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Sharma S, Jain P. Angiolipoma of testis in a case of undescended testis: A rare occurrence. INDIAN J PATHOL MICR 2024; 67:482-484. [PMID: 38391373 DOI: 10.4103/ijpm.ijpm_968_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/01/2023] [Indexed: 02/24/2024] Open
Affiliation(s)
- Sudha Sharma
- Department of Pathology, Dr. YSPGMC, Nahan, Himachal Pradesh, India
| | - Puneet Jain
- Surgery, Dr. YSPGMC, Nahan, Himachal Pradesh, India
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2
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Fullenkamp A, Paolini B, Spruill L, Lewis M. Angiolipoma an Uncommon Breast Mass in Men: A Case Series. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:201-206. [PMID: 37842969 DOI: 10.1002/jum.16343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/08/2023] [Indexed: 10/17/2023]
Abstract
Angiolipomas are uncommon benign masses of the breast which are rarely described in the male breast. They do not have a typical mammographic appearance and can present with concerning features such as microcalcifications or irregular borders. Ultrasound is helpful in evaluating these masses most commonly appearing as oval, circumscribed, and hyperechoic. Clinical, radiological, and pathological information needs to be carefully evaluated as angiolipomas can be confused with malignant pathology. Three cases of angiolipomas of the male breast are reported in this study with mammographic, sonographic, and pathologic correlation.
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Affiliation(s)
- Austin Fullenkamp
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
| | - Brielle Paolini
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
| | - Laura Spruill
- Department of Pathology, Medical University of South Carolina, Charleston, SC, USA
| | - Madelene Lewis
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
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3
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CT and MRI presentation of intradural epidural angiolipoma of the thoracic spinal canal (with a case report). Radiol Case Rep 2023; 18:1721-1726. [PMID: 36895895 PMCID: PMC9989297 DOI: 10.1016/j.radcr.2023.01.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 03/03/2023] Open
Abstract
Epidural angiolipoma is a rare benign tumor consisting of mature adipocytes, blood sinuses, capillaries, and small blood vessels. It constitutes about 0.04%-1.2% of spinal axis tumors and about 2%-3% of extradural spinal tumors. We report a case of thoracic epidural angiolipoma and review the literature. We describe a 42-year-old woman who had weakness and numbness in her lower extremities prior to diagnosis and had an onset of approximately 10 months. The patient was misdiagnosed as schwannoma on preoperative imaging, possibly because neurogenous tumor is the most common intramedullary subdural tumor, and the lesion grew into bilateral intervertebral foramina. However, the lesion demonstrated high signal on the T2-weighted and T2 fat suppression sequences, and the linear low signal at the lesion edge was ignored, leading to misdiagnosis. The patient underwent posterior thoracic 4-6 laminectomy, pathectomy, and spinal decompression/vertebroplasty under general anesthesia. The final pathologic diagnosis was intradural epidural angiolipoma of the thoracic vertebra. Spinal epidural angiolipoma is a rare benign tumor that occurs frequently in middle-aged women and is mostly located on the dorsal side of the thoracic spinal canal. Magnetic resonance imaging findings of spinal epidural angiolipoma depend on the ratio of fat to blood vessels. Most angiolipomas show equal or high signal on T1-weighted images and high intensity on T2-weighted images, with significant enhancement after injection of gadolinium. The treatment of spinal epidural angiolipoma is complete surgical resection with good prognosis.
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4
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Azam R, Mrkonjic M, Gupta A, Gladdy R, Covelli AM. Mesenchymal Tumors of the Breast: Fibroblastic/Myofibroblastic Lesions and Other Lesions. Curr Oncol 2023; 30:4437-4482. [PMID: 37232796 DOI: 10.3390/curroncol30050338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/05/2023] [Accepted: 04/08/2023] [Indexed: 05/27/2023] Open
Abstract
Mesenchymal breast tumors are a rare and diverse group of tumors that present some of the most challenging cases for multidisciplinary breast cancer teams. As a result of overlapping morphologies and a lack of large-scale studies on these tumors, practices are often heterogeneous and slow to evolve. Herein, we present a non-systematic review that focuses on progress, or lack thereof, in the field of mesenchymal breast tumors. We focus on tumors originating from fibroblastic/myofibroblastic cells and tumors originating from less common cellular origins (smooth muscle, neural tissue, adipose tissue, vascular tissue, etc.).
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Affiliation(s)
- Riordan Azam
- Postgraduate Medical Education, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Miralem Mrkonjic
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5G 1X5, Canada
- Mount Sinai Hospital and Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Abha Gupta
- Department of Medical Oncology, University of Toronto, Toronto, ON M5G 1X8, Canada
- The Hospital for Sick Children and Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 1X5, Canada
| | - Rebecca Gladdy
- Mount Sinai Hospital and Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2C4, Canada
- Division of Surgical Oncology, Department of Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada
| | - Andrea M Covelli
- Mount Sinai Hospital and Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2C4, Canada
- Division of Surgical Oncology, Department of Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada
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5
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Wang K, Shi L, Su Y, Wang H, Liu L. Clinical features and surgical outcomes of spinal epidural angiolipomas. Acta Neurol Belg 2023; 123:115-120. [PMID: 33948901 DOI: 10.1007/s13760-021-01689-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/23/2021] [Indexed: 11/25/2022]
Abstract
To discuss the clinical features and surgical outcomes of spinal epidural angiolipomas. We retrospectively analyzed the medical records of patients with spinal epidural angiolipomas who were performed microsurgery between January 2003 and December 2017. The diagnosis of spinal angiolipomas was based on pathological criteria. Modified McCormick classification was applied to evaluate neurological function. There were 11 females and 9 males with ages ranged from 38 to 74 years. Fourteen lesions were located in the thoracic region, 4 in the lumbar, 1 in the lumbosacral, and 1 in the thoracolumbar region. Patients presented with nonspecific symptoms and the duration of symptoms ranged from 1 to 168 months with a mean 21.3 months. 11 cases exhibited isointense on T1-weighted imaging(T1WI) and hyperintense on T2-weighted imaging(T2WI). The other 9 cases exhibited hyperintense on T1WI and T2WI imaging. Gross total resection (GTR) was performed in 19 patients, and subtotal resection (STR) was performed in 1 patient. Postoperatively, all patients showed a recovery or improvement of neurological functions except the STR patient. There was no recurrence or regrowth of the residual lesions observed on magnetic resonance images (MRI). Usually, spinal epidural angiolipomas have two types of MRI manifestations depending on the ratio of fat to vessels. Total resection of spinal epidural angiolipoma is possible regardless of it is infiltrative or not. Postoperative radiotherapy is not recommended for subtotal resection patients. A favorable functional outcome can be expected if the patient performed early surgery.
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Affiliation(s)
- Keda Wang
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China
| | - Liang Shi
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China
| | - Yibing Su
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China.
| | - Hanbin Wang
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China
| | - Longqi Liu
- Department of Neurosurgery, Beijing Jishuitan Hospital, No 31, Xinjiekou East Street, Xicheng, Beijing, 100035, China
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6
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Zhao F, Yang Z, Yang X. A Giant Mixed Infiltrative Angiolipoma of the Back with Venous Malformation- A Case Report and Related Gene Mutation Detection. Clin Cosmet Investig Dermatol 2023; 16:53-58. [PMID: 36636636 PMCID: PMC9831088 DOI: 10.2147/ccid.s389178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/14/2022] [Indexed: 01/08/2023]
Abstract
We report a case of a middle-aged male patient with a diffuse large mixed infiltrating angiolipoma on the back with venous malformation that grew from the age of 3 years. We discussed the design of the surgical flap for this large lipoma, observed its blood supply using SPY, and screened for possible causative genes, FCGR2A, BMP5, MUC2, and KRTAP4-9. To date, no invasive lipomas of this size and duration have been reported.
