior neck. It is rarely seen in the anterior neck, infratemporal fossa, oral cavity, pharynx, larynx and parotid gland. It may present in a variety of ways. We report a rare case of a lipoma involving the masticator space.

Management of giant intermuscular lipoma of hips: A case report and review of literature

Intermuscular lipomas are rare soft tissue tumors of mesenchymal origin. They are closely correlated with other benign and malign mesenchymal tumors in clinical presentation and imaging, causing problems in diagnosis and treatment. This study examined a rare giant intermuscular lipoma of the hip and its management, allowing clinicians to become familiar with this lesion. Furthermore, the clinical data of 13 patients with pathologically confirmed giant intermuscular lipomas (1 case treated by the authors, the remaining 12 cases reported in the Chinese literature during the period from January, 1992 to May, 2012) were also reviewed and analyzed. Based on the review, intermuscular lipomas were found to be more common in males and usually presented with an asymptomatic mass, with an average patient age of 39.7 years (range, 11-70), while symptom duration was between 1 month and 10 years. The most common tumor origin sites were the thigh and forearm and the option of treatment was surgical excision. The present study showed that it is crucial for the surgeon to consider infiltrating lipomas when dealing with deep soft tissue masses, while complete removal of the lesion was vital to avoid recurrence.

A Rare Case of Pericallosal Lipoma Associated with Bilaterally Symmetrical Lateral Ventricular Choroid Plexus Lipomas without Corpus Callosal Anomalies

Lipomas constitute less than 5% of primary brain tumors. Pericallosal lipomas (PCLp) constitute almost half of all intracranial lipomas. Corpus callosal anomalies commonly occur in cases with PCLps. Although PCLp is often described as corpus callosal lipoma, it is most often pericallosal in location. PCLps may have calcification in the periphery and may continue into lateral ventricles, which is a very rare presentation. We observed a case of PCLp with peripheral calcifications associated with PCLp continuing as bilaterally symmetrical lateral ventricular choroid plexus lipomas (CPLp) without any corpus callosal or other central nervous system anomalies, and as this is not been previously reported, we are presenting it. The appearance of PCLp in this case does not correspond to the descriptions of any of the existing morphological types (anterior and posterior) of classification of PCLps; it is rather mixed, where PCLp occupies both anterior and posterior locations around the corpus callosum.

Giant occipitocervical lipomas: evaluation with two cases

Lipomas are capsulated benign tumours that are commonly found in all body parts. A lipoma is a well-defined mesenchymal tumour that arises from the adipose tissue. Although giant lipomas are rare in the head and neck regions, when they are located here, they are most commonly found in the subcutaneous posterior neck area. Recurrence as well as invasion is very rare after total surgical excision. In this article, we present two rare cases of giant lipomas in the posterior occipitocervical region, which is an exceptional location.

Pancreatic lipoma: An incydentaloma which can resemble cancer - analysis of 13 cases studied with CT and MRI

Background:

The purpose of this article is to present computed tomography (CT) and magnetic resonance imaging (MRI) findings of rare pancreatic lipomas.

Material/Methods:

The analysis covered 13 patients (7 men and 6 women, aged 47–88, average: 65.6 years), with 13 pancreatic lipomas, whose cases constituted the basis for 10 contrast-enhanced CT and 5 MRI studies.

Results:

Lipomas measured from 6 mm to 32 mm (average 12.8 mm) and were located in the pancreatic head (n=7), body (n=2), tail (n=3) and uncinate process (n=1). Most lesions (n=11) were homogenous, well-circumscribed.

On contrast-enhanced CT scans, macroscopic fat (<−30 HU) was present in 9 lipomas. In one case (10 mm lesion) the density was −20 HU and the lesion was poorly circumscribed with septations, which altogether made it difficult to precisely characterize its contents.

On MR scans fat was demonstrated in all studied cases (n=5).

Conclusions:

Lipomas are rare, small, homogenous and well-circumscribed pancreatic tumours. The most important feature, decisive for the diagnosis and distinguishing them from pancreatic carcinoma, is detection of fatty tissue on CT and MR scans. In these cases differential diagnosis includes other rare fatty tumours of the pancreas (focal fatty infiltration, teratoma, liposarcoma).

