Giant lipoma of the back affecting quality of life

Giant pleomorphic lipoma in patient with multiple osteochondromatosis

Pleomorphic lipomas are infrequent soft tissue tumours with pseudosarcomatous behaviour. Their polymorphism provides them certain characteristics that may resemble malignancy, which may mislead the initial diagnosis. The presented case report is a 45-year-old man with a giant growing tumour on the left cervicoscapular region initially categorised as a liposarcoma by magnetic resonance with a final confirmed diagnosis of pleomorphic lipoma after the surgical resection and the examination of the pathologist. The patient presented important functional restriction of the upper left extremity, which decreased after surgical resection, improving the quality of life.

Giant thigh lipomas: from a case report to a guide for the surgical approach

The issue of international migration and health has received increased attention since its rise due to empirical studies on the immigrant paradox. Less examined has been research focused on countries in the Global South with growing immigrant population share and contentious debates on implications. Using data from the longitudinal National Income Dynamics Study (NIDS) (2008-2017) and panel logistic regression this study focused on evaluating whether reported physical health, mental health, and life satisfaction are all associated with immigrant status in South Africa. Accounting for several sociodemographic factors, results emanating from analysis showed no significant evidence of association between overall immigration status and self-reported health or life satisfaction. This however did not apply to depression as immigrants were found to be significantly less likely to report depressive level scores. Interestingly, preference to migrate was also found to be significantly associated with depression, and life satisfaction. Further evaluation amongst racial groups showed that African immigrants are also significantly more likely to report better health than non-immigrant counterparts. This study argues for the need of contextualisation of the immigrant paradox as evidence thereof varies dependent on specific outcomes and communities. The importance of other associated social determinants of wellbeing is also highlighted since gender, race, age, class, education, relationship status, location, and behavioural factors were found to be significantly associated with wellbeing. Policies should thus be aimed at reducing structural inequalities in broad whilst also introducing social programmes that reduce behavioural or lifestyle activities that have negative implications on wellbeing.

Giant Lipoma: A Case Report

Lipomas are one of the most common, benign, slow-growing tumours composed of adipose (fat) tissue. These soft, rubbery lumps are usually painless and move easily when touched. Lipomas are generally small, ranging from less than an inch to a few inches in diameter. However, when a lipoma grows to a size larger than 10 cm (about 4 in), it is referred to as a giant lipoma. Only about 1% of all lipomas can be called "giant". Though usually they are benign, in the case of a very large lipoma it is essential to rule out the possibility of malignancy before embarking on its surgical treatment. Lipomas can occur anywhere in the body, but they are most commonly found on the neck, shoulders, back, abdomen, arms, or thighs. Here, we present a case of a 42-year-old woman with a giant lipoma over her left scapula.

Minimal One-Third Incision and Four-Step (MOTIF) Excision Method for Lipoma

Excision is the gold standard for lipomas. Patients desire minimal scars, but minimal incisions can increase complications and produce hypertrophic scars. We propose an algorithmic method named the minimal one-third incision and four-step extraction method (MOTIF) for lipoma excision. This retrospective study analyzed lipomas surgically excised using the MOTIF method at our institution between January 2016 and December 2018. A total of 112 lipomas were included. The complication rates and Vancouver Scar Scale (VSS) for three different size groups (<3 cm, 3 ~ 6 cm, >6 cm) were compared. Complete excision of all palpable lipomas was achieved with this approach. There were two seromas, two hematomas, and one postoperative nerve injury. There was no difference in complication rates and VSS between the three size groups. The MOTIF method is a cost-effective, reliable, and cosmetically pleasing method that can be applied to all lipomas regardless of size and location.

Giant intramuscular thigh lipoma: A case report and review of literature

INTRODUCTION

Lipomas are the most common soft tissue tumor. Giant lipomas are defined by measuring at least 10 cm in diameter in one dimension or by a minimum of 1000 g. They often are asymptomatic; however, they can cause compression syndromes due to nerve damage and difficulties in walking.