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Affiliation(s)
- Fangning Zhao
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Zhenyu Yang
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China
| | - Xiaonan Yang
- The Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People’s Republic of China,Correspondence: Xiaonan Yang, Email
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7
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Angadi P, Keerthana DR. Fibrolipoma of the buccal mucosa: A rare case report. INDIAN JOURNAL OF HEALTH SCIENCES AND BIOMEDICAL RESEARCH (KLEU) 2023. [DOI: 10.4103/kleuhsj.kleuhsj_580_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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8
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Sun M, Tao B, Gao G, Shang A. Tethered Cord Syndrome Associated with Spina Bifida and Intradural Angiolipoma Coexisting with Intramedullary Arteriovenous Malformation. Clin Neuroradiol 2022; 32:1127-1130. [PMID: 35041010 DOI: 10.1007/s00062-021-01136-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 12/23/2021] [Indexed: 01/07/2023]
Affiliation(s)
- Mengchun Sun
- Department of Neurosurgery, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China.,Medical School, Nankai University, 94 Weijin Road, Nankai District, Tianjin, China
| | - Benzhang Tao
- Department of Neurosurgery, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China.,Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Gan Gao
- Department of Neurosurgery, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - Aijia Shang
- Department of Neurosurgery, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China.
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Lokdarshi G, Gaur N, Pushker N, Kashyap S. Orbital angiolipoma: a rare tumour of the orbit. BMJ Case Rep 2022; 15:e250343. [PMID: 36180105 PMCID: PMC9528476 DOI: 10.1136/bcr-2022-250343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A quadragenarian male presented with gradual protrusion of the left eyeball for 7-8 months' duration. On examination, the best corrected visual acuity in the right eye was 20/20, while in the left eye there was no light perception. Contrast-enhanced CT scan revealed a well-defined fat-density mass in the extraconal compartment of the left superior orbit, causing inferolateral globe dystopia with resultant stretching of the optic nerve. Provisionally, orbital dermoid or lipoma was considered in the differential diagnosis. Anterior orbitotomy with complete excision of the mass was performed under general anaesthesia. Histopathological examination revealed an encapsulated, lobulated lesion consisting of mature lipocytes and occasional blood vessels with thrombi. The lesion was divided into numerous lobules by thick fibrous bands. Immunohistochemical stain S100 was strongly positive in the lipocytes. At 3 months of follow-up, the patient had moderate ptosis with leucomatous corneal opacity with no recurrence.
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Affiliation(s)
- Gautam Lokdarshi
- Ophthalmology, All India Institute of Medical Sciences, New Delhi, India
| | - Nripen Gaur
- Ophthalmology, All India Institute of Medical Sciences - Bilaspur, Bilaspur, India
| | - Neelam Pushker
- Ophthalmology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kashyap
- Ocular Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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10
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Ramírez AS, Gutiérrez SVE, Rodríguez PA, Ortiz OAS, Heredia JNS. Juvenile angiolipoma in the subtemporal region, zygomatic, and pterygomaxillary fossa treated by microwave ablation – A case study and literature review. Surg Neurol Int 2022; 13:409. [PMID: 36324923 PMCID: PMC9610127 DOI: 10.25259/sni_501_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/13/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Angiolipomas are benign mesenchymal tumors that infrequently affect the head-and-neck region and can appear with infiltrating and non-infiltrating forms. Surgical excision is the treatment of choice; however, there are other alternatives to manage this condition whose consideration is quite useful to evaluate per each particular case. Case Description: An 11-year-old girl was diagnosed with non-infiltrating angiolipoma in the subtemporal region, the zygomatic, and pterygomaxillary fossa; she had a history of having undergone surgery on two previous occasions with a failed resection attempt due to the high vascularization of the injury and significant transoperative bleeding. The condition was managed with minimally invasive techniques through microwave ablation, requiring two sessions, achieving very satisfactory results both esthetically and in the final size of the lesion. Conclusion: The microwave ablation technique may turn out to be a very useful tool for the management of lesions with high vascularization such as angiolipoma. This technique offers a new possibility for initial management, both independent of and complementary to other management techniques for other lesions at the base of the skull and/or facial massif regions.
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Affiliation(s)
| | | | | | - Omar Alejandro Santana Ortiz
- Department of Health Sciences, Medical Surgeon Career Internship Program, Autonomous University of Guadalajara, Zapopan,
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11
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Chhetri P, Nandini DB, Singh KS, Banerjee S. Fibrolipoma of the Buccal Mucosa in a Geriatric Patient. J Microsc Ultrastruct 2022; 10:204-207. [PMID: 36687332 PMCID: PMC9846926 DOI: 10.4103/jmau.jmau_97_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/21/2022] [Accepted: 02/21/2022] [Indexed: 01/25/2023] Open
Abstract
Lipoma is the most common mesenchymal tumor seen in the trunk and extremities. It is rarely found in the mouth. Clinically, it resembles other lesions and is not considered in the initial diagnosis. Histopathological evaluation is needed for accurate diagnosis. Surgical excision is the main treatment modality. Histologically, many variants are described of which fibrolipoma is thought to have some recurrence. This article describes a case of fibrolipoma of the buccal mucosa in a geriatric patient.
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Affiliation(s)
- Priyanka Chhetri
- Department of Oral Pathology Microbiology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - D. B. Nandini
- Department of Oral Pathology Microbiology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India,Address for correspondence: Dr. D. B. Nandini, Department of Oral Pathology and Microbiology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India. E-mail:
| | - Koijam Sashikumar Singh
- Department of Oral Medicine and Radiology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Sumita Banerjee
- Department of Oral Pathology Microbiology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
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12
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Babiss E, Cheng E, Mema E. Radiologic and Pathologic Correlation for Angiolipomas of the Breast. JOURNAL OF BREAST IMAGING 2022; 4:177-182. [PMID: 38422429 DOI: 10.1093/jbi/wbac003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Indexed: 03/02/2024]
Abstract
Angiolipomas of the breast are rare; however, they are an important entity for the radiologist who determines radiologic-pathologic concordance and recommends appropriate management. They can present as a palpable concern, prompting diagnostic workup, or can be detected on screening breast examinations. They often present as a circumscribed low-density mass on mammography, which is hyperechoic on sonography; associated fibrin thrombi can produce soft tissue density and/or hypoechoic foci that appear hypointense on T1-weighted MRI. Due to the nonspecific radiographic appearance, tissue sampling is often required for definitive diagnosis. Pathologically, angiolipomas can be difficult to distinguish from angiosarcomas; however, scattered microthrombi in small blood vessels are a typical feature of angiolipomas. Generally, in the setting of radiologic-pathologic concordance, angiolipomas do not need to be excised and can be followed clinically when palpable. Surgical excision can be pursued when certain high-risk features, such as nuclear enlargement, an infiltrative pattern, endothelial mitoses, and a high proliferation rate, are present in the core-needle biopsy specimen.
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Affiliation(s)
- Emily Babiss
- Weill Cornell at NewYork-Presbyterian, Department of Radiology, New York, NY, USA
| | - Esther Cheng
- Weill Cornell at NewYork-Presbyterian, Department of Radiology, New York, NY, USA
| | - Eralda Mema
- Weill Cornell at NewYork-Presbyterian, Department of Radiology, New York, NY, USA
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13
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Angiolipoma of the chest wall: a case report. Surg Case Rep 2022; 8:32. [PMID: 35190922 PMCID: PMC8861245 DOI: 10.1186/s40792-022-01384-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background Angiolipoma is a rare histological variant of lipoma. Angiolipoma commonly occurs in the subcutaneous tissues of the extremity and trunk. There are few reports of angiolipoma occurring in the chest wall. Case presentation A 78-year-old woman was referred to our hospital for evaluation of angina pectoris. Coronary computed tomography (CT) showed a soft tissue nodule in the left chest wall by chance. Enhanced chest CT showed a heterogeneous enhanced nodule in the left chest wall. On magnetic resonance imaging (MRI), the lesion showed low signal intensity on T1-weighted images, heterogeneous high signal intensity on T2-weighted images and high signal intensity on fat-suppressed T2-weighted images. The lesion showed heterogeneous enhanced effect on gadolinium-based contrast agent. These radiological findings suggested neurogenic tumor with abundant blood flow or hemangioma. Video-assisted thoracic surgery (VATS) was performed for both diagnostic and therapeutic purposes. Histopathological examination of the tumor showed mature adipose tissue and capillary hyperplasia containing fibrin thrombi. These appearances were consistent with angiolipoma. She had an uneventful recovery and did not show recurrence until 8 months post-surgery. Conclusions Angiolipoma of the chest wall is extremely rare. Preoperative diagnosis is very difficult because the imaging findings of angiolipoma vary depending on the amount of vascular component and fat component, so surgical resection is suggested to be both diagnostic and therapeutic.