Dendritic myxofibrolipoma: often misdiagnosed as sarcoma

The author describes a benign soft tissue tumor that could be easily mistaken for sarcoma. It represents a combined feature of solitary fibrous tumor and spindle cell lipoma. The clinical presentation, diagnosis, and management of this lesion are discussed. It highlights the importance of proper diagnosis to prevent unnecessary and ineffective treatment by clinicians as the complete excision of this lesion is the treatment of choice and recurrence is very unlikely. It is believed that this case is the first reported case of dendritic myxofibrolipoma occurring in the lower lip mucosa in an Omani patient.

Intraosseous angiolipoma of the mandible

Lipoma is a common soft-tissue tumor. There are only very few reported cases of intraosseous lipoma of the jaws in the literature. Intraosseous angiolipomas are even rarer. The exact nature of these lesions is debatable, but it is widely accepted that they represent true benign tumors. These are slow-growing tumor consisting of a mass of mature fat cells. When the vascular component within these tumors is a prominent feature, they are considered to be angiolipomas. The cause of these lesions is uncertain. Clinically, intraosseous lipoma may be asymptomatic, may cause swelling, or may show neurologic signs such as hypesthesia or paresthesia, as was manifested in this case. Radiographically, the lesion usually appears as a well-circumscribed radiolucency. The diagnosis of intraosseous lipoma of the mandible may be a challenge, due to its rarity and clinical similarity with many other radiolucent jaw lesions; therefore, the histopathological examination is always required. Here, we report a case of intraosseous angiolipoma of mandible in a 21-year-old female patient.

Giant gastric lipoma mimicking well-differentiated liposarcoma

Authors report the case of a 51-year-old man, presenting with epigastralgia of recent onset. Physical exam was unremarkable. Endoscopy revealed a large, ulcerated, submucosal, antral tumor. CT scan reveals an antral mass with fat attenuation. The patient underwent a total gastrectomy. Macroscopic examination identified in the antral wall a 9-cm, well-circumscribed, nodular lesion, with a yellow, greasy cut surface. On histological examination, the tumor was composed of a mature adipocytes proliferation, showing significant variation in cell size, associated to some lipoblasts. Nuclei were sometimes large, slightly irregular, but without hyperchromasia nor mitosis. Diagnosis of a well-differentiated liposarcoma was suspected and molecular cytogenetic analyses showed no MDM2 nor CDK4 gene amplification on fluorescent in situ hybridization. The diagnosis of lipoma was made. Twelve months following surgery, the patient is doing well.

Spontaneously occurring intracranial lipomatous hamartoma in a young BALB/c mouse and a literature review

An intracranial lipomatous hamartoma was found in the third ventricle of a 7-week-old female BALB/cAnNCrlCrlj mouse. The nodule was composed of mature white adipose cells, which contained one large fat droplet, and there was no evidence of cytological atypia. The brain parenchyma at the retrosplenial granular cortex and the hippocampus in the cerebrum were slightly compressed, and the choroid plexus was dislocated downward. Scattered capillary vessels penetrated the nodule from the surrounding tissue. Based on these findings, the lesion was diagnosed as a lipomatous hamartoma that occurred from the roof of the third ventricle. This extremely rare tumor-like nodule represents an overgrowth of the mature adipocyte population as a malformation rather than a true neoplasm.

[Acute intussusception secondary to a lipoma of the small intestine: about a case and review of the literature]

L'invagination intestinale aiguë est une pathologie du nourrisson et du petit enfant. Sa survenue chez l'adulte est très inhabituelle. Elle est d’étiologie diverse. Dans l'immense majorité des cas, elle est secondaire à une tumeur qui peut être bénigne ou maligne. L'invagination intestinale sur lipome est exceptionnelle. Nous rapportons un cas d'invagination intestinale grêlo-grêlique sur lipome.

