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Mettu S, Gavvala SN, Shirodkar K, Iyengar KP, Papineni VRK, Botchu R. Intra-articular Lipoma of the Pisotriquetral Joint: A Rare Case Report. Indian J Radiol Imaging 2024; 34:558-561. [PMID: 38912239 PMCID: PMC11188722 DOI: 10.1055/s-0044-1779521] [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: 06/25/2024] Open
Abstract
Intra-articular lipomas are infrequently reported, with most reported cases occurring in the knee joint. A case of intra-articular lipoma in the small joints of the hand, specifically in the pisotriquetral joint, has been documented for the first time. A 24-year-old male visited the emergency department after a road traffic accident with a painful and swollen wrist. Radiographic examination revealed fractures of the distal radius and triquetrum. A subsequent wrist computed tomography scan identified an intra-articular lipoma within the pisotriquetral joint, further confirmed by ultrasonography. This article underscores the importance of recognizing that, though exceedingly rare, intra-articular lipomas should be considered in the differential diagnosis of soft-tissue tumors affecting the hand and wrist.
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Affiliation(s)
- Sindhura Mettu
- Department of Radiology, PACE Hospital, Hyderabad, Telangana, India
| | - Sai Niharika Gavvala
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - K. Shirodkar
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | | | - Vijay Ram Kumar Papineni
- Department of Radiology, Sheikh Shakhbout Medical City (Mayo Clinic), Abu Dhabi, United Arab Emirates
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
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Kashima A, Majima T, Muramatsu T, Kurosu H, Kawanishi H, Kobayashi I, Kajikawa K, Takahara T, Yamamoto T, Sassa N. Hibernoma in the renal sinus: A case mimicking malignancy. IJU Case Rep 2024; 7:308-312. [PMID: 38966762 PMCID: PMC11221932 DOI: 10.1002/iju5.12732] [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: 12/13/2023] [Accepted: 04/24/2024] [Indexed: 07/06/2024] Open
Abstract
Introduction Hibernomas are benign tumors of brown adipose tissue. Hibernoma in the renal sinus is extremely rare. Herein, we present the third known case of renal hibernoma. Case presentation A 71-year-old man reported to our department with a left kidney tumor with an average growth rate of 5 mm/year and a progressive contrast effect on computed tomography. It was diagnosed as a hibernoma following a laparoscopic radical nephrectomy. Conclusion We encountered a rare case of a hibernoma in the renal sinus. Development of new and accurate diagnostic methods for hibernoma, without resorting to nephrectomy, is essential.
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Affiliation(s)
- Ayano Kashima
- Department of UrologyAichi Medical UniversityNagakuteAichiJapan
| | - Tsuyoshi Majima
- Department of UrologyAichi Medical UniversityNagakuteAichiJapan
| | | | - Haruka Kurosu
- Department of UrologyAichi Medical UniversityNagakuteAichiJapan
| | | | - Ikuo Kobayashi
- Department of UrologyAichi Medical UniversityNagakuteAichiJapan
| | - Keishi Kajikawa
- Department of UrologyAichi Medical UniversityNagakuteAichiJapan
| | - Taishi Takahara
- Department of Surgical PathologyAichi Medical UniversityNagakuteAichiJapan
| | | | - Naoto Sassa
- Department of UrologyAichi Medical UniversityNagakuteAichiJapan
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De Maria F, Marra C, Blessent CGF, Starnoni M, Pappalardo M, De Santis G. Giant thigh lipomas: from a case report to a guide for the surgical approach. Case Reports Plast Surg Hand Surg 2024; 11:2335275. [PMID: 38682001 PMCID: PMC11047211 DOI: 10.1080/23320885.2024.2335275] [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: 07/03/2023] [Accepted: 03/20/2024] [Indexed: 05/01/2024]
Abstract
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.
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Affiliation(s)
| | | | | | - Marta Starnoni
- Unit of Plastic Surgery, Ospedale Alessandro Manzoni, Lecco
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Waters JP, Horenstein S, Egger A, Johnsen P, Kim TW. Parosteal lipoma of the left femur: A case report. Clin Case Rep 2024; 12:e8744. [PMID: 38654936 PMCID: PMC11035377 DOI: 10.1002/ccr3.8744] [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: 10/30/2023] [Accepted: 03/24/2024] [Indexed: 04/26/2024] Open
Abstract
Multidisciplinary team collaboration in the diagnosis of rare tumors such as parosteal lipoma is highly important, especially when suspicious of malignancy. The use of radiological and physical examinations is imperative to monitor recurrence and quality of life.
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Affiliation(s)
- James P. Waters
- Cooper Medical School of Rowan UniversityCamdenNew JerseyUSA
| | | | - Austin Egger
- Philadelphia College of Osteopathic MedicinePhiladelphiaPennsylvaniaUSA
| | | | - Tae Won Kim
- Cooper University HealthcareCamdenNew JerseyUSA
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Tamang M, Mahalik SK, Tripathy TP. Parosteal lipoma of rib causing widening of intercostal space in an adolescent. BMJ Case Rep 2023; 16:e257794. [PMID: 37899078 PMCID: PMC10618982 DOI: 10.1136/bcr-2023-257794] [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] [Accepted: 10/11/2023] [Indexed: 10/31/2023] Open
Abstract
Parosteal lipomas are typically seen in adults and affect mostly the diaphysis of the long bones of the upper and lower limbs. Only a few cases have been reported in children until now and none were reported involving ribs. A female adolescent patient presented with swelling on the left upper back over the scapular region for the past 4 years without any neurological deficit. MRI revealed a hyperintense lesion on the left paravertebral region extending from D5 to D12 and into the intercostal space, causing it to widen. The patient underwent surgical excision. The lipomatous mass was seen entering in to the intercostal space, causing it to widen. However, the pleura was not breached. In this report, we have performed a literature review compiling all cases of parosteal lipoma affecting the ribs.
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Affiliation(s)
- Manita Tamang
- Pediatric Surgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
| | - Santosh Kumar Mahalik
- Pediatric Surgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
| | - Tara Prasad Tripathy
- Radiodiagnosis, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Odisha, India
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Lepage B, Ropars M, Crepin V, Duval M, Robinet-Zimmermann G, Guillin R. The value of a new diagnostic strategy for adipocytic soft tissue tumors in adults: A retrospective study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:107012. [PMID: 37572589 DOI: 10.1016/j.ejso.2023.107012] [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: 06/04/2023] [Revised: 07/25/2023] [Accepted: 08/05/2023] [Indexed: 08/14/2023]
Abstract
INTRODUCTION The distinction between lipoma and well-differentiated liposarcoma (WDLPS), or "atypical lipomatous tumor" (ALT), is crucial as it impacts patient management. A group of European experts led by Benjamin Moulin recently issued a consensus report to define the role of radiology in managing these lesions. It describes an algorithm defining the criteria prompting a diagnostic biopsy of deep lipomatous tumors of the limbs and chest wall. The primary aim of this study was to evaluate the algorithm's diagnostic performance. MATERIALS AND METHODS Between 2012 and 2019, all biopsies of deep fatty tumors of the limbs or chest wall with a pre-biopsy MRI assessment were recorded at our institution. The MRI scans were reviewed by two radiologists. Each lesion was classified according to biopsy status by applying the algorithm of the European panel. The algorithm's diagnostic performance was assessed by calculating the sensitivity, specificity, positive predictive value and negative predictive value. Inter-rater agreement was also assessed. RESULTS Of the 156 tumors in our study, 148 (94.9%) required a biopsy, and the algorithm's sensitivity for detecting ALT/WDLPS was 100% with specificity of 6.3% and a PPV of 20.3%. Inter-rater agreement was almost perfect with a kappa value of 0.882. CONCLUSION The European algorithm demonstrates perfect sensitivity, an important criterion for a screening examination such as MRI in this setting. The algorithm's low specificity, however, emphasizes the need for further studies to redefine the optimum size cut-off value, especially for lesions without atypical criteria or an anatomical location at risk of post-surgical recurrence.