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Somrani K, Ammar H, Gargouri F, Mansouri N, Yedeas MD, Chkili R. A rare case report of sacral epidural angiolipoma: Diagnosis and treatment. Surg Neurol Int 2022; 13:38. [PMID: 35242404 PMCID: PMC8888184 DOI: 10.25259/sni_1115_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/17/2022] [Indexed: 11/04/2022] Open
Abstract
Background:
Spinal angiolipomas are rare benign tumors composed of mature adipose tissue and anomalous vascular channels. The sacral localization is extremely rare. To the best of our knowledge, there have been only two cases reported in the literature. Herein, we present an additional case of sacral angiolipoma.
Case Description:
We present a case of a 54-year-old woman who presented with the right lumbosciatica and distal crural weakness. Spinal MRI showed an epidural lesion at the level of L5-S1 extending to the first right sacral foramen. The patient had total resection of the tumor and the histological study concluded to an angiolipoma. The patients’ neurologic symptoms improved postoperatively and follow-up revealed no signs of tumor recurrence.
Conclusion:
Despite the rarity of sacral localization in angiolipomas, it is a diagnosis to be considered in the case of an epidural tumor with foraminal extension. Magnetic resonance imaging is important for detecting and characterizing spinal angiolipomas despite diagnosis is not always obvious. After surgical removal, the functional prognosis is generally favorable.
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Affiliation(s)
- Kaouther Somrani
- Department of Neurosurgery, Military Hospital of Instruction of Tunis, Tunis, Tunisia
| | - Hichem Ammar
- Department of Neurosurgery, Military Hospital of Instruction of Tunis, Tunis, Tunisia
| | - Faten Gargouri
- Department of Pathology, Military Hospital of Instruction of Tunis, Tunis, Tunisia
| | - Nada Mansouri
- Department of Pathology, Military Hospital of Instruction of Tunis, Tunis, Tunisia
| | | | - Ridha Chkili
- Department of Neurosurgery, Military Hospital of Instruction of Tunis, Tunis, Tunisia
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15
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Umana GE, Visocchi M, Roca E, Passanisi M, Fricia M, Tranchina MG, Tomasi SO, Nicoletti GF, Cicero S, Scalia G. Thoracic Spinal Angiolipomas: A Systematic Review. J Neurol Surg A Cent Eur Neurosurg 2021; 83:161-172. [PMID: 34929751 DOI: 10.1055/s-0041-1739217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Spinal angiolipomas (SAs) are rare, benign tumors, representing 0.0004 to 1.2% of angiolipomas, usually located at the extradural and posterior thoracic level, with multimetameric extension. METHODS A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The authors searched on PubMed and Scopus databases for published articles with the Mesh term "spinal angiolipoma" and pertinent associations. Language restriction to English papers was applied. The authors also reported three emblematic cases of patients who underwent surgical resection of spindle-shaped (type IA) and dumbbell-shaped (type II) SAs between 2014 and 2020. RESULTS Of the 256 retrieved articles, 33 were included in the meta-analysis. These 33 studies, together with our 3 reported cases, included a total of 60 patients, 36 females (60%) and 24 males (40%), with a mean age of 53.12 ± 12.82 years (range: 12-77 years).T5 was the most represented level (22 patients). Usually, the localization of SA was extradural, with 53 patients suffering from spindle-shaped type IA SA (88.3%) and 7 patients from dumbbell-shaped type II SA (11.6%). Almost all patients underwent laminectomy (78.3%) and presented a full recovery of motor deficits (85%). Gross total removal (GTR) was performed in 93.3% of patients. The mean follow-up was of 22.71 ± 21.45 months (range: 2-80 months). There was no documented recurrence at follow-up magnetic resonance imaging in any of the patients. CONCLUSIONS SAs are rare, benign tumors with a great vascular component that presents a favorable outcome. GTR is the gold standard treatment and usually an adjuvant therapy is not required. Even infiltrative lesions, which are more complex, can be treated successfully with a good prognosis. Dumbbell-shaped SAs must be differentiated from schwannomas and meningiomas, and require different surgical techniques, given the profuse bleeding associated with the attempt of debulking. En block resection is the key to treat these common benign tumors with acceptable blood loss.
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Affiliation(s)
| | - Massimiliano Visocchi
- Department of Neurosurgery, Policlinico Universitario Agostino Gemelli, Roma, Lazio, Italy.,Catholic University of the Sacred Heart Rome Campus, Roma, Italy
| | - Elena Roca
- Department of Neurosurgery, Head and Neck Surgery, Poliambulanza Foundation Hospitals, Brescia, Lombardia, Italy
| | - Maurizio Passanisi
- Department of Neurosurgery, Azienda Ospedaliera Cannizzaro, Catania, Sicilia, Italy
| | - Marco Fricia
- Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy
| | | | | | | | | | - Gianluca Scalia
- Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Sicilia, Italy
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A rare primary posterior mediastinal angiolipoma: A case report. Respir Med Case Rep 2021; 34:101536. [PMID: 34754750 PMCID: PMC8556652 DOI: 10.1016/j.rmcr.2021.101536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/29/2021] [Accepted: 10/19/2021] [Indexed: 11/22/2022] Open
Abstract
Mediastinal angiolipoma is a rare benign neoplasm composed of mature adipose tissue with an abnormal vessel. Owing to its unspecific symptoms and slow progressions, the diagnosis of this disease is often delayed by clinicians. Here we present a 68-years-old-woman presented with mild chest pain radiates to the back with chronic dry cough. Chest imaging showed right medial posterior intrathoracic mass attached to 3rd-5th vertebrae body without bone destructions. Exploratory thoracotomy with segmentectomy was successfully performed. Histopathology examinations showed adipose tissue surrounded by a blood vessel nest, typical for angiolipoma. The patient showed rapid recovery and was discharged a week after the surgery. After two years of follow-up, the patient showed no sign of tumor recurrence and was clinically stable. This case is the first occurrence of non-infiltrating mediastinal angiolipoma reported in Southeast Asia. This is the first case report of non-infiltrating mediastinal angiolipoma in Southeast Asia. Histopathology examination may be performed by using an invasive or non-invasive procedure. In developing countries where VATS cannot be carried out, early complete resection is essential to get favorable outcomes.
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Giant Posttraumatic Angiolipoma of the Forearm: A Case Report and Review of the Literature. Case Rep Orthop 2021; 2021:4047777. [PMID: 34336328 PMCID: PMC8318740 DOI: 10.1155/2021/4047777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/03/2021] [Indexed: 12/15/2022] Open
Abstract
Angiolipoma is a type of lipoma, a benign soft tissue tumor. It is distinguished by the excessive degree of vascular proliferation and the presence of mature adipocytes. It occurs commonly on the trunk and extremities. Angiolipomas larger than 4 cm are classified as "giant," and due to their size, histological evaluation is necessary to exclude malignancy. We report a case of a male patient who suffered from a giant noninfiltrating intramuscular angiolipoma which formed after venipuncture in the antecubital fossa. Clinical examination showed a palpable painless soft mass. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a giant angiolipoma on the right forearm. Surgical removal of the mass was performed, and the biopsy was negative for malignancy. To the best of our knowledge, this is the first report in the literature of posttraumatic intramuscular angiolipoma. Physicians and orthopedic/general surgeons should be aware of the possibility of soft tissue masses in a posttrauma situation.
