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Angiolipoma: a review of 778 lesions in 344 patients. Skeletal Radiol 2023; 52:541-552. [PMID: 35668116 DOI: 10.1007/s00256-022-04075-9] [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: 03/24/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Angiolipomas are benign subcutaneous nodules that are commonly multifocal and easily overlooked by those not familiar with their appearance. The objective of this study was to identify the spectrum of the clinical and imaging features of this lesion, to include MR, CT, and US features. METHODS A retrospective review of our institutional pathology database for biopsy-proven cases of angiolipoma between January 1, 2019, through December 31, 2021, was done. We identified 334 patients who underwent surgical resection of 788 individual lesions. MR imaging studies were available in 43 cases, CT in 39 cases, and ultrasound imaging in 72 cases. Clinical features (patient age, gender, surgical indication, number of lesions) were reviewed. Imaging feature analysis included the anatomic location, content of fat, vascularity, and modality-specific imaging features. RESULTS All 778 angiolipomas were located in the subcutaneous tissues (median size, 2.4 cm, range 0.4-7.7 cm), with over 51% located in the upper extremity. The most common presentation was a symptomatic mass or slowly growing symptomatic mass. Imaging showed a subcutaneous lesion with a lobulated bean shape, which typically abutted the skin. Intralesional fat was identified in 85% of lesions on CT and MRI. Vessels were commonly seen on CT and MR, with enhancement best seen on MR. On US, lesions were heterogeneous and mildly hyperechoic, most often with no identifiable vascularity. CONCLUSION Angiolipomas typically have characteristic imaging features. Awareness of this diagnosis and the spectrum of its imaging features is important and can facilitate a definitive diagnosis.
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Giant Posttraumatic Angiolipoma of the Forearm: A Case Report and Review of the Literature. Case Rep Orthop 2021; 2021:4047777. [PMID: 34336328 PMCID: PMC8318740 DOI: 10.1155/2021/4047777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/03/2021] [Indexed: 12/15/2022] Open
Abstract
Angiolipoma is a type of lipoma, a benign soft tissue tumor. It is distinguished by the excessive degree of vascular proliferation and the presence of mature adipocytes. It occurs commonly on the trunk and extremities. Angiolipomas larger than 4 cm are classified as "giant," and due to their size, histological evaluation is necessary to exclude malignancy. We report a case of a male patient who suffered from a giant noninfiltrating intramuscular angiolipoma which formed after venipuncture in the antecubital fossa. Clinical examination showed a palpable painless soft mass. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a giant angiolipoma on the right forearm. Surgical removal of the mass was performed, and the biopsy was negative for malignancy. To the best of our knowledge, this is the first report in the literature of posttraumatic intramuscular angiolipoma. Physicians and orthopedic/general surgeons should be aware of the possibility of soft tissue masses in a posttrauma situation.
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Affiliation(s)
- Robert W Morris
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Youssef Al Hmada
- Department of Pathology and Laboratory Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Joseph R Chaudry
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Kathryn M Nutter
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Chris D Reed
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
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Yeo ED, Chung BM, Kim EJ, Kim WT. Infiltrating angiolipoma of the foot: magnetic resonance imaging features and review of the literature. Skeletal Radiol 2018; 47:859-864. [PMID: 29322209 DOI: 10.1007/s00256-017-2870-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/25/2017] [Accepted: 12/27/2017] [Indexed: 02/02/2023]
Abstract
Angiolipoma is a benign soft tissue tumor with two subtypes: non-infiltrating and infiltrating. Although histologically benign, infiltrating angiolipoma can invade surrounding structures. The foot is a very rare location for angiolipoma, with only four cases reported in the English literature, including one infiltrating type. Here, we report a very rare case of infiltrating angiolipoma of the foot with magnetic resonance imaging (MRI) and ultrasonography (US) findings. A 7-year-old boy presented with a slowly growing foot mass. MRI showed an unencapsulated mass involving the third web space extending to the foot dorsum and sole. The mass was isointense to subcutaneous fat and was mixed with internal T1 low-signal-intensity enhancing areas. On US, we observed a heterogeneously hypoechoic mass with internal vascularity. Imaging and clinical features of angiolipoma and the radiologic differential diagnoses of a fat-containing mass in the pediatric foot are reviewed here. When there is an ill-defined foot mass with a fat component and variable enhancing portions in a child, infiltrating angiolipoma should be included in the differential diagnosis along with other fat-containing tumors.