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Affiliation(s)
- Benoît Lepage
- Department of Radiology, Rennes University Hospital, 2 Rue Henri le Guilloux, 35033, Rennes, France.
| | - Mickaël Ropars
- Department of Orthopedics and Trauma Center, Pontchaillou University Hospital, 2 Rue Henri le Guilloux, 35033, Rennes, France
| | - Valentine Crepin
- Department of Radiology, Rennes University Hospital, 2 Rue Henri le Guilloux, 35033, Rennes, France
| | - Mélanie Duval
- Public Health Department, University Hospital of Nantes, 85 Rue Saint-Jacques, 44093, Nantes, France
| | | | - Raphaël Guillin
- Department of Radiology, Rennes University Hospital, 2 Rue Henri le Guilloux, 35033, Rennes, France
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Vargas Lara R, Serrano R, Chaves C, Perez O. Lipoma of the Teres Minor in Rotator Cuff Arthropathy-A Case Report. J Shoulder Elb Arthroplast 2023; 7:24715492231180713. [PMID: 37427390 PMCID: PMC10328154 DOI: 10.1177/24715492231180713] [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: 04/02/2023] [Revised: 05/01/2023] [Accepted: 05/22/2023] [Indexed: 07/11/2023] Open
Abstract
Although lipomas are the most common mesenchymal tumors, the intramuscular type is rare. We report the case of a patient with rotator cuff arthropathy with a lipoma in the teres minor. Wide surgical excision and total shoulder arthroplasty with reverse prosthesis was performed and 18 months of follow up showed excellent results with any recurrence. The teres minor is extremely important for the proper function of a reverse prosthesis, and lipoma growth in the muscular belly can compromise the functionality of the prosthesis. To the best of our knowledge, this is the first case report of a rotator cuff arthropathy with a lipoma in the teres minor.
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Affiliation(s)
- Rodrigo Vargas Lara
- Hospital Universitario Hospital Universitario Mayor: Bogota, Bogota, CO
- El Rosario University, Bogota, Colombia
| | - Rafael Serrano
- Hospital Universitario Hospital Universitario Mayor: Bogota, Bogota, CO
- El Rosario University, Bogota, Colombia
| | | | - Oriana Perez
- Pontificia Universidad Catolica del Ecuador
- La Sabana University, Chia, Colombia
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Aru MG, Davis JL, Stacy GS, Mills MK, Yablon CM, Hanrahan CJ, McCallum R, Nomura EC, Hansford BG. Beyond schwannomas and neurofibromas: a radiological and histopathological review of lesser-known benign lesions that arise in association with peripheral nerves. Skeletal Radiol 2023; 52:649-669. [PMID: 36280619 DOI: 10.1007/s00256-022-04207-1] [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: 08/02/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 02/02/2023]
Abstract
Peripheral nerve sheath tumors comprise a significant percentage of both benign and malignant soft tissue tumors. The vast majority of these lesions are schwannomas and neurofibromas, which most radiologists are familiar with including the well-described multimodality imaging features. However, numerous additional often under-recognized benign entities associated with nerves exist. These rarer entities are becoming increasingly encountered with the proliferation of cross-sectional imaging, particularly magnetic resonance imaging (MRI). It is important for the radiologist to have a basic understanding of these entities as many have near-pathognomonic MR imaging features as well as specific clinical presentations that when interpreted in concert, often allows for a limited differential or single best diagnosis. The ability to provide a prospective, pre-intervention diagnosis based solely on imaging and clinical presentation is crucial as several of these entities are "do not touch" lesions, for which even a biopsy may have deleterious consequences. To our knowledge, the majority of these benign entities associated with nerves have only been described in scattered case reports or small case series. Therefore, the aim of this article is to provide a radiopathologic comprehensive review of these benign entities that arise in association with nerves with a focus on characteristic MRI features, unique histopathologic findings, and entity specific clinical exam findings/presentation.
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Affiliation(s)
- Marco G Aru
- Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
| | - Jessica L Davis
- Department of Pathology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, L-471, Portland, OR, 97239, USA
| | - Gregory S Stacy
- Department of Diagnostic Radiology, University of Chicago, 5841 South Maryland Avenue, MC2026, Chicago, IL, 60637, USA
| | - Megan K Mills
- Department of Radiology and Imaging Sciences, University of Utah, 30 N 1900 E, Rm #1A71, Salt Lake City, UT, 84132, USA
| | - Corrie M Yablon
- Department of Diagnostic Radiology, University of Michigan Health System, 1500 E. Medical Center Dr, TC2910Q, Ann Arbor, MI, 48109, USA
| | - Christopher J Hanrahan
- Department of Diagnostic Radiology, University of Utah School of Medicine, Intermountain Healthcare, Salt Lake City, UT, 84132, USA
| | - Raluca McCallum
- Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Eric C Nomura
- Department of Pathology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, L-471, Portland, OR, 97239, USA
| | - Barry G Hansford
- Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
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Sudjai N, Siriwanarangsun P, Lektrakul N, Saiviroonporn P, Maungsomboon S, Phimolsarnti R, Asavamongkolkul A, Chandhanayingyong C. Tumor-to-bone distance and radiomic features on MRI distinguish intramuscular lipomas from well-differentiated liposarcomas. J Orthop Surg Res 2023; 18:255. [PMID: 36978182 PMCID: PMC10044811 DOI: 10.1186/s13018-023-03718-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Background To develop a machine learning model based on tumor-to-bone distance and radiomic features derived from preoperative MRI images to distinguish intramuscular (IM) lipomas and atypical lipomatous tumors/well-differentiated liposarcomas (ALTs/WDLSs) and compared with radiologists. Methods The study included patients with IM lipomas and ALTs/WDLSs diagnosed between 2010 and 2022, and with MRI scans (sequence/field strength: T1-weighted (T1W) imaging at 1.5 or 3.0 Tesla MRI). Manual segmentation of tumors based on the three-dimensional T1W images was performed by two observers to appraise the intra- and interobserver variability. After radiomic features and tumor-to-bone distance were extracted, it was used to train a machine learning model to distinguish IM lipomas and ALTs/WDLSs. Both feature selection and classification steps were performed using Least Absolute Shrinkage and Selection Operator logistic regression. The performance of the classification model was assessed using a tenfold cross-validation strategy and subsequently evaluated using the receiver operating characteristic curve (ROC) analysis. The classification agreement of two experienced musculoskeletal (MSK) radiologists was assessed using the kappa statistics. The diagnosis accuracy of each radiologist was evaluated using the final pathological results as the gold standard. Additionally, we compared the performance of the model and two radiologists in terms of the area under the receiver operator characteristic curves (AUCs) using the Delong’s test. Results There were 68 tumors (38 IM lipomas and 30 ALTs/WDLSs). The AUC of the machine learning model was 0.88 [95% CI 0.72–1] (sensitivity, 91.6%; specificity, 85.7%; and accuracy, 89.0%). For Radiologist 1, the AUC was 0.94 [95% CI 0.87–1] (sensitivity, 97.4%; specificity, 90.9%; and accuracy, 95.0%), and as to Radiologist 2, the AUC was 0.91 [95% CI 0.83–0.99] (sensitivity, 100%; specificity, 81.8%; and accuracy, 93.3%). The classification agreement of the radiologists was 0.89 of kappa value (95% CI 0.76–1). Although the AUC of the model was lower than of two experienced MSK radiologists, there was no statistically significant difference between the model and two radiologists (all P > 0.05). Conclusions The novel machine learning model based on tumor-to-bone distance and radiomic features is a noninvasive procedure that has the potential for distinguishing IM lipomas from ALTs/WDLSs. The predictive features that suggested malignancy were size, shape, depth, texture, histogram, and tumor-to-bone distance. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-023-03718-4.