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18
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Porter K, Boring M, Jehu TM, Neychev V. Digital angiolipoma: uncommon location and presentation of a common tumour. BMJ Case Rep 2021; 14:14/5/e241777. [PMID: 34011637 DOI: 10.1136/bcr-2021-241777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 56-year-old woman presented with an enlarging soft-tissue mass of the left ring finger, causing worsening range of motion in the metacarpophalangeal and interphalangeal joints. Excision of the mass was performed and a 3.5×3.5×3 cm lipoma was found displacing the digital neurovascular bundles laterally and posteriorly. Surgical pathology revealed a rare angiolipoma. This case was unusual because of the location of the mass, and the fact that it was non-tender, and larger than the typical angiolipoma presentation. Definitive identification of angiolipomas, especially those without gross vascularisation, as in this case, is often delayed until final pathology. Reporting cases of angiolipoma of the finger will increase awareness of this rare lesion and broaden the differential diagnosis to improve identification and management in future cases. We discuss a surgical approach which successfully increased range of motion of the hand and preserved neurovascular integrity.
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Affiliation(s)
- Katherine Porter
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Michael Boring
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Tara M Jehu
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Vladimir Neychev
- University of Central Florida College of Medicine, Orlando, Florida, USA
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19
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Sun J, Kang W, Zeng Z, Zhang Z, Wang X. Rare localization of angiolipoma in the gastrointestinal tract: a case series. J Int Med Res 2021; 48:300060520938589. [PMID: 32972286 PMCID: PMC7522849 DOI: 10.1177/0300060520938589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective Angiolipoma is a benign tumor that rarely occurs in the gastrointestinal (GI) tract. This case series was performed to increase clinicians’ understanding of the diagnosis and management of GI angiolipoma. Methods We evaluated the clinical presentations, diagnoses, and treatments of 3 patients with angiolipoma in the upper GI tract in our hospital and 27 cases reported in the literature. Results Among all 30 cases of GI angiolipoma, 2 originated in the esophagus, 4 in the stomach, 2 in the duodenum, 1 in the jejunum, 7 in the ileum, 1 in the cecum, 9 in the colon, 2 in the rectum, and 2 in both the duodenum and colon. Conclusion Angiolipoma of the GI tract may be more likely to occur in middle-aged and elderly men and be located in the ileum and colon. The clinical manifestations generally involve upper GI hemorrhage and lower GI pain and obstruction. Computed tomography and endoscopy may be effective diagnostic techniques, but postoperative histopathologic examination is still the gold standard. The management of angiolipoma in the GI tract depends on the size and type of lesion. Most cases in the present series were managed by complete surgical resection, after which no recurrence was found.
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Affiliation(s)
| | - Weiming Kang
- Wei-Ming Kang, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, No. 1 Shuaifuyuan Street, Dongcheng District, Beijing 100730, China.
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20
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Nakamura D, Kobayashi N, Miyazawa M, Satomi H, Ihara N, Tsunoda M. Primary posterior mediastinal angiolipoma: a case report. J Surg Case Rep 2021; 2021:rjab168. [PMID: 33981406 PMCID: PMC8101613 DOI: 10.1093/jscr/rjab168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
An angiolipoma is a benign tumor, and a primary mediastinal angiolipoma is extremely rare. Herein, we describe the presentation and management of a posterior mediastinal angiolipoma in a woman with loss of consciousness. Chest computed tomography (CT) revealed a contrast-enhancing mass in the right posterior mediastinum, with intercostal arterial blood supply identified on three-dimensional reconstruction CT (3D-CT). Magnetic resonance imaging revealed a fatty component. Pre-operative embolization of the supplying intercostal artery was performed to reduce intraoperative bleeding. Mass resection was performed using video-assisted thoracic surgery. Histopathology confirmed angiolipoma diagnosis. Although rare, a posterior mediastinum angiolipoma should be considered a possibility; 3D-CT and pre-operative embolization may be useful in the surgical treatment of hypervascular mediastinal tumors, such as angiolipomas.
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Affiliation(s)
- Daisuke Nakamura
- Department of Thoracic Surgery, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Nobutaka Kobayashi
- Department of Thoracic Surgery, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Masahisa Miyazawa
- Department of Thoracic Surgery, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Hidetoshi Satomi
- Department of Pathology, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Nobumaro Ihara
- Department of Radiology, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
| | - Mayu Tsunoda
- Department of Radiology, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan
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21
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Benhayoun O, Makhchoune M, Jehri A, Yassine Haouas M, Hilmani S, Lakhdar A. Spinal extradural angiolipomas: A case report. Ann Med Surg (Lond) 2021; 65:102289. [PMID: 33912345 PMCID: PMC8066406 DOI: 10.1016/j.amsu.2021.102289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
Angiolipoma are benign tumors composed of mature adipocytes ad mixed with abnormal vascular elements. It reportedly accounts for 0.1–0.5% of all spinal axis tumors in adults and is extremely rare in children. This article describes a case of spinal extradural angiolipoma in a 35-year-old man, who presented with paraplegia and sphincter disorders, the MRI showed extradural spinal lesions at the level of T7 to T10, that squeezed the spinal cord. We attained total resection without any further neurological complication. The diagnosis of SEALs initially can be challenging radiologically since they may imitate other spinal lesions. The gold standard treatment modality should always be surgery, however in some cases, total resection can not be done. This paper presents a 35-year-old man complaining for 1 months a numbness and lowerlimbs heaviness. The neurological examination revealed paraplegia with a muscle power was 2/5. However, in lower limbs, the deep tendon reflexes were absent, walking was impossible also without any sensitive disorder. MRI revealed T7-T10 extradural spinal lesion. The tumor appeared as an hyperintense on T1 and T2-weighted images, and as heterogeneous on STIR. Total resection after dissecting the tissue around the tumor. The histopathological examination of the specimens obtained, showed that the lesion was made up of fatty tissue and angioma-like tissue. SAL is a rare benign tumor and considered as a specific clinico-pathological entity. MRI is considered to be the “gold standard” in diagnosing SAL and surgery appears to be the treatment of choice.
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Affiliation(s)
- Othman Benhayoun
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
| | - Marouane Makhchoune
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
| | - Abdelhamid Jehri
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
| | | | - Said Hilmani
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
| | - Abdelhakim Lakhdar
- Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco
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22
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Yang T, Niu C. Microsurgical treatment for spinal epidural angiolipomas. Acta Neurol Belg 2021; 121:421-427. [PMID: 31309454 DOI: 10.1007/s13760-019-01192-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/08/2019] [Indexed: 12/22/2022]
Abstract
Spinal epidural angiolipomas are rare lesions composed of mature lipomatous and angiomatous elements. In this paper, the authors review a surgical series of ten patients with epidural angiolipomas. All patients had performed preoperative and postoperative magnetic resonance imaging. The diagnosis of angiolipoma was based on pathology. All the follow-up data were obtained during office visits. There were 5 males and 5 females with a mean age of 53.6 years. One tumor was located in the cervicothoracic, six in the thoracic, and three in the lumbar spine. The most common symptom was progressive motor deficit. Gross total resection of the tumor was achieved in nine cases, and subtotal resection was obtained in one case. No recurrence or regrowth of the residual tumor was observed during a follow-up period of 50.8 months. At the last follow-up, 90% of patients experienced improvement in the neurological function. Epidural angiolipomas are benign but clinically progressive lesions. Early surgery should be performed to prevent irreversible neurological deficits. Postoperative radiotherapy is not recommended. The risk of long-term recurrence/regrowth of the lesions is low, and a good clinical outcome after total or subtotal removal can be expected.
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Affiliation(s)
- Tao Yang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, People's Republic of China
| | - ChaoShi Niu
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, People's Republic of China.
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23
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Yeo SM, Lee JK, Kim HS, Park CG, Jung JK, Kim DJ, Chung YJ, Ryu HJ. Gastric Angiolipoma Resected with Endoscopic Submucosal Dissection. Clin Endosc 2021; 54:432-435. [PMID: 33715342 PMCID: PMC8182249 DOI: 10.5946/ce.2020.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 12/07/2020] [Indexed: 11/14/2022] Open
Abstract
Angiolipoma is a benign fatty neoplasm that has components of proliferating blood vessels. These types of lesions commonly occur in the subcutaneous tissue of the limbs and trunk. Angiolipoma in the gastrointestinal tract is extremely rare, and the final diagnosis generally depends on histological examination of the excised biopsy. In most previously reported cases, the lesions were diagnosed and treated with surgical management. In this study, we report a case of gastric angiolipoma of approximately 4 cm in size that was diagnosed and treated with endoscopic submucosal dissection.
