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Merino-Rueda LR, Casas-Ramos P, Honrado-Franco E, Izquierdo-García FM, Ramos-Pascua LR. [Translated article] Comparative study of deep lipomas and atypical lipomatous tumours: Malignancy risk factors. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:T383-T389. [PMID: 38508379 DOI: 10.1016/j.recot.2024.03.005] [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: 11/09/2023] [Revised: 12/17/2023] [Accepted: 01/02/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The diagnostic suspicion of an atypical lipomatous tumour (ALT) is difficult. The aim of this study is to delve into the most controversial diagnostic aspects of the subject. MATERIAL AND METHOD Observational, longitudinal and retrospective study of a series of 96 deep adipose tumours (75 lipomas and 21 TLA) from 2006 to 2016: demographic, clinical, imaging and pathological variables were analysed and compared, as well as other variables related to treatment and oncological outcomes of the patients. A descriptive analysis of the collected variables was performed for the statistical study. To evaluate the potential predictor variables of malignancy, a multivariate logistic regression analysis was performed, including those that were statistically significant in the univariate analysis. RESULTS Older age at diagnosis, lower limb location and larger size were significantly more frequent in ALTs. MRI findings showed no statistically significant differences between the two groups. In multivariate analysis, the same clinical variables were confirmed as predictors of malignancy. In the ROC curve, an optimal cut-off point of 134.0mm was used as a predictor of malignancy. CONCLUSIONS Advanced age, location in the lower limbs and larger size are risk factors for malignancy in the differential diagnosis of deep lipomas and atypical lipomatous tumours. No radiological variable on MRI reached significance as a predictor of malignancy in our series.
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Affiliation(s)
- L R Merino-Rueda
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, Spain; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario La Paz, Madrid, Spain.
| | - P Casas-Ramos
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de León, León, Spain
| | - E Honrado-Franco
- Servicio de Anatomía Patológica, Hospital Universitario de León, León, Spain
| | | | - L R Ramos-Pascua
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, Spain
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Merino-Rueda LR, Casas-Ramos P, Honrado-Franco E, Izquierdo-García FM, Ramos-Pascua LR. Comparative study of deep lipomas and atypical lipomatous tumours: Malignancy risk factors. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:383-389. [PMID: 38199434 DOI: 10.1016/j.recot.2024.01.001] [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: 11/09/2023] [Revised: 12/17/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The diagnostic suspicion of an atypical lipomatous tumour (ALT) is difficult. The aim of this study is to delve into the most controversial diagnostic aspects of the subject. MATERIAL AND METHOD Observational, longitudinal, and retrospective study of a series of 96 deep adipose tumours (75 lipomas and 21 TLA) from 2006 to 2016: demographic, clinical, imaging and pathological variables were analysed and compared, as well as other variables related to treatment and oncological outcomes of the patients. A descriptive analysis of the collected variables was performed for the statistical study. To evaluate the potential predictor variables of malignancy, a multivariate logistic regression analysis was performed, including those that were statistically significant in the univariate analysis. RESULTS Older age at diagnosis, lower limb location and larger size were significantly more frequent in ALTs. MRI findings showed no statistically significant differences between the two groups. In multivariate analysis, the same clinical variables were confirmed as predictors of malignancy. In the ROC curve, an optimal cut-off point of 134.0 mm was used as a predictor of malignancy. CONCLUSIONS Advanced age, location in the lower limbs and larger size are risk factors for malignancy in the differential diagnosis of deep lipomas and atypical lipomatous tumours. No radiological variable on MRI reached significance as a predictor of malignancy in our series.