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Affiliation(s)
- Narumol Sudjai
- grid.10223.320000 0004 1937 0490Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Palanan Siriwanarangsun
- grid.10223.320000 0004 1937 0490Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700 Thailand
| | - Nittaya Lektrakul
- grid.10223.320000 0004 1937 0490Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700 Thailand
| | - Pairash Saiviroonporn
- grid.10223.320000 0004 1937 0490Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700 Thailand
| | - Sorranart Maungsomboon
- grid.10223.320000 0004 1937 0490Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700 Thailand
| | - Rapin Phimolsarnti
- grid.10223.320000 0004 1937 0490Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Apichat Asavamongkolkul
- grid.10223.320000 0004 1937 0490Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Chandhanarat Chandhanayingyong
- grid.10223.320000 0004 1937 0490Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
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Al-Qassab S, Lalam R, Singh J, Tyrrell PNM. Imaging of Lower Limb Tumors and Tumor-Like Conditions. Radiol Clin North Am 2023; 61:361-373. [PMID: 36739150 DOI: 10.1016/j.rcl.2022.10.008] [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: 12/14/2022]
Abstract
Bone and soft tissue lesions are frequently seen in the lower limbs. Many are non-neoplastic but may mimic tumours. In this article, we discuss a practical approach for the diagnosis and management of the most common tumours and tumour-like conditions seen in the lower limbs.
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Affiliation(s)
- Sinan Al-Qassab
- Radiology Department, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, SY10 7AG, UK
| | - Radhesh Lalam
- Radiology Department, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, SY10 7AG, UK.
| | - Jaspreet Singh
- Radiology Department, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, SY10 7AG, UK
| | - Prudencia N M Tyrrell
- Radiology Department, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, SY10 7AG, UK
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Burke CJ, Fritz J, Samim M. Musculoskeletal Soft-tissue Masses. Magn Reson Imaging Clin N Am 2023; 31:285-308. [PMID: 37019551 DOI: 10.1016/j.mric.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Evaluation of soft-tissue masses has become a common clinical practice indication for imaging with both ultrasound and MR imaging. We illustrate the ultrasonography and MR imaging appearances of soft-tissue masses based on the various categories, updates, and reclassifications of the 2020 World Health Organization classification.
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Affiliation(s)
- Christopher J Burke
- NYU Langone Orthopedic Hospital, 301 East 17th Street, New York, NY 10003, USA.
| | - Jan Fritz
- NYU Langone Orthopedic Hospital, 301 East 17th Street, New York, NY 10003, USA
| | - Mohammad Samim
- NYU Langone Orthopedic Hospital, 301 East 17th Street, New York, NY 10003, USA
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Saccheri P, Sabbadini G, Travan L. Two paleopathological cases suggestive of paralabral cysts of the shoulder. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2022; 39:109-114. [PMID: 36347173 DOI: 10.1016/j.ijpp.2022.10.004] [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: 05/31/2022] [Revised: 10/12/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To undertake differential diagnosis of scapular bone defects found in two medieval skeletons buried in different necropoles of Friuli Venezia Giulia (Italy) and to evaluate the clinical significance of paralabral cysts in the context of shoulder pathology. MATERIALS Individual JoT36 is an adult male exhumed from a necropolis belonging to a rural agricultural settlement dated to the 10th to 11th century A.D. Individual CIVT58 is an adult male from a Langobard necropolis dated to 630-670 A.D. METHODS Macroscopic examination of the skeletons was performed using standard osteological methods and review of pertinent clinical literature to assist differential diagnosis. RESULTS Between the glenoid cavity and the spinoglenoid notch of the right scapula of JoT36 there is a multilocular circular defect adjacent to the glenoid rim. On the neck of the left scapula of CIVT58, immediately above the spinoglenoid notch, there is a unilocular circular depression. In both cases, the cortical bone appears smooth without any evidence of erosion or sclerosis. CONCLUSIONS Skeletal findings and historical/archaeological contexts of both cases are compatible with the diagnosis of paralabral cysts. SIGNIFICANCE Paralabral cysts are relatively frequently observed in clinical settings but very few examples have been documented in paleopathological literature. This study seeks to improve recognition and interpretation of this pathology in historical/archaeological contexts. LIMITATIONS Findings from a case report can neither generate epidemiological information nor be generalized. SUGGESTIONS FOR FURTHER RESEARCH Identification of new cases may add valuable information about lifestyles and related shoulder pathologies in ancient times.
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Affiliation(s)
- Paola Saccheri
- Department of Medicine, Section of Anatomy and History of Medicine, University of Udine, P.le Kolbe 3, 33100 Udine, Italy.
| | - Gastone Sabbadini
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34100 Trieste, Italy.
| | - Luciana Travan
- Department of Medicine, Section of Anatomy and History of Medicine, University of Udine, P.le Kolbe 3, 33100 Udine, Italy.
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Mansour J, Ghanimeh J, Ghersi A, Moutinot B, Coulomb R, Kouyoumdjian P, Mares O. Percutaneous ultrasound-guided ulnar nerve release technique compared to open technique: A cadaveric study. SICOT J 2022; 8:40. [PMID: 36155647 PMCID: PMC9511962 DOI: 10.1051/sicotj/2022041] [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: 07/20/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To evaluate the outcomes of a novel percutaneous ultrasound-guided technique for release of ulnar nerve entrapment at the elbow when compared to standard open release Methods: One single surgeon performed an ultrasound-guided percutaneous release of the cubital tunnel on a group of five cadaveric elbows and open release on five others. All procedures were timed, and incision lengths were recorded. Meticulous anatomic dissection was then performed to assess the complete release of the carpal tunnel and iatrogenic injuries. RESULTS No significant difference was found between the two groups in terms of complete release and iatrogenic injury, whereas Operative time was significantly shorter for the US-guided technique. Incomplete releases of the nerve were found only during the first two trials in each group, while the third, fourth, and fifth trials showed a complete ulnar nerve release in both series, highlighting a fast learning curve for both techniques. All of this through a significantly smaller incision in the US-guided technique. CONCLUSIONS This study highlights the similar effects of these two techniques in terms of complete release of the ulnar nerve, with no clear superiority of one over the other in terms of morbidity rate. Both have a fast learning curve for an ultrasound-trained surgeon, with the US-guided technique being a less traumatic and quicker alternative procedure.
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Affiliation(s)
- Jad Mansour
- Centre Hospitalier Universitaire Nîmes-Caremeau place du professeur Robert-Debré 30029 Nîmes France
| | - Joe Ghanimeh
- Department of Orthopedic Surgery, Lebanese American University-Rizk Hospital, Lebanese American University, School of Medicine Beirut Lebanon
| | - Abdelhamid Ghersi
- Centre Hospitalier Universitaire Nîmes-Caremeau place du professeur Robert-Debré 30029 Nîmes France
| | - Berenice Moutinot
- Centre Hospitalier Universitaire Nîmes-Caremeau place du professeur Robert-Debré 30029 Nîmes France
| | - Remy Coulomb
- Centre Hospitalier Universitaire Nîmes-Caremeau place du professeur Robert-Debré 30029 Nîmes France
| | - Pascal Kouyoumdjian
- Centre Hospitalier Universitaire Nîmes-Caremeau place du professeur Robert-Debré 30029 Nîmes France
| | - Olivier Mares
- Centre Hospitalier Universitaire Nîmes-Caremeau place du professeur Robert-Debré 30029 Nîmes France
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14
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Alsalem AA, Alessa MA, Almanea KA, Almanea BA, Khan A. Hypopharyngeal lipomatous hamartoma in piriform fossa: A case report and review of literature. J Taibah Univ Med Sci 2022; 18:132-136. [DOI: 10.1016/j.jtumed.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022] Open
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15
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Weiss SN, Mohla A, Zhu GG, Gutowski C, Kim TWB, Amin R. Intraosseous hibernoma: Two case reports and a review of the literature. Radiol Case Rep 2022; 17:2477-2483. [PMID: 35586163 PMCID: PMC9108732 DOI: 10.1016/j.radcr.2022.01.079] [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: 09/23/2021] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Abstract
Intraosseous hibernomas are exceedingly rare tumors with only 35 cases reported worldwide. They are composed of vestigial brown adipose tissue and require biopsy and pathologic analysis for definitive diagnosis. Given their propensity to mimic more insidious malignant neoplasms, early and accurate identification may spare the patient both anxiety and invasive therapeutic interventions. In this report, we present two cases of intraosseous hibernomas and provide a review of current literature to further characterize the clinical, radiographic, and histopathologic parameters of these lesions. Clinicians should consider the diagnosis of intraosseous hibernoma when evaluating patients with characteristic presentations as it may be more prevalent than currently reported.