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Affiliation(s)
- Sang Myung Yeo
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jae Kwang Lee
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Hyun Soo Kim
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Chang Geun Park
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jae Kwon Jung
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Dae Jin Kim
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Yun Jin Chung
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Han Jun Ryu
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
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24
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Wang L, Tang Y, Yin H, Hu S. 18F-PSMA-1007 PET/CT uptake in multiple angiolipomas caused by PSMA expression in capillaries: a case report. Transl Androl Urol 2021; 10:991-996. [PMID: 33718100 PMCID: PMC7947451 DOI: 10.21037/tau-20-1099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Prostate specific membrane antigen (PSMA) is a transmembrane glycoprotein that was originally cloned in the membrane of prostate gland epithelial cells. It has been confirmed to be highly expressed in prostate cancer cells, and in some non-prostatic tissues, including the brain and some benign lesions. PSMA-based imaging has been extensively used for the assessment of prostate carcinoma. The high uptake of PSMA imaging in these non-prostate cancer lesions may lead to some misdiagnosis. It is of important clinical significance to explore the possible causes of high PSMA uptake in these lesions. Here, we present a case of a 77-year-old man with prostate carcinoma who underwent a whole-body 18F-PSMA-1007 positron emission tomography/computed tomography (PET/CT) scan for staging. The results of the scan showed intense tracer uptake in both the prostatic bed and in multiple subcutaneous lesions. The subcutaneous lesions were later found to be angiolipomas by histopathological examination. Immunohistochemistry demonstrated strong positive cytoplasmic PSMA staining in lesional prostate cancer cells in prostate carcinoma, and mild-to-moderate positive cytoplasmic capillary PSMA staining in angiolipoma fatty density nodules. Our case report therefore demonstrated that 18F-PSMA-1007 PET/CT uptake in multiple angiolipomas was caused by PSMA expression in capillaries, and further knowledge of PSMA expression in benign lesions may be critical to minimize false-positive findings with 18F-PSMA-1007 PET/CT imaging.
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Affiliation(s)
- Long Wang
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yongxiang Tang
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Hongling Yin
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, China
| | - Shuo Hu
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Biological Nanotechnology of National Health Commission, Xiangya Hospital, Central South University, Changsha, China
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25
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Ikpeze T, Kulp A, Williams D, Huber A, Mesfin A. Lumbar Extradural Angiolipoma: Clinical Presentation and Management. Cureus 2020; 12:e12380. [PMID: 33527059 PMCID: PMC7842241 DOI: 10.7759/cureus.12380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Angiolipomas are rare primary benign tumors that can arise in the epidural canal and cause stenosis. Of the few cases of spinal angiolipomas described, most lesions have been located in the thoracic spine, and presentation of angiolipoma in the lumbar spine is very rare. The surgical management of a 39-year-old morbidly obese woman with angiolipoma that caused stenosis with neurogenic claudication and urinary changes is described. The lesion spanned L1-L2 and surgical management consisted of T12-L2 laminectomy and en-bloc resection of the lesion. During the latest follow-up, four years after the surgery, the patient’s neurological symptoms showed improvement and there was no recurrence.
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Affiliation(s)
- Tochukwu Ikpeze
- Emergency Medicine, Hospital Corportation of America Kingwood, University of Houston, Houston, USA
| | - Abigail Kulp
- Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, USA
| | - Devin Williams
- Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, USA
| | - Aaron Huber
- Pathology, University of Rochester Medical Center, Rochester, USA
| | - Addisu Mesfin
- Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, USA
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26
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Abstract
Spinal angiolipomas (SALs) are extremely rare benign tumors composed of both mature fatty tissue and anomalous vascular channels. We present two cases of SALs and review the clinical presentation, radiological appearance, pathological aspects, and treatment of this distinct clinicopathological mass. The patients’ neurologic symptoms improved postoperatively and follow-up revealed no signs of tumor recurrence or neurological deficit. SAL should be considered as a differential diagnosis in patients with spinal cord compression. Magnetic resonance imaging is important for detecting and characterizing SALs. The gold standard treatment modality should be total resection.
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Affiliation(s)
- RuiDeng Wang
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Hai Tang
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
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27
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DeGiovanni JC, Simmonds J, Lang-Orsini M, Lee A. Recurrent Intramuscular Hemangioma (Infiltrating Angiolipoma) of the Lower Lip: A Case Report and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2020; 101:306-311. [PMID: 32921186 DOI: 10.1177/0145561320957759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To report a case of a recurrent intramuscular hemangioma (IMH) of the lower lip of a 68-year-old female and review the published literature to provide an overview of the presentation, diagnostic strategy, pathological classification, and management of these lesions within the oral cavity. METHODS A case report was conducted by reviewing the documentation at a single institution. A systematic literature review on OVID MEDLINE and PubMed was performed using the MESH terms "intramuscular hemangioma" and "oral cavity," "tongue," "cheek," "buccal," "gingiva," and "lip." RESULTS A 62-year-old female presented to our institution with a 2 × 2 × 1 cm IMH of the lower lip involving the surrounding orbicularis oris muscle. She underwent a submucosal resection and did well postoperatively. Six and a half years later, she represented to our institution with a new lower lip lesion in the area of her previous resection. Preoperative magnetic resonance imaging showed a new 10 × 11 mm lesion with a well circumscribed central component surrounded by ill-defined tissue. Preoperative angiography showed that the lesion was supplied by vessels branching off the left facial artery, which were embolized. She underwent wide-local excision (WLE) with bilateral advancement flaps and at her 2-month postoperative visit has not had recurrence. CONCLUSION Only 39 cases of IMH in the oral cavity have been reported, with only 3 others occurring in the lower lip. Here we add the first case of an IMH of the oral cavity that recurred after primary WLE. The patient was successfully retreated with WLE. At a 3-month follow-up visit, she noted some incompetence with oral secretions and occasional tingling along the incision site but no evidence of recurrence.
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Affiliation(s)
| | | | | | - Arnold Lee
- Tufts University School of Medicine, Boston, MA, USA.,1867Tufts Medical Center, Boston, MA, USA
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28
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Morgan KM, Hanft S, Xiong Z. Cranial intraosseous angiolipoma: case report and literature review. Intractable Rare Dis Res 2020; 9:175-178. [PMID: 32844077 PMCID: PMC7441033 DOI: 10.5582/irdr.2020.03038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Angiolipomas are slow-growing, soft tissue tumors consisting of mature adipocytes and thin-walled blood vessels. While most angiolipomas are subcutaneous lesions in the trunk and upper extremities, intraosseous angiolipomas are rare at cranial site. We present the case of a 61-year-old female with an enlarging lesion in the left frontoparietal skull following minor head trauma. Radiography confirmed an expansile, enhancing, spiculated bony lesion in the left frontoparietal calvarium with extension outside the cortex into the soft tissues. She underwent a craniectomy for complete resection of the calvarial mass, which was histologically composed of mature adipocytes and disorganized blood vessels highlighted by an immunophenotype positive for S100 and CD34, respectively, consistent with a cranial intraosseous angiolipoma. The review of the literature that reported five cases of cranial intraosseous angiolipoma with our case representing the sixth case is discussed.
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Affiliation(s)
- Katherine M. Morgan
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA
| | - Simon Hanft
- Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA
| | - Zhenggang Xiong
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA
- Address correspondence to:Zhenggang Xiong, Neuropathology Division, Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School and University Hospital, Rutgers University, 125 Paterson Street, MEB 231, New Brunswick, NJ 08903, USA. E-mail:
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29
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Noia G, Basilico M, Vitiello R, Perna A, Leone A, Rumi N, Tamburrelli FC. Thoracic spine fracture associated with an extradural lipoma: Case report and systematic review of the literature. Orthop Rev (Pavia) 2020; 12:8684. [PMID: 32913612 PMCID: PMC7459376 DOI: 10.4081/or.2020.8684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 02/08/2023] Open
Abstract
Isolated extradural lipoma (IEL), not associated to spinal dysraphisms, is a rare condition. Frequently IEL was confused with much more frequent diffuse lipomatosis. The lesion can be completely asymptomatic and occasionally diagnosed with magnetic resonance (MR) imaging. This paper describes a case of a patient with an axial compression fracture of the thoracic spine associated with an extradural lipoma. We also performed a systematic review of the pertinent literature in order to retrieve the key information regarding: the diagnosis, the clinical features and the treatment.