PRESENTATION OF CASE

We described the case of a 25-year-old female with no significant medical history who began her condition two years before her consultation. The patient referred to the appearance of a non-painful mass on her right thigh with progressive growth that hinders daily activities. A simple CT scan reported a 10.3 × 8.1 × 19.6 cm adipose mass with infiltration towards the semitendinosus muscle and the biceps femoris muscle. A free margin resection of the tumor was performed, and the involved muscles were preserved. The patient had a satisfactory postoperative outcome.

DISCUSSION

Lipomas are common benign soft tissue tumors that arise from fatty tissue and may challenge surgical management due to their extension and dimensions; they often require delicate surgical intervention due to their potential risk of malignant transformation. We believe surgical pathologists and radiologists must draw attention to muscle involvement and the infiltrative pattern.

CONCLUSION

Giant lipomas should always raise awareness of malignant transformation. Radiological guidance should provide enough evidence to decide whether to do a biopsy or not; hence, saving the patient an extra invasive procedure. We recommend taking at least 1 cm of border margin while removing these tumors to avoid local recurrence.

Benign Tumors in Long-Term Survivors of Retinoblastoma

Simple Summary

It is well-established that hereditary retinoblastoma survivors have a substantially increased risk of developing subsequent malignant neoplasms (SMNs). Although clinicians have long suspected that this population is also at increased risk for developing benign neoplasms, the evidence is unclear. Benign tumors can substantially impact health status and quality of life, while raising questions for clinicians, when faced with a mass in a retinoblastoma survivor. By 60 years following retinoblastoma diagnosis, 17.6% of hereditary survivors had developed a benign tumor, with lipomas and leiomyomas being the most frequently diagnosed types. Additionally, we report both an increased risk of benign tumors after SMNs and a reciprocal increased risk of SMNs after benign tumors among hereditary retinoblastoma survivors. If confirmed, the large magnitude of the absolute risks and the association between benign tumors and SMNs in this population may have implications for long-term surveillance.

Abstract

Hereditary retinoblastoma survivors have substantially increased risk of subsequent malignant neoplasms (SMNs). The risk of benign neoplasms, a substantial cause of morbidity, is unclear. We calculated the cumulative incidence of developing benign tumors at 60 years following retinoblastoma diagnosis among 1128 hereditary (i.e., bilateral retinoblastoma or unilateral with family history, mutation testing was not available) and 924 nonhereditary retinoblastoma survivors diagnosed during 1914–2006 at two US medical centers with follow-up through 2016. Using Cox proportional hazards regression, we compared benign tumor risk by hereditary status and evaluated the association between benign tumors and SMNs. There were 100 benign tumors among 73 hereditary survivors (cumulative incidence = 17.6%; 95% confidence interval [CI] = 12.9–22.8%) and 22 benign tumors among 16 nonhereditary survivors (cumulative incidence = 3.9%; 95%CI = 2.2–6.4%), corresponding to 4.9-fold (95%CI = 2.8–8.4) increased risk for hereditary survivors. The cumulative incidence after hereditary retinoblastoma was highest for lipoma among males (14.0%; 95%CI = 7.7–22.1%) and leiomyoma among females (8.9%; 95%CI = 5.2–13.8%). Among hereditary survivors, having a prior SMN was associated with 3.5-fold (95%CI = 2.0–6.1) increased risk of developing a benign tumor; the reciprocal risk for developing an SMN after a benign tumor was 1.8 (95%CI = 1.1–2.9). These large-scale, long-term data demonstrate an increased risk for benign tumors after hereditary versus nonhereditary retinoblastoma. If confirmed, the association between benign tumors and SMNs among hereditary patients may have implications for long-term surveillance.

Giant Lipoma in the Fronto-Temporo-Parietal Region in an Adult Man: Case Report and Literature Review

Lipoma belongs to a group of benign mesenchymal tumors. It is in the form of soft masses of adipose tissue encapsulated by a thin layer of fibrous tissue and usually localized subcutaneously. The tumor most often appears in the upper part of the body. Lipomas tend to grow slowly and are small (less than 5cm) lesions. Larger tumors are rare. In this article, we present the case of a patient with a giant head lipoma in the fronto-temporo-parietal region. Both tumor size and location are unique and no such case has been described in the literature so far.