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Affiliation(s)
- Samantha N. Weiss
- Cooper Medical School of Rowan University, 401 Broadway, Camden, NJ 08103, USA
| | - Ankit Mohla
- Department of Interventional Radiology, Cooper University Hospital, Camden, NJ, USA
| | - Gord Guo Zhu
- Department of Pathology, Cooper University Hospital, Camden, NJ, USA
| | | | - Tae Won B Kim
- Bone and Joint Institute, Cooper University Hospital, Camden, NJ, USA
| | - Rohan Amin
- Department of Interventional Radiology, Cooper University Hospital, Camden, NJ, USA
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16
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Otelea MR, Nartea R, Popescu FG, Covaleov A, Mitoiu BI, Nica AS. The Pathological Links between Adiposity and the Carpal Tunnel Syndrome. Curr Issues Mol Biol 2022; 44:2646-2663. [PMID: 35735622 PMCID: PMC9221759 DOI: 10.3390/cimb44060181] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
An association between obesity and carpal tunnel syndrome is found in many epidemiological studies. Therefore, there is a need to evaluate the physiopathological links that could explain the association between these two entities. Ectopic adipose tissue is responsible for metabolic syndrome and inflammation, and is a major risk factor for diabetes and cardiovascular diseases. Taking these elements into consideration, we conducted an extensive literature revision of the subject, considering as ectopic fat-related mechanisms the following: (a) the direct compression and the association with the metabolic syndrome of the fat deposition around the wrist, (b) the insulin resistance, dyslipidemia, inflammatory, and oxidative mechanisms related to the central deposition of the fat, (c) the impaired muscle contraction and metabolism related to myosteatosis. Each section presents the cellular pathways which are modified by the ectopic deposition of the adipose tissue and the impact in the pathogeny of the carpal tunnel syndrome. In conclusion, the experimental and clinical data support the epidemiological findings. Efforts to reduce the obesity epidemics will improve not only cardio-metabolic health but will reduce the burden of the disability-free life expectancy due to the carpal tunnel syndrome.
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Affiliation(s)
- Marina Ruxandra Otelea
- Clinical Department 5, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Roxana Nartea
- Clinical Department 9, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.C.); (B.I.M.); (A.S.N.)
- National Institute for Rehabilitation, Physical Medicine and Balneoclimatology, 030079 Bucharest, Romania
- Correspondence:
| | - Florina Georgeta Popescu
- Department V, Internal Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Emergency Municipal Hospital, 300254 Timisoara, Romania
| | - Anatoli Covaleov
- Clinical Department 9, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.C.); (B.I.M.); (A.S.N.)
| | - Brindusa Ilinca Mitoiu
- Clinical Department 9, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.C.); (B.I.M.); (A.S.N.)
| | - Adriana Sarah Nica
- Clinical Department 9, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.C.); (B.I.M.); (A.S.N.)
- National Institute for Rehabilitation, Physical Medicine and Balneoclimatology, 030079 Bucharest, Romania
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17
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Cells to Surgery Quiz: December 2021. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Rousslang LK, Burr CR, Wood JR. Scrotal Lipoblastoma with Radiological and Histological Correlation. Indian J Radiol Imaging 2021; 31:710-713. [PMID: 34790320 PMCID: PMC8590560 DOI: 10.1055/s-0041-1736395] [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] [Indexed: 12/02/2022] Open
Abstract
Lipoblastomas are rare benign mesenchymal tumors comprised primarily mature adipocytes, which are most commonly found in infants and children younger than 3 years. They are usually found in the extremities, trunk, head, neck, and retroperitoneum, although cases occurring in the scrotum have been reported. Due to its rarity, there is a relative paucity of literature describing its imaging and management. We present a rare case of a scrotal lipoblastoma, and discuss the current imaging strategies to differentiate this adipocytic tumor from other more common paratesticular masses, including aggressive neoplasms such as rhabdomyosarcomas. Knowledge of the radiological appearance of lipoblastoma can provide the correct diagnosis and prevent unnecessary orchiectomy.
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Affiliation(s)
- Lee K Rousslang
- Department of Radiology, Tripler Army Medical Center, Hawaii, United States
| | - Cole R Burr
- Department of Radiology, Tripler Army Medical Center, Hawaii, United States
| | - Jonathan R Wood
- Department of Radiology, Tripler Army Medical Center, Hawaii, United States
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19
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Al-Mnayyis A, Al Sharie S, Araydah M, Talafha M, Haddad F. Parosteal lipoma of the forearm: A case report and a literature review. Medicine (Baltimore) 2021; 100:e27876. [PMID: 34797330 PMCID: PMC8601361 DOI: 10.1097/md.0000000000027876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/21/2021] [Accepted: 11/03/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Parosteal lipomas are rare neoplasms comprising mature adipocytes situated in a proximity to bone. Although these tumors follow a benign course, the reactive osseous changes that may occur with such lesions might raise the suspicion of malignancy. PATIENT CONCERNS Here we present a case of a 33-year-old male patient complaining of pain and swelling in the right anterior forearm without history of trauma. DIAGNOSIS An magnetic resonance imaging of the region revealed a lobulated intramuscular fat intensity mass within the supinator muscle. Bony projection inseparable from the anterolateral radial diaphyseal cortex and periosteum was also seen. The radiological features suggested the diagnosis of parosteal lipoma. INTERVENTION After the radiological diagnosis of a parosteal lipoma, the patient was offered a total surgical excision of the mass. OUTCOMES The mass was removed successfully. Histopathology showed mature benign adipose tissue bordered by thin fibrous septa confirming the diagnosis of parosteal lipoma. Follow-up magnetic resonance imaging after 6 months did not reveal any signs of complications or recurrence. LESSONS Distinction of the features of parosteal lipomas is needed to establish the accurate diagnosis, discriminate it from malignant lesions, predict potential neurovascular compromises, and follow up until a curative action is planned.
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Affiliation(s)
- Asma’a Al-Mnayyis
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | | | | | - Muna Talafha
- Faculty of Medicine, Yarmouk University, Irbid, Jordan
- Princess Basma Teaching Hospital, Irbid, Jordan
| | - Fadi Haddad
- Faculty of Medicine, Yarmouk University, Irbid, Jordan
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20
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Rai V, Sabhikhi GS, Sircar P, Kumar D, Kundra R, Jeyaraman M. Fibrolipomatous Hamartoma of Median Nerve - A Diagnostic Challenge. J Orthop Case Rep 2021; 11:69-73. [PMID: 35415127 PMCID: PMC8930339 DOI: 10.13107/jocr.2021.v11.i11.2520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/16/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Fibrolipomatous hamartoma (FLH) is an uncommon slow-growing tumor of benign etiology, which predominantly affects the median nerve. CASE REPORT We report the case study of a 17-year-old male patient, who presented with complaints of a gradually increasing localized swelling over the volar aspect of left hand for 1 year. A contrast-enhanced Magnetic resonance (MR) scan of the left hand was performed which demonstrated characteristic findings. The patient was treated surgically and post-excision histopathological examination confirmed the diagnosis. CONCLUSION The characteristic MR imaging features of coaxial cable-like appearance on axial section or spaghetti shaped enlarged nerve fascicles and fibrous tissue is confirmatory for a definitive diagnosis of FLH, which alleviates the need for any unnecessary biopsy.