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Affiliation(s)
| | | | | | | | - Antonio Leone
- Istituto di Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicolò Rumi
- Istituto di Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy
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30
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Reiser V, Haj Yahya B, Chaushu G, Kaplan I, Hamzani Y. Angiolipoma in the Head and Neck: Imaging, Diagnosis and Management. ACTA ACUST UNITED AC 2020; 56:medicina56060283. [PMID: 32532063 PMCID: PMC7353847 DOI: 10.3390/medicina56060283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/28/2020] [Accepted: 06/08/2020] [Indexed: 11/22/2022]
Abstract
Angiolipoma, distinguishable from other lipomas by its excessive degree of vascular vessels, are rare in the head and neck and require unique management. A slow growing mass, located underneath the inferior border of the right mandibular angle of a 51-year-old female, was excised under general anesthesia. Unexpected excessive bleeding during the excision was observed and the histological specimen was diagnosed as angiolipoma. As shown in this case report, pre-operative imaging modalities have a crucial influence and are sufficient to diagnose and manage angiolipomas. The “Gold standard” treatment is excision with clear margins and bleeding management should be taken into account according to appropriate differential diagnosis.
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Affiliation(s)
- Vadim Reiser
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel; (V.R.); (B.H.Y.); (G.C.)
| | - Bahaa Haj Yahya
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel; (V.R.); (B.H.Y.); (G.C.)
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel; (V.R.); (B.H.Y.); (G.C.)
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Ilana Kaplan
- Department of Oral Pathology, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel;
| | - Yafit Hamzani
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49100, Israel; (V.R.); (B.H.Y.); (G.C.)
- Correspondence:
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31
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Jaiswal PA, Divakar G, Krishnakumar K, Karthikayan A, Sawakare Y, Mhatre R, Abraham M. Spinal angiolipoma-a rare but reversible cause of paraplegia in a child. Childs Nerv Syst 2020; 36:1121-1125. [PMID: 32052158 DOI: 10.1007/s00381-020-04542-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/08/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Spinal angiolipomas are benign spinal epidural tumors consisting of mature fat cells with angiomatous components. These tumors are rare in children and there are no definite management guidelines. METHOD To the best of our knowledge, only five cases of spinal angiolipomas have been reported in children below 12 years. This article discusses the presentation, diagnostics, and surgical tips for the management of a case of spinal angiolipoma. RESULT In this paper, we present a one and half-year-old child presenting with a spontaneous spinal epidural hematoma from a spinal angiolipoma and underscore the importance of early surgery in a benign disease for a good outcome. CONCLUSION Overall neurological recovery and prognosis following timely intervention for spinal angiolipomas are good.
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Affiliation(s)
- Palak A Jaiswal
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Ganesh Divakar
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India.
| | - K Krishnakumar
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Arunkumar Karthikayan
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Yogesh Sawakare
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Radhika Mhatre
- Department of Pathology, National Institute of Mental Health and Neurosciences (NIMHANS), Benguluru, India
| | - Mathew Abraham
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, Kerala, India
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Iampreechakul P, Tangviriyapaiboon T, Liengudom A, Lertbutsayanukul P, Thammachantha S, Siriwimonmas S. Sacral Extradural Angiolipoma Associated with Tight Filum Terminale and Spina Bifida Coexisting with Spinal Arteriovenous Fistula. World Neurosurg 2020; 140:37-45. [PMID: 32407913 DOI: 10.1016/j.wneu.2020.04.239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Spinal arteriovenous fistula (AVF) may rarely associate with spinal dysraphism, that is, tethered spinal cord and spinal intradural lipoma. Spinal extradural angiolipoma coexisting with spinal AVF has not been reported in the literature. We reported an extremely rare case of sacral angiolipoma associated with tight filum terminale and sacral spina bifida coexisting with spinal AVF within this tumor. CASE DESCRIPTION A 55-year-old women presented with progressive myelopathy for 10 months. She had a painless, slow-growing mass at her left buttock since birth. Magnetic resonance imaging of the lumbosacral spine showed an extradural mass at the level of S3-S4, extending from the spinal canal through the spina bifida to the subcutaneous fat of the left buttock. There was a low conus medullaris at S2. Magnetic resonance imaging of the thoracic spine disclosed venous congestion with tortuous intradural flow voids along both ventral and dorsal surfaces of the spinal cord. Magnetic resonance angiography and spinal angiography revealed a hypervascular mass at the sacral level and associated arteriovenous shunt with cranial drainage into an enlarged medullary vein. Due to an infected pressure sore on the mass, endovascular treatment was initially performed with minimal recovery. Six months after complete healing of her infected pressure ulcer, the patient underwent surgical removal of extradural mass containing the AVF, and subsequent release of the tight filum. Histologic findings were consistent with angiolipoma. CONCLUSIONS Sacral extradural angiolipoma in the present case may be congenital in origin with development of an acquired spinal AVF within the tumor.
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Affiliation(s)
| | | | - Anusak Liengudom
- Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand
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Endoscopic Submucosal Dissection of the Angiolipoma at Hypopharynx-Esophageal Introitus. Gastroenterol Res Pract 2020; 2020:3581267. [PMID: 32148476 PMCID: PMC7042500 DOI: 10.1155/2020/3581267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/07/2020] [Indexed: 11/17/2022] Open
Abstract
Angiolipoma in the region of the hypopharynx-esophageal introitus is a rare occurrence. Surgical treatment was performed in the few cases reported in the literature. Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for hypopharyngeal and esophageal lesions. Our objective was to evaluate the feasibility, safety, and efficacy of ESD for treatment of angiolipoma at the hypopharynx-esophageal introitus. The patients with submucosal tumors at the hypopharynx-esophageal introitus were diagnosed as angiolipoma by preoperative evaluation with endoscopy, endoscopic ultrasonography, and computed tomography (CT). The patients who were diagnosed with angiolipoma agreed to undergo endoscopic submucosal dissection. Under general anesthesia and endotracheal intubation, ESD was used to remove the lesions. Preoperative, intraoperative, and postoperative data were collected and analyzed to evaluate the feasibility, safety, and effectiveness of endoscopic submucosal dissection. From January 2013 to December 2018, 6 cases of angiolipoma were treated with ESD with a success rate of 100%. The average operation time was 107.0 ± 69.4 minutes. Intraoperative blood loss is the main risk. Endoscopic thermocoagulation successfully stopped bleeding in all cases. Pharyngeal pain and painful swallowing were the main clinical signs. There was no stricture at the hypopharynx-esophageal introitus after the operation. ESD treatment of angiolipoma at hypopharynx-esophageal introitus is feasible, safe, and effective.
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Spinal angiolipoma: Presentation of two cases and review of the literature for the years 2012–2017. Neurocirugia (Astur) 2020; 31:76-86. [DOI: 10.1016/j.neucir.2019.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/25/2019] [Accepted: 04/17/2019] [Indexed: 12/27/2022]
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Kaorey N, Mandale M, Bhavthankar J. Adipocytic tumors of orofacial region: Clinicopathologic appraisal of ten cases with a review of its variants. J Oral Maxillofac Pathol 2020; 24:S115-S119. [PMID: 32189918 PMCID: PMC7069150 DOI: 10.4103/jomfp.jomfp_8_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/30/2020] [Indexed: 02/05/2023] Open
Abstract
Lipomas are the most common benign tumors. However, their presence in oral cavity is albeit erratic. Even scarcer is the prevalence of the various histopathological variants. We, hereby, report the wide range of clinical and histopathologic presentations of these uncommon entities affecting the orofacial region. Discussed herein are six cases of lipomas, two cases of intramuscular lipomas and one case each of osteolipoma and sialolipoma.