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Affiliation(s)
- L R Merino-Rueda
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario La Paz, León, Madrid, España.
| | - P Casas-Ramos
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de León, León, España
| | - E Honrado-Franco
- Servicio de Anatomía Patológica, Hospital Universitario de León, León, España
| | | | - L R Ramos-Pascua
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
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Li Q, Zhang Z, Chen G, Hu Y, Mao R, Xie L, Chen S, Lao Y, Gao J. Clinical manifestations and imaging and pathological features of giant cell angioblastoma: Report of four cases and literature review. Front Surg 2023; 9:1062309. [PMID: 36684227 PMCID: PMC9849588 DOI: 10.3389/fsurg.2022.1062309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/21/2022] [Indexed: 01/06/2023] Open
Abstract
Giant cell angioblastoma is a relatively rare vasogenic tumour. To date, studies on its clinical manifestations, imaging characteristics, pathological features, and prognosis are extremely limited and unknown, with only a few cases recorded. In this study, four cases of giant cell angioblastoma confirmed by pathological examination were reported to improve our understanding and deep exploration of the tumour spectrum. All cases in our study were male, including two adults and two boys. The lesions were located in the lower segment of the femur, medial condyle of the femur, knee joint, and popliteal fossa. Regarding the imaging characteristics, two patients with lesions in bone showed bone destruction, while the other two had lesions that invaded soft tissues, showing irregular, abnormal signal shadows and obvious enhancement. Histopathological analysis revealed that the nodular tumour tissue was mainly composed of oval and spindle cells, with varying numbers of osteoclast-like multinucleated giant cells, and the interstitial tissues were often filled with blood vessels of different sizes. The immunophenotype demonstrates that endothelial cells of small vessels in nodules expressed CD31, SMA, and ERG, while osteoclast-like multinucleated giant cells and histiocytes expressed CD68 and CD163, and the surrounding cells expressed SMA. All four patients were treated with surgical resection. One of them relapsed 1 month after surgery and received a second surgical resection. No distant metastasis or death occurred during the follow-up period. This study indicates that giant cell angioblastoma is a local invasive vascular tumour that can develop both in children and adults with skin, mucous membrane, soft tissue, and bone involvement. Imaging characteristics show bone destruction and irregular, abnormal signal shadows; in addition, obvious pathological morphological features can be observed. Currently, the treatment is mainly surgical resection, and interferons may be used as adjuvant chemotherapy.
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Affiliation(s)
- Qingbin Li
- Department of Orthopaedics, The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, China,Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Zhaohua Zhang
- Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Guocai Chen
- Department of Orthopaedics, The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, China,Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Yongbo Hu
- Department of Orthopaedics, The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, China,Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Rongjun Mao
- Department of Pathology, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Le Xie
- Department of Pathology, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Shaoluan Chen
- Department of Radiology, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Yongqiang Lao
- Department of Orthopaedics, The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, China,Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Foshan, China,Correspondence: Yongqiang Lao Junqing Gao
| | - Junqing Gao
- Department of Orthopaedics, The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, China,Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Foshan, China,Correspondence: Yongqiang Lao Junqing Gao
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Toft F. Surgical resection of a giant intramuscular lipoma of the biceps brachii: a case report and review of the literature. Arch Orthop Trauma Surg 2022; 142:373-379. [PMID: 33099672 DOI: 10.1007/s00402-020-03614-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/30/2020] [Indexed: 02/02/2023]
Abstract
Lipomas are frequent benign soft-tissue tumors mainly located in the subcutis. Occasionally, subfascial or inter- or intramuscular lipomas are encountered. This case report describes the surgical management of a very rare giant intramuscular lipoma of the right biceps brachii muscle in a 71-year-old male patient. Preoperative magnetic resonance imaging as well as intraoperative photographs depict the complexity of this case and aid in the discussion about indications for surgery, as management guidelines of these deep-seated tumors are still inconsistent.
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Affiliation(s)
- Felix Toft
- Leitender Arzt Orthopädie, Leiter Schulter- und Ellenbogenchirurgie, Department of Orthopedics, Klinik für Orthopädie, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.
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Talsania AJ, Novak CB, Alolabi N, Pirela Cruz MA, Levis CM, Kozin SH. Forearm mass dilemma during a pediatric hand surgery medical mission: a case report. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000001042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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