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Affiliation(s)
- Vikrant Rai
- Department of Radiodiagnosis, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - G S Sabhikhi
- Department of Radiodiagnosis, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India,
Address of Correspondence: Dr. G S Sabhikhi, Department of Radiodiagnosis, School of Medical Sciences and Research, Sharda University, Greater Noida - 201306, Uttar Pradesh, India. E-mail:
| | - Pankaj Sircar
- Department of General Surgery, Himalayan Institute of Medical Science, Dehradun, Uttarakhand, India
| | - Dev Kumar
- Department of Radiodiagnosis, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Rohit Kundra
- Department of Radiodiagnosis, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Madhan Jeyaraman
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
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21
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Bansal A, Goyal S, Goyal A, Jana M. WHO classification of soft tissue tumours 2020: An update and simplified approach for radiologists. Eur J Radiol 2021; 143:109937. [PMID: 34547634 DOI: 10.1016/j.ejrad.2021.109937] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023]
Abstract
The WHO classification of soft tissue tumours categorizes the lesions based on histological differentiation. In the recent fifth edition (2020), many new entities have been introduced, based on their distinct biological behaviour, genetics and morphology. With the recent advances and better understanding of molecular genetics, several novel recurrent genetic alterations have been incorporated in this edition. These may serve as reliable diagnostic and prognostic markers for various soft tissue tumours. Though predominantly a pathologist's game; the radiologists must be aware of the recent updates to contribute towards the optimal diagnosis and management of soft tissue tumours. The imaging features of the new entities have not yet been described but are expected to be explored in the coming years. We hereby present a concise review of the updates in the recent WHO classification of soft tissue tumours. We have tried to emphasize the novel molecular genetics and their surrogate immunohistochemical markers which have brought a paradigm shift in the diagnosis, therapeutics, and prognosis of soft tissue tumours. We also present simplified diagnostic algorithms to characterize soft tissue tumours based on the clinico-radiological features.
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Affiliation(s)
- Abhinav Bansal
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Surbhi Goyal
- Department of Pathology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Ankur Goyal
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Manisha Jana
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
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22
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Ayalew D, Vadlamudi V, Neville R, Comerota AJ. Common femoral vein obstruction secondary to femoral sheath lipoma. Ann Vasc Surg 2021; 77:347.e13-347.e17. [PMID: 34437956 DOI: 10.1016/j.avsg.2021.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/09/2021] [Accepted: 05/03/2021] [Indexed: 11/28/2022]
Abstract
Common femoral vein obstruction secondary to femoral sheath lipomas are rare. We describe the case of a 49 year-old male that presented to the clinic with a 3 month history of progressive right lower extremity pain, edema and discoloration. Venous duplex imaging was consistent with proximal venous obstruction and led to Computerized Tomographic Venography (CTV) which demonstrated a large mass obstructing the external iliac vein (EIV) and common femoral vein (CFV) consistent with a femoral sheath lipoma. Surgical exploration revealed a large well encapsulated lipoma in the right femoral sheath posterior to the CFV and external iliac vein causing near occlusion. We present an overview of the diagnosis and surgical management of symptomatic femoral vein obstruction caused by a large femoral sheath lipoma.
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Affiliation(s)
- Dawit Ayalew
- Virginia Commonwealth University School of Medicine, Richmond, VA.
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23
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Patel NG, Patel DM, Patel MV, Patel MM, Patel TR, Patel SY. Diagnostic Value of Dynamic High-frequency Ultrasound for the Slipping Rib and Twelfth Rib Syndrome: A Case Series with Review. Curr Med Imaging 2021; 17:459-463. [PMID: 33019936 DOI: 10.2174/1573405616666201005114406] [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: 03/29/2020] [Revised: 07/23/2020] [Accepted: 07/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND High-frequency ultrasound (HFUS) is a mobile, radiation-free imaging tool for the diagnosis of musculoskeletal disorders. We aim to demonstrate the diagnostic value of dynamic HFUS for undiagnosed lower chest, upper abdomen, and loin pain with this case series. CASE SERIES A cricketer presented with long-standing left-sided dull ache lower chest and upper abdominal pain, aggravated on exertion and leaning forward. His previous laboratory and previous imaging tests were unrevealing. Dynamic HFUS of his left ribs during hooking maneuver demonstrated slipping of the eighth rib over the seventh rib associated with clicking. He also reported tenderness over this region. He was diagnosed with slipping rib syndrome (SRS), and was treated with the eighth nerve block under the HFUS guidance. The second and third cases presented with chronic undiagnosed waxing and waning loin pain despite extensive laboratory and radiological workup. Both patients demonstrated twelfth rib HFUS probe tenderness in a sitting position with a specific movement that reproduced the pain during the dynamic HFUS study. The diagnosis of twelfth rib syndrome (TRS) was confirmed and treated successfully with a local intercostal nerve block. REVIEW OF THE LITERATURE HFUS is the most underutilized imaging tool for the diagnosis of unexplained upper abdominal and lower chest pain syndromes. We identified only a few such reported cases managed with the help of HFUS. CONCLUSION The dynamic HFUS is a valuable imaging modality for the undiagnosed lower chest, upper abdominal, or loin pain.
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Affiliation(s)
- Nalin G Patel
- Department of Radiology, Dr. M.K. Shah Medical College and Research Center, Ahmedabad, India
| | | | | | - Maitri M Patel
- GCS Medical College, and Hospital and Research Center, Ahmedabad, India
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24
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Elamin M, Yeluri V, Khatir H, O'Grady P, Bennani F. Subacromial impingement by a lipoma arborescens. SICOT J 2021; 7:12. [PMID: 33704057 PMCID: PMC7949903 DOI: 10.1051/sicotj/2021004] [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: 09/07/2020] [Accepted: 02/05/2021] [Indexed: 12/12/2022] Open
Abstract
Subacromial impingement syndrome (SIS) is the leading cause of shoulder pain. A systemic approach for abnormal causes of SIS is recommended to avoid misdiagnosing rare or sinister pathologies. To our knowledge, only nine cases of subacromial lipoma arborescens associated with impingement syndrome have been reported in the literature. In this report, we briefly discuss histopathologic and radiological signs of an unusual case of impingement syndrome caused by subacromial "lipoma arborescens" and describe arthroscopic synovectomy after the failure of conservative management. The patient remains symptom-free five years after surgery.
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Affiliation(s)
- Mohamed Elamin
- Department of Orthopaedics, Mayo University Hospital, Castlebar, Co. Mayo, F23 H529, Ireland
| | - Venkatramana Yeluri
- Department of Orthopaedics, Mayo University Hospital, Castlebar, Co. Mayo, F23 H529, Ireland
| | - Hisham Khatir
- Department of Orthopaedics, Mayo University Hospital, Castlebar, Co. Mayo, F23 H529, Ireland
| | - Paul O'Grady
- Department of Orthopaedics, Mayo University Hospital, Castlebar, Co. Mayo, F23 H529, Ireland
| | - Fadel Bennani
- Department of Pathology, Mayo University Hospital, Castlebar, Co. Mayo, F23 H529, Ireland
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25
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Mahmood N, Kaya G, Zhang TT, Topple J, Howlett DC. Sonographic appearances of facial lumps in adults with a focus on cheek masses: A pictorial essay. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:175-183. [PMID: 33295669 DOI: 10.1002/jcu.22959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/30/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Nadia Mahmood
- Radiology Department, Brighton and Sussex NHS Trust, Brighton, UK
| | - Guven Kaya
- Radiology Department, Brighton and Sussex NHS Trust, Brighton, UK
| | - Ting Ting Zhang
- Radiology Department, Brighton and Sussex NHS Trust, Brighton, UK
| | - Jane Topple
- Radiology Department, East Sussex University Hospitals Trust, Eastbourne, UK
| | - David C Howlett
- Radiology Department, East Sussex University Hospitals Trust, Eastbourne, UK
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26
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Hallinan JTPD, Huang BK. Shoulder Tumor/Tumor-Like Lesions: What to Look for. Magn Reson Imaging Clin N Am 2021; 28:301-316. [PMID: 32241665 DOI: 10.1016/j.mric.2019.12.011] [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: 02/07/2023]
Abstract
This article discusses the most common tumor and tumor-like lesions arising at the shoulder. Osseous tumors of the shoulder rank second in incidence to those at the knee joint and include benign osteochondromas and myeloma or primary malignant lesions, such as osteosarcoma or chondrosarcomas. Soft tissue tumors are overwhelmingly benign, with lipomas predominating, although malignant lesions, such as liposarcomas, can occur. Numerous tumor-like lesions may arise from the joints or bursae, due to either underlying arthropathy and synovitis (eg, rheumatoid arthritis and amyloid) or related to conditions, including tenosynovial giant cell tumor and synovial osteochondromatosis.