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Affiliation(s)
- Nivedita Kaorey
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Aurangabad, Maharashtra, India
| | - Mandakini Mandale
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Aurangabad, Maharashtra, India
| | - Jyoti Bhavthankar
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Aurangabad, Maharashtra, India
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Son BS. Non-infiltrating mediastinal angiolipoma presenting with recurrent pleural effusion: A rare case report. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Intratesticular Angiolipoma: A Rare Case of Adipose Tissue Presence in the Testis. Case Rep Urol 2019; 2019:7606530. [PMID: 31934489 PMCID: PMC6942722 DOI: 10.1155/2019/7606530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/08/2019] [Accepted: 12/19/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction Solid, fat-containing tumors of the testes are extremely rare with only a few cases having been reported so far, contrary to the more frequent occurrence of paratesticular lipomatosis. Testicular angiomyolipomas and gonadal involvement in Cowden's disease, although infrequently occurring, are known examples of fat-bearing testicular lesions. Hereby, we present an extremely rare case of intratesticular angiolipoma. Angiolipomas are benign tumors of the subcutaneous tissue commonly occurring in the trunk and the extremities. Histologically, they are characterized by ample vascularity and an excess of mature adipocytes. Definitive diagnosis is established by biopsy of the lesion. Presentation of the Case A 35-year-old patient presented to our andrology outpatient clinic for fertility assessment. Physical examination of external genitalia revealed no significant pathology. Testicular ultrasound however depicted an isoechoic lesion on the upper pole of the right testis measuring 1.8 cm × 0.8 cm × 1 cm and exhibiting intense arterial flow. After sonographic and MRI investigation, the patient was referred for semen analysis and cryopreservation. Subsequently, the patient underwent testicular biopsy (frozen section biopsy) and right partial orchiectomy. Final histology reported a noninfiltrating testicular angiolipoma. No recurrences have been observed in the follow-up period. Discussion Angiolipomas, which mainly occur in the trunk and extremities, are classified as infiltrating and noninfiltrating. The diagnosis is based on both clinical and histologic criteria, and the main method of treatment for both types is by surgical excision. The infiltrating type exhibits higher recurrence rates. Conclusion Angiolipomas commonly occur in the subcutaneous tissue and have been invariably treated by radical excision. Hereby, we report the first case of an intratesticular, noninfiltrating type angiolipoma which was treated by partial orchiectomy.
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Zhang X, Wang JJ, Guo Y, Dong S, Shi W, Wang G, Zhang H, Wang G. Sudden Aggravated Radicular Pain Caused by Hemorrhagic Spinal Angiolipomas After Back Massage. World Neurosurg 2019; 134:383-387. [PMID: 31733392 DOI: 10.1016/j.wneu.2019.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Spinal angiolipomas (SALs) are benign tumors that usually present a slow progressive spinal cord or radicular compression. Acute myelopathy or acute aggravated radicular syndrome are exceedingly rare. CASE DESCRIPTION The authors report an original case with sudden aggravated radicular pain caused by hemorrhagic SALs. A 54-year-old woman presented with a 2-month history of mild back pain, and the pain was significantly aggravated after a therapeutic back massage. Neurologic examination showed pain and hyperalgesia between T4 and T7 dermatome, from back to front, just like a band. Spinal magnetic resonance imaging (MRI) showed a dorsally located epidural lesion (T4-T6) and a small intratumoral hemorrhage at the lower part of the tumor. A bilateral T4-T6 laminectomy was performed to achieve total excision of the tumors. Histologic examination showed that the tumors were composed of mature adipose tissue and vascular tissue as angiolipomas. The postoperative course was uneventful with complete neurologic recovery 4 days after the surgery. MRI at 1-year follow-up indicated no recurrence. CONCLUSIONS SALs are unusual benign tumors that are composed of mature fatty tissue and abnormal blood vessels; sudden aggravated spinal cord or radicular compression syndrome is rare. MRI is the best choice in the diagnosis of SALs. Surgery may be performed in different ways depending on the type of SALs, and the prognosis is generally good.
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Affiliation(s)
- Xiaolei Zhang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital; School of Clinical Medcine, Tsinghua University, Beijing, China
| | - James Jin Wang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital; School of Clinical Medcine, Tsinghua University, Beijing, China
| | - Yi Guo
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital; School of Clinical Medcine, Tsinghua University, Beijing, China
| | - Sheng Dong
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital; School of Clinical Medcine, Tsinghua University, Beijing, China
| | - Wei Shi
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital; School of Clinical Medcine, Tsinghua University, Beijing, China
| | - Guoqin Wang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital; School of Clinical Medcine, Tsinghua University, Beijing, China
| | - Huifang Zhang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital; School of Clinical Medcine, Tsinghua University, Beijing, China
| | - Guihuai Wang
- Department of Neurosurgery, Beijing Tsinghua Changgung Hospital; School of Clinical Medcine, Tsinghua University, Beijing, China.
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Spinal extradural angiolipomas: 7 new cases and review of the literature. NEUROLOGÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.nrleng.2018.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Spinal angiolipomas in pregnancy: Natural history and surgical treatment. Clin Neurol Neurosurg 2019; 178:25-30. [DOI: 10.1016/j.clineuro.2019.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/07/2019] [Accepted: 01/20/2019] [Indexed: 12/23/2022]
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Pakanati R, Gogineni R, Ede N. Recurrent giant intermuscular lipoma of thigh. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2019. [DOI: 10.4103/jdrntruhs.jdrntruhs_4_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sundararajan SR, Rajagopalakrishnan R, Rajasekaran S. Arthroscopic Excision of Angio-Fibro-Lipomatous Hamartoma of the Knee: A Rare Case Report. Indian J Orthop 2019; 53:732-735. [PMID: 31673174 PMCID: PMC6804391 DOI: 10.4103/ortho.ijortho_330_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Angio-fibro-lipomatous hamartoma is a benign adipose tissue tumor very rarely seen in musculoskeletal distribution, and its incidence in the knee joint has never been reported. The patient in our case presented with knee pain of 2 years' duration, following blunt trauma. Preoperatively, veno-lymphatic malformation/hemangioma was considered as the diagnosis. Only after arthroscopic excision biopsy, histopathological examination, retrospective radiological analysis, and a review of literature, we were able to diagnose this rare condition. The histopathological picture of this benign adipose tissue tumor contained a mixture of mature adipose tissue and fibrous and vascular tissues. Here, in this case report, we discuss about PTEN gene causing PTEN hamartoma of soft tissue and angiolipoma presentations and its variants.
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Affiliation(s)
| | - Ramakanth Rajagopalakrishnan
- Department of Arthroscopy and Sports Medicine, Ganga Hospital, Coimbatore, Tamil Nadu, India,Address for correspondence: Dr. Ramakanth Rajagopalakrishnan, Ganga Hospital, Coimbatore, Tamil Nadu, India. E-mail:
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Abstract
Spinal angiolipomas are benign tumors predominantly found in the epidural space. Infiltrating spinal angiolipoma is an extremely rare type, which tends to invade the surrounding tissue and may mimic an aggressive tumor. Herein, we reported the case of a 64-year-old woman with a thoracic angiolipoma involving the T9 vertebral body and its appendix. The lesion showed long T1 and T2 signal intensity on MRI and slightly increased FDG uptake on PET/CT. After surgery, the pathologic examination demonstrated features consistent with angiolipoma, and the patient was free of symptoms.
