Angiolipoma in head and neck: report of two cases and review of the literature

KTP-532 Laser Assisted Excision of a Rare Laryngeal Angiolipoma: A Case Report with Review of Literature

Angiolipoma is a benign mesenchymal tumor and its occurrence in head and neck region is very rare. Only 2 cases of Laryngeal angiolipomas have been reported in the medical literature. We present one such rare case in a 32-year-old male who presented with complaints of change in voice and foreign body sensation in the throat since past 9 months along with features suggestive of obstructive sleep apnoea and dysphagia. Contrast enhanced CT scan of the neck showed a cystic lesion arising from right ventricle extending superiorly till the vallecula, partially obstructing the airway. Suspecting a supraglottic cyst, trans-oral microlaryngoscopic KTP-532 laser assisted excision was planned, intraoperatively a solid tumor was encountered. We discuss herein the clinical presentation and management of this rare neoplasm with review of literature.

Juvenile angiolipoma in the subtemporal region, zygomatic, and pterygomaxillary fossa treated by microwave ablation – A case study and literature review

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.

Angiolipoma of the chest wall: a case report

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.

Periauricular Angiolipoma: A Case Report

Angiolipoma is an uncommon benign fatty tumor which is a variant of lipoma. Microscopic studies on angiolipoma show that it includes the mature lipocytes and blood vessels. Infiltrating angiolipoma is an un-capsulated angiolipoma and, due to penetration into the surrounding structures, complete excision of the tumor is difficult. According to previous studies, the relapse rate of the infiltrating angiolipoma after surgical intervention is 35-50%. Infiltrating angiolipoma is rarely seen in the head and neck region and often occurs in the trunk and limbs. In this study, we report a 10-year-old boy with periauricular infiltrating angiolipoma who underwent surgery. After surgery, the patient developed transient left frontal branch palsy, but recovery was excellent and after one year there is no relapse.

Giant Posttraumatic Angiolipoma of the Forearm: A Case Report and Review of the Literature

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.

Angiolipoma in the Head and Neck: Imaging, Diagnosis and Management

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.

Intratesticular Angiolipoma: A Rare Case of Adipose Tissue Presence in the Testis

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.

Angiolipoma of the Orbit

Angiolipoma is characteristically described as an encapsulated mass of mature adipose tissue containing clusters of small blood vessels. The authors have described an extremely rare case of angiolipoma of the orbit. This rare case is only the third reported in the orbit and should be readily recognized from other differential diagnoses. The patient had an excellent prognosis after full surgical excision.

Infiltrating angiolipoma of the foot: magnetic resonance imaging features and review of the literature

Angiolipoma is a benign soft tissue tumor with two subtypes: non-infiltrating and infiltrating. Although histologically benign, infiltrating angiolipoma can invade surrounding structures. The foot is a very rare location for angiolipoma, with only four cases reported in the English literature, including one infiltrating type. Here, we report a very rare case of infiltrating angiolipoma of the foot with magnetic resonance imaging (MRI) and ultrasonography (US) findings. A 7-year-old boy presented with a slowly growing foot mass. MRI showed an unencapsulated mass involving the third web space extending to the foot dorsum and sole. The mass was isointense to subcutaneous fat and was mixed with internal T1 low-signal-intensity enhancing areas. On US, we observed a heterogeneously hypoechoic mass with internal vascularity. Imaging and clinical features of angiolipoma and the radiologic differential diagnoses of a fat-containing mass in the pediatric foot are reviewed here. When there is an ill-defined foot mass with a fat component and variable enhancing portions in a child, infiltrating angiolipoma should be included in the differential diagnosis along with other fat-containing tumors.

Upper eyelid angiolipoma associated friction in the glide zone

A 74-year-old man was examined for a mass in the left upper eyelid. It was inconspicuous in inspection. There was no visual restriction, however a feeling of friction on the superior orbit during lid movement. Through eyelid crease lid incision, a solitary lesion appeared in the preaponeurotic space that orginated from the upper tarsal plate. Excisional biopsy revealed adipose proliferation with patch form vessels. This case represents the second reported angiolipoma of the eyelid in English literature.

Non-Infiltrating Angiolipoma of Floor of Mouth-A Rare Case Report and Literature Review

Angiolipoma, a subtype of lipoma is a benign tumour in which adipose tissue and vascular component are intermingled. The tumour occurs commonly in the trunk and extremities and very rarely seen in maxillofacial region. Here we report a case of Non-Infiltrating Angiolipoma (NIAL) in floor of mouth which is the second case to be reported in literature to the best of our knowledge. We have reviewed all NIAL cases involving the oral cavity from 2008 to 2016 and found 12 cases of NIAL and assessment was made according to age, sex, site and size of lesion for better understanding of the lesion and its nature.

Bronchoscopic resection of bronchial angiolipoma: A rare case report

Angiolipoma is a rare benign tumor that most commonly occurs in the extremities and trunk. Angiolipomas originating in the bronchial tree are extremely rare. To the best of our knowledge, only one such case, confined to the bronchus intermedius, has been reported to date. The present study describes the case of an asymptomatic 74-year-old man with a yellowish round mass incidentally discovered at the orifice of the right lower bronchus during a routine health check. The tumor originated from the membranous part of the right inferior bronchus. Using a high-frequency electric snare and argon plasma coagulation under general anesthesia, successful bronchoscopic resection of the tumor was performed. At 15 months after the surgery, the patient remained recurrence- and symptom-free.

Angiolipoma of the Orbit: A Rare Tumor in an Unusual Location

Despite their relatively frequent occurrence on the trunk and extremities, lipomas rarely present in the orbit. Rarer still are variants of lipoma such as fibrolipoma, myxoid lipoma, and angiolipoma. The authors report a 66-year-old woman who presented with a large, slowly growing tumor of the forehead and orbit. The case presentation conforms to the tenets of the Declaration of Helsinki and is HIPAA compliant. Clinical and radiographic evidence suggested a lipomatous type of tumor, and excisional biopsy revealed adipose proliferation with numerous small vessels and fibrin thrombi consistent with angiolipoma. The tumor was completely excised without ophthalmic sequelae or recurrence in 6 months of follow up. To the authors' knowledge, this tumor represents only the second reported case of this type of highly vascularized lipomatous lesion within the orbit. This case is a novel entity in the differential diagnosis of orbital tumors and demonstrates the value of total excision in such cases.

Oral soft-tissue angiolipoma: report of two cases of rare oral lipomatous lesion with emphasis on morphological and immunohistochemical features

Oral angiolipomas are exceedingly rare and little is known about their morphological and etiological features. Here, we report two cases of oral angiolipoma and discuss their clinicopathological and immunohistochemical features, focusing on endothelial markers. Both lesions presented mature adipocytes interspersed by small blood vessels containing fibrin thrombi. Immunohistochemical analysis showed numerous mast cells and expression of CD34, vascular endothelial growth factor, intercellular adhesion molecule-1, interferon-γ and interleukin 6 in most endothelial and stromal cells. Mast cell-endothelial cell interaction may be responsible for the reactive or neoplastic origin of the vascular proliferation of these entities.

Non-infiltrating angiolipoma of the upper lip: A rare entity

Angiolipoma is a variant of lipoma with a prominent vascular component. It is the most common tumor of the forearm followed by trunk and extremities of young individuals. It's occurrence in head and neck region is rare. In this report, we present clinical and histopathologic features of non-infiltrating angiolipoma occurring on the upper lip in a 9-year-old female. Toluidine blue stain is used to demonstrate increased mast cell density around blood vessels, speculating its role in vasculogenesis.