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Affiliation(s)
- James Thomas Patrick Decourcy Hallinan
- Department of Diagnostic Imaging, National University Health System, 1E Kent Ridge Road, Singapore 119074, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Block MD11, 10 Medical Drive, Singapore 119074, Singapore.
| | - Brady K Huang
- Department of Radiology, University of California San Diego, School of Medicine, UCSD Teleradiology and Education Center, 408 Dickinson Street, Mail Code #8226, San Diego, CA 92103-8226, USA
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27
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Evaluation of primary lateral neck mass in adults: Cross sectional study. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.703630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Shimamori N, Kishino T, Okabe N, Morii T, Matsushima S, Yamasaki S, Ohtsuka K, Shibahara J, Ohnishi H, Watanabe T. Discrimination of well-differentiated liposarcoma from benign lipoma on sonography: an uncontrolled retrospective study. J Med Ultrason (2001) 2020; 47:617-623. [PMID: 32960385 DOI: 10.1007/s10396-020-01051-5] [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: 05/11/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Well-differentiated liposarcoma, the most common subtype of liposarcoma, should be discriminated from benign lipoma. However, features on sonography for discriminating these two types of tumor have not been fully investigated. The present study was therefore aimed at clarifying differences in sonographic findings between well-differentiated liposarcoma and lipoma. METHODS The study population comprised 23 cases of well-differentiated liposarcoma and 181 cases of lipoma. We investigated differences in sonographic appearance and pathological findings between the two types of tumor. RESULTS Well-differentiated liposarcoma tended to develop more frequently in older patients and in the lower extremities including the gluteal region, compared with lipoma. Concerning sonographic findings, both tumors exhibited well-defined margins and heterogeneous internal echogenicity, including typical tiny striated hyperechoic lines. Well-differentiated liposarcoma was characterized by a higher frequency of the following findings compared with lipoma: (1) deep location, (2) irregular shape, (3) large diameter, (4) hyperechogenicity compared to surrounding tissue, and (5) presence of vascularity on Doppler sonography (p < 0.01 each). Notably, hyperechogenicity corresponded to the intermingled sclerosing component within the adipocytic component when sonographic findings were compared with those of pathology. CONCLUSION The present study suggests that several sonographic findings including hyperechogenicity and presence of vascularity might be key features for discriminating well-differentiated liposarcoma from lipoma.
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Affiliation(s)
- Naoko Shimamori
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | - Tomonori Kishino
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan. .,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan. .,Department of Clinical Engineering, Kyorin University Faculty of Health Sciences, Mitaka, Tokyo, Japan.
| | - Naota Okabe
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Takeshi Morii
- Department of Orthopaedic Surgery, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Satsuki Matsushima
- Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Satoko Yamasaki
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Kouki Ohtsuka
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Hiroaki Ohnishi
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Takashi Watanabe
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
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29
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Phan VT, Nguyen NT, He J, Robinson AS, Nguyen QD. A Male Patient With Breast Hamartoma: An Uncommon Finding. Cureus 2020; 12:e9444. [PMID: 32864268 PMCID: PMC7451077 DOI: 10.7759/cureus.9444] [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] [Indexed: 12/30/2022] Open
Abstract
Mammary hamartoma is a rare type of breast tumor that is composed of the same elements as normal mammary tissue. This condition is very rare in men. In current literature, there are fewer than five case reports on male breast hamartoma. This benign pathology is under-reported because of several reasons. Since breast tumors are still considered an exclusively female diagnosis and statistically proven to be gynecomastia when arising in men, they are often overlooked. In addition to the uncommon clinical presentation in men, insufficiency of definitive pathologic and radiologic characteristics can make an accurate diagnosis a challenging task. Mammary hamartoma is a benign condition with an excellent prognosis. The following case describes a rare instance of an enlarging mammary hamartoma in a male patient, highlighting the imaging features, pathohistological findings, and clinical management.
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Affiliation(s)
- Vincent T Phan
- Radiology, University of Texas Medical Branch, Galveston, USA
| | - Nga T Nguyen
- Radiology, University of Texas Medical Branch, Galveston, USA
| | - Jing He
- Pathology, University of Texas Medical Branch, Galveston, USA
| | | | - Quan D Nguyen
- Radiology, University of Texas Medical Branch, Galveston, USA
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30
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Thinking beyond hernia: a review of non-hernia groin lumps. Abdom Radiol (NY) 2020; 45:1929-1949. [PMID: 31786622 DOI: 10.1007/s00261-019-02351-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
With increasing reliance on imaging, a large number of patients presenting with a groin lump are being referred to radiology to confirm the diagnosis of hernia, usually with an ultrasound in the first instance (occasionally MRI or CT). However, when imaging of the groin was performed, we have encountered many different kinds of non-hernia lesions in our practice. Such lesions can be categorized based on their tissue of origin and pathology. A specific diagnosis can often be reached using ultrasonography, MRI or a combination of imaging modalities. This review article will help general, musculoskeletal and abdominal radiologists to understand the anatomy of the groin, diagnose and characterise soft tissue lesions that may present as a groin lump, provide guidance for further imaging and insight into imaging features which may need specific investigations like core biopsy, tertiary referral and review at multidisciplinary meetings.
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31
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Donners R, Krieg AH, Baumhoer D, Boll DT, Harder D. Quantitative signal intensity ratios to distinguish between subfascial lipoma and atypical lipomatous tumor/well-differentiated liposarcoma using short-tau inversion recovery (STIR) MRI. Diagn Interv Imaging 2020; 101:383-390. [PMID: 32107197 DOI: 10.1016/j.diii.2020.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/24/2020] [Accepted: 01/30/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To establish simple quantitative variables at short-tau inversion recovery (STIR) magnetic resonance imaging (MRI) to identify lipomas with high specificity in patients with indeterminate subfascial lipomatous tumors. MATERIALS AND METHODS The MRI examinations of 26 patients (14 men, 12 women; mean age 63±12.5 [SD] years; range: 40-84years) with histopathologically proven subfascial atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLs) and those of 68 patients (32 men, 36 women; mean age, 56±13.5 [SD] years; range: 21-83years) with lipomas were retrospectively reviewed. Ratios derived from region of interest based signal intensity (SI) measurements of tumors and adjacent fat on STIR images were calculated and maximum tumor diameters were noted. Diagnostic parameter capabilities were assessed using ROC curve analysis. Interreader agreement was evaluated by calculation of intraclass correlation coefficients (ICC). RESULTS Using a cut-off value of 1.18, STIR-SI ratios allowed discriminating between lipoma and ALT/WDL (AUC=0.88; P<0.001) yielding 93% specificity (95% CI: 77-99%) and 74% sensitivity (95% CI: 61-84%) for the diagnosis of lipoma. Interreader agreement was excellent (ICC=0.93). A significant difference in maximum tumor diameter was found between ALT/WDLs (mean: 18.1±6.0 [SD] cm; range: 5.6-33.1cm) and lipomas (mean: 9.7±5.0 [SD] cm; range: 2.9-29.1cm) (P<0.001). Using a cut-off of 11cm, maximum tumor diameter allowed discriminating between lipoma and ALT/WDLs with 92% specificity (95% CI: 75-99%) and 69% sensitivity (95% CI: 57-80%). The combination of a STIR-SI ratio<1.4 and maximum tumor diameter<11cm yielded 100% specificity (95% CI: 87-100%) and 65% sensitivity (95% CI: 54-77%) for the diagnosis of lipoma. CONCLUSION The combination of STIR-SI ratio and maximum diameter allows discriminating between lipoma and ALT/WDL in initially indeterminate lipomatous tumors.