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Yang X, Richard SA, Lei C, Liu J, Huang S. Spinal extradural angiolipoma: a report of two cases and review of literature. JOURNAL OF SPINE SURGERY 2018; 4:490-495. [PMID: 30069550 DOI: 10.21037/jss.2018.06.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Spinal extradural angiolipomas (SEALs) are extremely extraordinary benign extradural lesions. They are infrequently encountered in normal clinical practice although several authors have report single cases or case series. We present two cases of SEAL which we successfully surgical resected with no further neurological deficits. Our cases comprise of a male and a female with ages ranging from 30 to 60 years. Their principal presenting complains were numbness and pain at the lower extremity with associated fecal and urinary incontinence. In all our cases, MRI revealed extradural spinal lesions that exerted compressive effect on the spinal cord. The male patient had an infiltrating type while the female had non-infiltrating type. We attained total resection in both cases without any further neurological complication. The diagnosis of SEALs initially can be challenging radiologically since they may mimic other spinal lesions. The gold standard treatment modality should always be surgery although total resection may not be achievable in some cases.
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Affiliation(s)
- Xiang Yang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Seidu A Richard
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Immunology, Jiangsu University, Zhenjiang 212013, China.,Department of Surgery, Volta Regional Hospital, Ho, Ghana-West Africa
| | - Chuanfen Lei
- Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiagang Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Siqing Huang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China
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Epidural angiolipoma: A rare cause of spinal cord compression. Int J Surg Case Rep 2018; 45:72-76. [PMID: 29573600 PMCID: PMC6000995 DOI: 10.1016/j.ijscr.2018.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/23/2018] [Accepted: 03/11/2018] [Indexed: 11/22/2022] Open
Abstract
Spinal epidural angiolipoma is a rare cause of progressive spinal cord compression. Magnetic resonance imaging is necessary for diagnosis. Total resection is the treatment of choice. Necessary precautions before and during surgery have to be taken (embolisation, transfusion). Prognosis after surgical management is excellent even at the stage of complete paraplegia.
Introduction Angiolipomas are benign, slow growing lesions, almost always located subcutaneously in the trunc or limbs. They are composed of mature lipocytes admixed with abnormal blood vessels. Spinal epidural angiolipoma are rare accounting for approximately 0.14–1.2% of all spinal axis tumors and 2–3% of epidural spinal tumors. Presentation of case We report the case of a 65 years-old-woman, presenting with complete paraplegia installed since 7 months. Magnetic resonance imaging (MRI) showed an epidural dorsal fatty mass. The patient recovered immediately after surgery. The pathological examination concluded to an angiolipoma. Discussion Angiolipoma patients most commonly have long-lasting pain and then develop progressive neurological symptoms secondary to spinal cord compression. The mean duration of symptom progression at diagnosis is 1 year. MRI is the most reliable examination for the diagnosis of spinal angiolipoma. Total resection is the treatment of choice. No adjuvant treatment is indicated. Since SAL are very haemorrhagic lesions, preoperative embolization is recommended. Conclusion We think that spinal cord compression caused by angiolipoma have very good functional prognosis, even if tardily diagnosed
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Four cases of spinal epidural angiolipoma. J Clin Neurosci 2018; 48:243-244. [DOI: 10.1016/j.jocn.2017.10.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 10/22/2017] [Indexed: 11/18/2022]
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47
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Kang HI, Kim TW, Kim EJ, Park KH. Angiolipoma on the Lumbar Spine. KOREAN JOURNAL OF SPINE 2017; 14:112-114. [PMID: 29017310 PMCID: PMC5642094 DOI: 10.14245/kjs.2017.14.3.112] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/15/2017] [Accepted: 09/22/2017] [Indexed: 11/19/2022]
Abstract
Angiolipomas are composed of mature adipose tissue and blood vessels. Spinal angiolipomas are rare benign tumors with a good prognosis, and most symptoms are due to progressive compression of the spinal cord and root. The treatment of choice is total resection without any additional therapy. We report a case of an epidural angiolipoma on the lumbar spine in a 69-year-old man with weakness of the lower extremities. Lumbar magnetic resonance images revealed a well-enhanced epidural mass. He underwent laminectomy, and the tumor was completely removed. Pathologic examination confirmed the tumor was an angiolipoma. The patient's symptoms gradually improved postoperatively.
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Affiliation(s)
- Hee Il Kang
- Department of Neurosurgery, VHS Medical Center, Seoul, Korea
| | - Tae Wan Kim
- Department of Neurosurgery, VHS Medical Center, Seoul, Korea
| | - Eun Ju Kim
- Department of Pathology, VHS Medical Center, Seoul, Korea
| | - Kwan Ho Park
- Department of Neurosurgery, VHS Medical Center, Seoul, Korea
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Abstract
Angiolipoma is a benign tumor composed of adipose tissue and proliferating blood vessels that is commonly found in the subcutaneous tissue of the trunk and extremities. Gastric angiolipoma is a rare entity, and to the best of our knowledge, only 4 cases have been reported in the English-language literature thus far. These tumors may present as gastrointestinal bleeding and anemia or with obstructive symptoms. Accurate preoperative diagnosis is challenging because of nonspecific clinical symptoms and lack of specific findings on imaging studies. The correct diagnosis is usually made by histopathologic examination. The clinical significance lies in being aware of this rare entity in the stomach and distinguishing it from other benign and malignant gastric neoplasms that may be in the differential diagnosis. We herein discuss the clinical presentation, radiologic and histopathologic features, ancillary studies, differential diagnosis, and treatment and prognosis of this rare entity.
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Affiliation(s)
| | - Dipti M Karamchandani
- From the Department of Pathology, Penn State Milton S. Hershey Medical Center & Penn State College of Medicine, Hershey, Pennsylvania
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Abstract
Lipomatous lesions are common musculoskeletal lesions that can arise within the soft tissues, bone, neurovascular structures, and synovium. The majority of these lesions are benign, and many of the benign lesions can be diagnosed by radiologic evaluation. However, radiologic differences between benign and malignant lipomatous lesions may be subtle and pathologic correlation is often needed. The use of sonography, computed tomography (CT), and magnetic resonance imaging (MRI) is useful not only in portraying fat within the lesion, but also for evaluating the presence and extent of soft tissue components. Lipomas make up most soft tissue lipomatous lesions, but careful evaluation must be performed to distinguish these lesions from a low-grade liposarcoma. In addition to the imaging appearance, the location of the lesion and the patient demographics can be utilized to help diagnose other soft tissue lipomatous lesions, such as elastofibroma dorsi, angiolipoma, lipoblastoma, and hibernoma. Osseous lipomatous lesions such as a parosteal lipoma and intraosseous lipoma occur less commonly as their soft tissue counterpart, but are also benign. Neurovascular and synovial lipomatous lesions are much rarer lesions but demonstrate more classic radiologic findings, particularly on MRI. A review of the clinical, radiologic, and pathologic characteristics of these lesions is presented.
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Affiliation(s)
- Ashley M Burt
- Department of Radiology, University of California San Diego, 200 West Arbor Drive, Mail Code: 8756, San Diego, CA 92130, USA
| | - Brady K Huang
- Department of Radiology, University of California San Diego, 200 West Arbor Drive, Mail Code: 8756, San Diego, CA 92130, USA
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Wang FF, Wang S, Xue WH, Cheng JL. Epidural spinal angiolipoma: a case series. BMC Res Notes 2017; 10:128. [PMID: 28320469 PMCID: PMC5359808 DOI: 10.1186/s13104-017-2432-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 02/16/2017] [Indexed: 12/27/2022] Open
Abstract
Background Spinal angiolipomas (SAL) are rare benign tumors, commonly presenting with slow progressive spinal cord compression. There are only about 170 cases identified so far. Magnetic resonance imaging (MRI) has become the modality of choice for SAL. The purpose of this article is to report three cases of SAL and their characteristic MRI features. Case presentation Three cases of epidual spinal angiolipoma from ethnic Han Chinese patients are presented here, including one lumbar and two thoracic tumors. MRI imaging findings were reviewed. Conclusions Multiple MRI technology for characterization of SAL provides useful information for differential diagnosis and therapeutic management.
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Affiliation(s)
- Fei Fei Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, 1 Jian She E Road, Zhengzhou, 450052, China
| | - Song Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, 1 Jian She E Road, Zhengzhou, 450052, China
| | - Wen Hua Xue
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, 1 Jian She E Road, Zhengzhou, 450052, China
| | - Jing Liang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, 1 Jian She E Road, Zhengzhou, 450052, China.
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