Giant transmural lipoma of the sigmoid colon

Lipomas of the colon are relatively rare benign tumors of mesenchymatic origin. They are usually asymptomatic but as they become larger they can cause symptoms including abdominal pain, diarrhea, nausea, constipation, haematochezia, loss of body weight, anemia or even intussusception and colonic obstruction. We present a 52 year old male patient who visited the emergency room complaining of constipation, rectal bleeding, mucus in stools and a palpable rectal mass. Colonoscopy revealed a polypoid mass of the sigmoid colon lying about 30 cm from the anal verge. Sigmoidectomy was performed. The postoperative recovery was uneventful and he was discharged five days later. At follow up a month after surgery the patient was asymptomatic. The pathological examination revealed a transmural tumor of the sigmoid colon measuring a 9x5x2.5cm and histologically compatible with a lipoma.

Osteochondrolipoma of the submandibular region: a case report and review of the literature

Lipoma is an extremely common and ubiquitous benign soft tissue tumor composed of mature adipose tissue, with frequent differentiation towards other mesenchymal elements such as blood vessels, fibrous tissue, or muscle. They are typically slow-growing, encapsulated, superficial or deep, and have a wide range in size depending on their location. The presence of cartilage or bone is very rare, with most reported cases in the head and neck area. We report the case of an osteochondrolipoma of the submandibular region with associated benign bone marrow elements, with a review of the literature and discussion of the differential diagnosis.

Large oral lipoma: Case report and literature review in Iran

Lipoma is a benign mesenchymal tumor of fat with uncertain pathogenesis. Although the most common mesenchymal neoplasm in trunk and proximal portions of the extremities, it is rarely seen in the oral cavity. Oral lipomas are clinically soft, smooth-surfaced nodular masses that mostly are less than 3 cm in size. Typically the tumor is asymptomatic unless bitten or become noticeable because of their size. The buccal mucosa and buccal vestibule are the most common intraoral sites and account for 50% of all cases. Reported here is a relatively large lipoma of buccal mucosa that was treated surgically under local anesthesia. In an 18-month postsurgical follow up no complication or recurrence has occurred. This case will also be compared to intraoral lipomas reported in Iranian population. As lipomas are usually smaller than 3 cm in diameter, lipoma with the size reported, is of clinical importance. Since the large lipomas are in differential diagnosis with other, even malignant, mesenchymal, or salivary gland tumors. Thus, this case report recommends clinical awareness in diagnosis of large intraoral soft tissue lesions.

Intestinal subocclusion due to colonic lipoma: a case report

Colonic lipomas are rare benign tumors infrequently met in clinical practice. Most of them are asymptomatic making frequent their fortuitous discovery. The therapeutic approach to the fortuitous discovery of a lipoma is even less clear. The treatment depends essentially on the clinical picture, on the size of the lipoma and on its location. We report the case of a 31-year old woman, which sub-occlusive accidents events revealed a lipoma of the descending colon. The diagnosis was suspected on colonoscopy and segmental colectomy was performed. The diagnosis was confirmed by histological examination. We review the literature and discuss the clinical features, diagnosis and treatment of this uncommon disease.

Duodenal lipoma associated with ectopic duodenal glands

Duodenal lipomas are relatively uncommon and are rarely responsible for clinical symptoms. Occasionally, searching for aetiology of gastrointestinal bleeding leads to the final diagnosis of duodenal lipomas. Here, we present the case of a 68-year-old woman who suffered with repeated melena and weight loss. Endoscopy, abdominal computed tomography (CT) and histopathological outcomes are described in this case of duodenal lipoma with ectopic duodenal glands.

Vulvar lipoma: is it so rare?

Vulvar lipoma is said to be so rare that only a few cases have been reported. We present two cases of vulvar lipoma that were diagnosed within six months in our centre in a 28 year-old para 2 and 35 year-old para 1 woman both of whom presented with slow-growing masses in the vulva. A detailed discussion of the clinical features and current management options are outlined, with emphasis on the need to subject all excised lesions to histopathological evaluation; to ensure accurate diagnosis and differentiate this benign swelling from cystic swellings and malignant neoplasms in the vulva.

The appearance of angiolipomatosis after using laptop computer on the thighs: a relationship?

A 56-year-old patient developed angiolipomatosis of the anterior part of the thighs after repeated laptop contact localisation. Histological findings exhibit an unusual inflammatory infiltrate. We postulate that the computer could favour lipoma development by a physiopathological mechanism that remains to be clarified.