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Affiliation(s)
- R Donners
- Department of Radiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.
| | - A H Krieg
- Bone and Soft tissue Sarcoma Center, University Basel (KWUB), University Childrens Hospital (UKBB), 4031 Basel, Switzerland
| | - D Baumhoer
- Bone Tumor Reference Center at the Institute of Pathology, University Hospital and University of Basel, 4031 Basel, Switzerland
| | - D T Boll
- Department of Radiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland
| | - D Harder
- Department of Radiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland
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Radiomics and Machine Learning Differentiate Soft-Tissue Lipoma and Liposarcoma Better than Musculoskeletal Radiologists. Sarcoma 2020; 2020:7163453. [PMID: 31997918 PMCID: PMC6969992 DOI: 10.1155/2020/7163453] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/19/2019] [Indexed: 02/07/2023] Open
Abstract
Distinguishing lipoma from liposarcoma is challenging on conventional MRI examination. In case of uncertain diagnosis following MRI, further invasive procedure (percutaneous biopsy or surgery) is often required to allow for diagnosis based on histopathological examination. Radiomics and machine learning allow for several types of pathologies encountered on radiological images to be automatically and reliably distinguished. The aim of the study was to assess the contribution of radiomics and machine learning in the differentiation between soft-tissue lipoma and liposarcoma on preoperative MRI and to assess the diagnostic accuracy of a machine-learning model compared to musculoskeletal radiologists. 86 radiomics features were retrospectively extracted from volume-of-interest on T1-weighted spin-echo 1.5 and 3.0 Tesla MRI of 38 soft-tissue tumors (24 lipomas and 14 liposarcomas, based on histopathological diagnosis). These radiomics features were then used to train a machine-learning classifier to distinguish lipoma and liposarcoma. The generalization performance of the machine-learning model was assessed using Monte-Carlo cross-validation and receiver operating characteristic curve analysis (ROC-AUC). Finally, the performance of the machine-learning model was compared to the accuracy of three specialized musculoskeletal radiologists using the McNemar test. Machine-learning classifier accurately distinguished lipoma and liposarcoma, with a ROC-AUC of 0.926. Notably, it performed better than the three specialized musculoskeletal radiologists reviewing the same patients, who achieved ROC-AUC of 0.685, 0.805, and 0.785. Despite being developed on few cases, the trained machine-learning classifier accurately distinguishes lipoma and liposarcoma on preoperative MRI, with better performance than specialized musculoskeletal radiologists.
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McClintock NC, Satyananda V, Dauphine C, Hari DM, Chen KT, Ozao-Choy JJ. Lipomatous Soft Tissue Masses: Challenging the Paradigm of Routine Preoperative Biopsy. J Surg Res 2019; 247:103-107. [PMID: 31767281 DOI: 10.1016/j.jss.2019.10.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/26/2019] [Accepted: 10/20/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lipomatous masses are the most common soft tissue tumors. While the majority are benign lipomas, it is important to identify those masses that are malignant prior to excision. Current guidelines recommend core needle biopsy (CNB) for all lipomatous masses larger than 3-5 cm. The objective of this study was to determine if routine preoperative CNB based on mass size is necessary, or if radiographic features can guide the need for CNB. MATERIALS AND METHODS Patients who underwent excision of extremity or truncal lipomatous masses at a single institution from October 2014 to July 2017 were retrospectively reviewed. By protocol, preoperative imaging was routinely obtained for all masses larger than 5 cm. High-risk radiographic features (intramuscular location, septations, nonfat nodules, heterogeneity, and ill-defined margins) and surgical pathology were evaluated to determine patients most likely to benefit from preoperative CNB. RESULTS Of 178 patients, 2 (1.1%) had malignant tumors on surgical pathology. All masses smaller than 5 cm were benign and, if imaging was obtained, had two or fewer high-risk radiographic features. Both of the patients with malignant tumors had masses larger than 5 cm, preoperative imaging that showed at least four high-risk radiographic features, and underwent CNB prior to excision. CONCLUSIONS The overall rate of malignancy is very low. The results of this study suggest that lipomatous masses smaller than 5 cm without concerning clinical characteristics do not require preoperative imaging or CNB. Conversely, lipomatous masses larger than 5 cm should undergo routine MRI with subsequent CNB if multiple high-risk radiographic features are present.
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Affiliation(s)
- Natalie C McClintock
- Division of Surgical Oncology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - Vikas Satyananda
- Division of Surgical Oncology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - Christine Dauphine
- Division of Surgical Oncology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - Danielle M Hari
- Division of Surgical Oncology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - Kathryn T Chen
- Division of Surgical Oncology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - Junko J Ozao-Choy
- Division of Surgical Oncology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, California.
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Okromelidze L, Middlebrooks EH, Bhatt AA. Lipoma of the Larynx and Other Differential Diagnoses. J Clin Imaging Sci 2019; 9:51. [PMID: 31819828 PMCID: PMC6884984 DOI: 10.25259/jcis_123_2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 11/11/2022] Open
Abstract
Fatty lesions in the head and neck region are uncommon but can present in any subsite, including rarely the larynx. Most commonly, the fatty lesion is a benign lipoma and an incidental finding as in this case. However, the lesion must be differentiated from other fatty lesions such as liposarcoma, lipoblastoma, and hibernoma. Accurate diagnosis on imaging can prevent unnecessary biopsy and more importantly worry for the patient. We report a case of an incidental lipoma within the vocal folds of the larynx.
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Affiliation(s)
- Lela Okromelidze
- Department of Radiology, Mayo Clinic, Jacksonville, Florida, United States
| | | | - Alok A Bhatt
- Department of Radiology, Mayo Clinic, Jacksonville, Florida, United States
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Iacobellis F, Di Serafino M, Blasio R, Barbuto L, Pezzullo F, Romano L. Secondary Neurolymphomatosis of the Radial Nerve: A Diagnostic Challenge. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:1652-1658. [PMID: 31707401 PMCID: PMC6859932 DOI: 10.12659/ajcr.916961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 08/19/2019] [Indexed: 12/03/2022]
Abstract
BACKGROUND Secondary neurolymphomatosis is a rare clinical condition that may be observed in patients with hematologic malignancies. Clinical findings can overlap with other conditions. Diagnosis can be obtained by magnetic resonance imaging (MRI) and imaging with positron emission tomography (PET) and confirmed by biopsy. CASE REPORT A 55-year-old male patient with known previous history of periocular non-Hodgkin's lymphoma mucosa-associated lymphoid tissue (MALT) type presented reporting he had a focal soft-tissue swelling mass on the external side of the right arm, suspected for lipoma. US, MRI, and FDG PET/CT were performed, revealing malignant imaging characteristics of the lesion, suspected to be a neurolymphoma. A biopsy confirmed the nature of the lesion. No further sites of malignancy were detected on whole-body PET/CT. CONCLUSIONS Lymphomatous involvement of peripheral nerves may clinically overlap with other, more common, benign conditions; therefore, although it is rarer, this diagnosis has to be considered in patients with a clinical history of hematologic malignancies.
