Intramuscular lipoma of the superior oblique muscle

Infiltrative Intramuscular Lipoma with Overlying Fascial Defect in the Anterior Thigh: A Case Report

This case report details a unique presentation of an infiltrative intramuscular lipoma in the anterior thigh of a 51-year-old female with an overlying fascial defect. The patient reported a progressively enlarging left thigh mass associated with pain exacerbated by knee movement and exercise. MRI revealed a homogeneous intramuscular lipoma without contrast enhancement with a fascial defect. An 8 cm longitudinal incision exposed a 7 x 4 cm fascial defect overlying the lipomatous mass within the rectus femoris muscle. Pathological analysis confirmed an intramuscular lipoma without malignancy. Follow-ups at two, six, and 12 weeks demonstrated pain resolution and no soft tissue bulge. This case underscores the importance of distinguishing intramuscular lipomas from other neoplasms, such as lipomatosis and liposarcomas. The association of a fascial defect with intramuscular lipomas is unprecedented and may be due to the increased pressure on the fascia by the lipoma. The report emphasizes the role of MRI in diagnosis and appropriate surgical management, and highlights the need for further exploration into the etiology of fascial defects associated with intramuscular lipomas.

Intramuscular intercostal lipoma in the left axillary tail: A case report and discussion

Intercostal lipomas are rare benign tumors that predominantly occur in the subcutaneous tissue. However, intramuscular intercostal lipomas are exceedingly uncommon and pose diagnostic challenges due to their atypical presentation. Here, we present a case report of an intramuscular intercostal lipoma located in the left axillary tail, along with a comprehensive discussion of its clinical features, diagnostic evaluation, and management options.

Well-Circumscribed Intramuscular Lipoma of Superior Rectus Muscle

Extraocular muscle lipoma is a rare benign mesenchymal tumor of the orbit. We report a case of a 37-year-old woman who presented with chronic progressive proptosis and inferior globe displacement of left eye. External eye examination revealed a yellowish mass at the superior bulbar conjunctiva. Magnetic resonance imaging showed a well-circumscribed mass confined in the superior rectus muscle belly and tendon with a fat signal. Debulking surgery was performed using the transconjunctival and vertical lid split approach. A pathological study demonstrated matured adipose tissue cells encapsulated by a thin layer of fibrous tissue, in addition to the chronic non-specific inflammation of the tenon capsule tissue sample. Histopathological findings of the mass were consistent with a well-circumscribed intramuscular lipoma. The symptoms of the patient were significantly improved 3 months after surgical and short-course systemic steroid treatments. However, long-term surveillance is needed.

Lipoma in the pronator quadratus: A case report

RATIONALE

Lipomas are common benign tumors, constituting 16% of soft tissue mesenchymal tumors. They usually occur under the skin or in the large muscles of the thigh, shoulder, or upper arm. There are few reported cases of lipomas located in the forearm and hand muscles, accounting for less than 1% of all lipomas.

PATIENT CONCERNS

A 47-year old man presented with a history of swelling and accompanying pain in the left wrist for 2 years.

DIAGNOSES

The patient was diagnosed with intramuscular lipoma in the pronator quadratus.

INTERVENTIONS

The mass was resected completely with wide-awake technique.

OUTCOMES

The patient was followed up for 2 years with no recurrence. The symptoms of swelling and pain resolved within 3 weeks post-surgery, and there was no clear abnormality in wrist and finger movement and sensation. A satisfactory outcome was achieved.

LESSONS

Intramuscular lipoma in the pronator quadratus is a rare benign tumor which should be distinguished from malignant tumors. Especially for patients with carpal tunnel syndrome presenting with wrist swelling, ultrasound, computed tomography, or magnetic resonance imaging can be used to assess deep tissue masses.

Co-existence of oral intra-muscular lipoma and lobular capillary hemangioma: A rare case report

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Intra muscular lipoma are rare with an incidence of 1.8%.

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Most common site for oral intramuscular lipoma is tongue.

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Intramuscular lipoma has shown recurrence due to difficulty in complete excision of the lesion.

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Immunohistochemistry plays a crucial role to distinguish Lobular capillary hemangioma from pyogenic granuloma.

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Co-existence of other lesions with Lipoma are reported in literature hence it is crucial to do a complete clinical examination in such cases.

Introduction

Intramuscular lipoma are benign mesenchymal soft tissue neoplasm of mature adipocytes that arises within the muscle. Oral intramuscular lipoma are more commonly seen on tongue. Lobular capillary hemangioma (LCH) on the other hand are common benign vascular neoplasms which are often confused with pyogenic granuloma.

Presentation of case

In this paper we present a rare case of co-existence of oral intramuscular lipoma with LCH. A 65 year old male complains of swelling on the left chin region from past 4–5 years. On complete intraoral examination another mass was noted on ventral surface of tongue. After performing USG and FNAC of the swelling in the chin region, an excisional biopsy was done and was sent for histopathological examination which showed thin connective tissue septa separating lobules of mature adipocytes.

Histopathological examination of tongue mass revealed a benign tumor composed of blood vessels comprising of small capillary sized vascular channels. After a follow-up of 1 year patient showed no signs of recurrence.

Discussion

According to the literature recurrences are seen in case of intramuscular lipoma due to difficulty in total excision of the lesion. Immunohistochemistry plays a crucial role in distinguishing LCH from pyogenic granuloma. Intraoral LCH should be properly excised after understanding the vascularity of the lesion.

Conclusion

In literature, the co-existence of intraoral lipoma with other lesions have been encountered hence for a surgeon a complete examination of oral cavity plays a crucial role to rule out such co-existence.

Endoscopic treatment of a periorbital fat herniation caused by spontaneous solution of continuity of the papyracea lamina

We present a case of a 16-year-old girl with interruption of papyracea lamina and herniation of the periorbital fat covered by a bone shell. The patient presents with a history of diplopia and visual disturbances ever since she can remember. Thanks to radiological imaging and biopsy, we have done differential diagnosis with periorbital lipoma, intraosseous lipoma and intramuscular lipoma of medial rectus. Diagnostic for images is necessary for a correct operative planning. Endoscopic sinus surgery with computer-assisted navigation is the safest and most effective method to remove the lesion that was closely related to the medial rectum muscle and to the anterior ethmoidal artery. The patient after surgery and in 1 year of follow-up reports the disappearance of symptoms.

Intramuscular lipoma: a review of the literature

Lipomas are the most common type of soft tissue mesenchymal tumors. They are typically located subcutaneously and consist of mature fatty tissue. When they occur under the enclosing fascia, they are called deep-seated lipomas. Infrequently, lipomas can arise inside the muscle and are called intramuscular lipomas. Intramuscular lipomas have been commonly investigated and categorized in the same group as other deep-seated and superficial lipomatous lesions. Their clinical, histological and imaging characteristics may resemble well-differentiated liposarcomas, further adding to the difficulties in the differential diagnosis. This article summarizes the available literature and describes the typical epidemiological, pathological and clinical features of intramuscular lipomas, as well as delineating their treatment and prognosis.

Well-circumscribed type of intramuscular lipoma in the chest wall

A tumor shadow was identified in the chest X-ray of a 40-year-old Korean man and he was referred to our hospital. The computed tomographic (CT) scan of his chest showed a 3-cm rounded pleural-based mass lesion with calcification, which was growing into the intercostal muscles. Thoracoscopic surgery was performed to resect the tumor. From the histological findings, the tumor was diagnosed as an intramuscular lipoma. The patient displayed no evidence of recurrence for more than 18 months. As well-circumscribed type of intramuscular lipoma is a rare tumor, we report this case with a literature review in this paper.