Excision of a massive lipoma of the thigh following extensive weight loss and bariatric surgery

A 52-year-old morbidly obese man with a body mass index (BMI) of 78 kg/m² lost a great deal of weight through diet control over a 3-year period before undergoing bariatric surgery in the form of laparoscopic sleeve gastrectomy. He continued to lose weight, reducing BMI to 56 kg/m²; however, a large left medial thigh mass persisted. Differential diagnoses included lipoma, liposarcoma and hernia. An MRI scan revealed a 37 × 23 × 23 cm oedematous fatty swelling through which contained multiple enlarged inguinal lymph nodes and the great saphenous vein. Plastic surgeons excised the mass with direct closure of skin. Pathology confirmed lipoma with localised lymphoedema. This represents a case of giant lipoma, of which several reports have been described. We highlight the importance of preoperative imaging when planning resection of large masses to delineate the regional anatomy and the need for histological and genetic analysis to differentiate liposarcoma from lipoma due to their similar presentations.

Abdominoplasty: An Easy Approach to Giant Abdominal Lipomas

Introduction. Giant lipomas, which are greater than 10 cm, are rare, cosmetically unacceptable, and deteriorate the quality of daily living. Removal of giant abdominal lipomas either by liposuction, excision, or both, can lead to the formation of a loose, pendulous drooping abdomen, and abdominal wall laxity, which is aesthetically displeasing. The objective of this case report is to highlight an easy approach to treat giant abdominal lipoma through therapeutic abdominoplasty. Case History. In this case, a 29-year-old man with a known case of hypothyroidism and HCV was in remission but had a huge abdominal mass on his lower left side; it progressed for 7 years and increased in size and caused discomfort. His BMI was 29.53 and the mass measured about 15 × 13 cm. All other investigations were normal and showed no malignancies. He underwent excision of the giant abdominal lipoma using a standard abdominoplasty approach. Conclusion. In conclusion, in selected patients, giant abdominal lipomas can be successfully excised along with the redundant abdominal skin.

Surgical management of lipomas: Proposal of the Z-incision design and surgical algorithm based on tumor size

Surgical excision is the treatment of choice for lipomas. However, linear incision methods or minimal extraction techniques often do not provide a sufficient surgical view. Therefore, removing large lipomas is often difficult. To present the Z-incision and half Z-incision designs for lipoma extraction, this retrospective study analyzed lipomas surgically excised at our institution between September 2015 and December 2018. The area of surgical field exposed by the Z-incision versus that exposed by the linear incision was calculated using a schematic model. Cure rate, complications, and surgical field area were investigated. A total of 84 lipomas were included. A Z- or half Z-incision was used to treat 30 lipomas, while a linear incision was used to treat 54 lipomas. The mean diameter of the mass in the Z- or half Z-incision group was 47.7 mm (range, 15-160 mm), larger than that in the linear incision group (25.5 mm; range, 7-59 mm) (p < .001). The Z-incision involved making rectangular windows by lifting 2 triangular flaps. According to our mathematical model, the Z-incision provided a larger surgical field area than that provided by the linear incision based on stretched angles (1.81 times larger at 30° and 3.14 times larger at 15°). The Z- and half Z-incisions were successfully performed in all but 1 lipoma (29 lipomas, 96.7%). There was 1 lipoma that resulted in postoperative complications (seroma, 3.3%). The Z-incision design can be a useful alternative technique for the extirpation of lipomas, especially large lipomas. Here, we proposed a surgical algorithm for lipoma surgery based on tumor size.

Giant gluteal lipoma surgical management

Surgical treatment of lipomas is typically only considered when they are painful or unsightly. We present the case of a massive hip lipoma; with this extreme case, we show that the global prolongation of life expectancy can lead to other indications of removal.