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Affiliation(s)
- Francesca Iacobellis
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, Naples, Italy
| | - Marco Di Serafino
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, Naples, Italy
| | - Roberta Blasio
- Department of Radiology, University of Naples “Federico II”, Naples, Italy
| | - Luigi Barbuto
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, Naples, Italy
| | - Filomena Pezzullo
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, Naples, Italy
| | - Luigia Romano
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, Naples, Italy
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Shimamori N, Kishino T, Morii T, Okabe N, Motohashi M, Matsushima S, Yamasaki S, Ohtsuka K, Shibahara J, Ichimura S, Ohnishi H, Watanabe T. Sonographic Appearances of Liposarcoma: Correlations with Pathologic Subtypes. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2568-2574. [PMID: 31202456 DOI: 10.1016/j.ultrasmedbio.2019.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 05/14/2019] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
Liposarcoma is the second most common malignant soft-tissue tumor. This entity is pathologically categorized into 4 subtypes: well-differentiated, myxoid, dedifferentiated and pleomorphic. Although features on magnetic resonance imaging and computed tomography for these 4 subtypes have been reported quite precisely, those on sonography have not been fully investigated. The present study was therefore aimed at clarifying the sonographic appearances of each liposarcoma subtype and assessing correlations with histopathology. The study population was made up of 35 cases, including 21 cases of well-differentiated liposarcoma, 6 cases of myxoid liposarcoma, 6 cases of dedifferentiated liposarcoma and 2 cases of pleomorphic liposarcoma. Compared with the other subtypes, well-differentiated liposarcoma was characterized by the high frequency of the following findings: isoechogenicity, tiny hyperechoic lines and hypovascularity (p < 0.01, in each). Myxoid liposarcomas were characterized by low echogenicity, intermingled with anechoic areas and moderate vascularity (p < 0.01, in each). Dedifferentiated liposarcomas showed a specific biphasic pattern of hyperechoic and hypoechoic areas and hypervascularity (p < 0.01, in each). Pleomorphic liposarcomas showed a specific gyrus-like mixture of hyperechoic and hypoechoic areas (p < 0.01). In conclusion, the present study revealed different characteristics of sonographic appearance among the 4 histopathologic subtypes of liposarcoma.
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Affiliation(s)
- Naoko Shimamori
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan
| | - Tomonori Kishino
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan; Department of Clinical Engineering, Kyorin University Faculty of Health Sciences, Tokyo, Japan.
| | - Takeshi Morii
- Department of Orthopaedic Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Naota Okabe
- Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan
| | - Mitsue Motohashi
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan
| | - Satsuki Matsushima
- Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Satoko Yamasaki
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Kouki Ohtsuka
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan
| | - Shoichi Ichimura
- Department of Orthopaedic Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiroaki Ohnishi
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Takashi Watanabe
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
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Nevus lipomatosus cutaneous superficialis on the shoulder: A case report with MRI findings. Radiol Case Rep 2019; 14:1259-1263. [PMID: 31452824 PMCID: PMC6702441 DOI: 10.1016/j.radcr.2019.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/18/2019] [Accepted: 07/20/2019] [Indexed: 11/20/2022] Open
Abstract
Nevus lipomatosus cutaneous superficialis is a rare disease, and its magnetic resonance imaging features have not been reported. A 1-year-old male infant was admitted to our hospital for examination of a mass on his right shoulder. Magnetic resonance imaging revealed hypertrophic skin and a lipomatous subcutaneous mass, consistent with a hamartoma-like lesion or mesenchymal tumor; after surgery, the tumor was pathologically diagnosed as nevus lipomatosus cutaneous superficialis. To the best of our knowledge, this is the first case report focusing on the magnetic resonance imaging features of this disease. Hypertrophy of all skin structures involved (epidermis, dermis, and subcutaneous fat) may be specific to nevus lipomatosus cutaneous superficialis, enabling its differentiation from other tumors.
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Reichel T, Rueckl K, Fenwick A, Vogt N, Rudert M, Plumhoff P. Hibernoma of the Upper Extremity: Complete Case of a Rare but Benign Soft Tissue Tumor. Case Rep Orthop 2019; 2019:6840693. [PMID: 31263612 PMCID: PMC6556353 DOI: 10.1155/2019/6840693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/14/2019] [Indexed: 01/05/2023] Open
Abstract
Hibernoma is a rare benign lipomatous tumor showing differentiation of brown fatty tissue. To the author's best knowledge, there is no known case of malignant transformation or metastasis. Due to their slow, noninfiltrating growth hibernomas are often an incidental finding in the third or fourth decade of life. The vast majority are located in the thigh, neck, and periscapular region. A diagnostic workup includes ultrasound and contrast-enhanced MRI. Differential diagnosis is benign lipoma, well-differentiated liposarcoma, and rhabdomyoma. An incisional biopsy followed by marginal resection of the tumor is the standard of care, and recurrence after complete resection is not reported. The current paper presents diagnostic and intraoperative findings of a hibernoma of the upper arm and reviews similar reports in the current literature.
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Affiliation(s)
- Thomas Reichel
- Department of Orthopedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| | - Kilian Rueckl
- Department of Orthopedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| | - Annabel Fenwick
- Department of Orthopedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
- Department of Trauma Surgery, Klinikum Augsburg, 86156 Augsburg, Germany
| | - Niklas Vogt
- Department of Pathology, University of Wuerzburg, 97080 Wuerzburg, Germany
| | - Maximilian Rudert
- Department of Orthopedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| | - Piet Plumhoff
- Department of Orthopedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
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40
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Kovitwanichkanont T, Naidoo P, Guio-Aguilar P, Leong J. Hibernoma: a rare benign soft tissue tumour resembling liposarcoma. BJR Case Rep 2018; 4:20170067. [PMID: 31489209 PMCID: PMC6711274 DOI: 10.1259/bjrcr.20170067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 01/24/2018] [Accepted: 01/27/2018] [Indexed: 12/25/2022] Open
Abstract
Hibernoma is a rare benign soft tissue tumour that can mimic a liposarcoma on
radiographic imaging. Our case series review illustrates the clinical
presentation and radiographic appearances of four patients with histologically
confirmed hibernoma. Hibernoma is usually hypointense relative to subcutaneous
fat on T1 weighted MRI and demonstrates partial fat suppression on
fat-saturated sequences. Large intratumoral vessels likely support the diagnosis
of hibernoma but are not invariably present. Fludeoxyglucose avidity on PET scan
is not beneficial in distinguishing hibernoma from soft tissue malignancy
because of its inherent, metabolically active property. Owing to the
radiographic heterogeneity of hibernoma, it is currently not possible to
diagnose hibernoma based on imaging characteristics alone. Given the excellent
prognosis of hibernoma with marginal excision alone, an appreciation of the
radiographic features is helpful in the appropriate pre-operative workup of soft
tissue tumours.
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Affiliation(s)
- Tom Kovitwanichkanont
- Department of Rheumatology, Monash Health, Melbourne, VIC, Australia.,Department of Dermatology, Monash Health, Melbourne, VIC, Australia.,University of Sydney, Sydney, NSW, Australia
| | - Parm Naidoo
- Department of Radiology, Monash Health, Melbourne, VIC, Australia.,Monash University, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, VIC, Australia
| | - Pedro Guio-Aguilar
- Department of Plastic Surgery and Reconstructive Surgery, Monash Health, Melbourne, VIC, Australia
| | - James Leong
- Monash University, Melbourne, VIC, Australia.,Department of Plastic Surgery and Reconstructive Surgery, Monash Health, Melbourne, VIC, Australia
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Teniola O, Wang KY, Wang WL, Tseng WW, Amini B. Imaging of liposarcomas for clinicians: Characteristic features and differential considerations. J Surg Oncol 2017; 117:1195-1203. [DOI: 10.1002/jso.24949] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 11/12/2017] [Indexed: 12/12/2022]
Affiliation(s)
| | - Kevin Yuqi Wang
- Department of Radiology; Baylor College of Medicine; Houston Texas
| | - Wei-Lien Wang
- Department of Pathology; MD Anderson Cancer Center; The University of Texas; Houston Texas
| | - William W. Tseng
- Department of Surgery; Keck School of Medicine; Los Angeles California
| | - Behrang Amini
- Department of Diagnostic Radiology; The University of Texas; MD Anderson Cancer Center; Houston Texas
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