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Affiliation(s)
- Eui Dong Yeo
- Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, Republic of Korea
| | - Bo Mi Chung
- Department of Radiology, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, Republic of Korea.
| | - Eun Ju Kim
- Department of Pathology, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, Republic of Korea
| | - Wan Tae Kim
- Department of Radiology, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, Republic of Korea
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Wu Z, Wan H, Shi M, Li M, Wang Z, Yang C, Gao W, Li Q. Bronchoscopic resection of bronchial angiolipoma: A rare case report. Mol Clin Oncol 2017; 5:850-852. [PMID: 28101361 DOI: 10.3892/mco.2016.1069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 10/20/2016] [Indexed: 11/06/2022] Open
Abstract
Angiolipoma is a rare benign tumor that most commonly occurs in the extremities and trunk. Angiolipomas originating in the bronchial tree are extremely rare. To the best of our knowledge, only one such case, confined to the bronchus intermedius, has been reported to date. The present study describes the case of an asymptomatic 74-year-old man with a yellowish round mass incidentally discovered at the orifice of the right lower bronchus during a routine health check. The tumor originated from the membranous part of the right inferior bronchus. Using a high-frequency electric snare and argon plasma coagulation under general anesthesia, successful bronchoscopic resection of the tumor was performed. At 15 months after the surgery, the patient remained recurrence- and symptom-free.
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Affiliation(s)
- Zhiqiang Wu
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Hongli Wan
- Department of Gynecology and Obstetrics, Sichuan Provincial Communications Department Highway Bureau Hospital, Chengdu, Sichuan 611731, P.R. China
| | - Min Shi
- Department of Pathology, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Ming Li
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Zhanpeng Wang
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Caixia Yang
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Wei Gao
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
| | - Qingxin Li
- Department of Thoracic Surgery, Lanzhou General Hospital of PLA, Lanzhou, Gansu 730050, P.R. China
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Papakonstantinou PE, Korkolopoulou P, Lassithiotakis D, Lolis ED. Giant angiolipoma of the arm in an elderly patient. Ann R Coll Surg Engl 2016; 98:e100-2. [PMID: 27241610 DOI: 10.1308/rcsann.2016.0150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Angiolipoma is a histological variant of lipoma and is the most common neoplasm in the trunk and extremities of young adults. It is extremely rare in elderly people, and its size is ≤4cm. Few data are available for large angiolipomas. Case History An 86-year-old patient was admitted to our surgical department due to a large mass on his left arm, which was resected. The specimen measured 19.5 × 15 × 10.5cm. Histopathological examination revealed a benign non-infiltrating angiolipoma. This is the first report of a giant angiolipoma of the arm reported in an octogenarian patient. Conclusions Giant lipomas of the upper extremities are extremely rare. Resection is associated with cure in most patients, but regular follow-up should be considered.
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Affiliation(s)
| | - P Korkolopoulou
- First Department of Pathology, National and Kapodistrian University of Athens , Athens, Greece
| | - D Lassithiotakis
- Department of Surgery, General Hospital of Rethymno , Rethymno, Crete , Greece
| | - E D Lolis
- Department of Surgery, General Hospital of Rethymno , Rethymno, Crete , Greece
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Zhuang KD, Tandon AA, Ho BCS, Chong BK. MRI features of soft-tissue lumps and bumps. Clin Radiol 2014; 69:e568-83. [PMID: 25256016 DOI: 10.1016/j.crad.2014.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 08/18/2014] [Accepted: 08/20/2014] [Indexed: 12/28/2022]
Affiliation(s)
- K D Zhuang
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore.
| | - A A Tandon
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - B C S Ho
- Department of Pathology, Tan Tock Seng Hospital, Singapore
| | - B K Chong
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
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Kumar S, Hasan R, Maddukuri SB, Mathew M. Angiomyoma presenting as a painful subcutaneous mass: a diagnostic challenge. BMJ Case Rep 2014; 2014:bcr-2014-206606. [PMID: 25323285 DOI: 10.1136/bcr-2014-206606] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Angiomyoma of the extremity is a notoriously elusive preoperative diagnosis, as the list of differentials for its described classic clinical features of a painful mobile subcutaneous mass is quite vast. Imaging features described for angiomyomas are far from being specific. On ultrasound, angiomyomas are mostly described as a well-defined solid mass lesion showing robust internal vascularity. On T2-weighted MRI they have been described as homogenous to heterogeneously hyperintense relative to skeletal muscle. We report a pathologically proven angiomyoma around the knee joint in a middle aged man, describe its clinical and imaging features, and outlay an approach in diagnosing this rare entity as a differential for painful subcutaneous mass lesions.
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Affiliation(s)
- Sandeep Kumar
- Department of Radiodiagnosis, Kasturba Medical College, Manipal, Karnataka, India
| | - Roumina Hasan
- Department of Pathology, Melaka Manipal Medical College, Manipal, Karnataka, India
| | | | - Mary Mathew
- Department of Pathology, Kasturba Medical College, Manipal, Karnataka, India
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Kitagawa Y, Miyamoto M, Konno S, Makino A, Maruyama G, Takai S, Higashi N. Subcutaneous Angiolipoma: Magnetic Resonance Imaging Features with Histological Correlation. J NIPPON MED SCH 2014; 81:313-9. [DOI: 10.1272/jnms.81.313] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Yasuyuki Kitagawa
- Department of Orthopaedic Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Masabumi Miyamoto
- Department of Orthopaedic Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Shunsuke Konno
- Department of Orthopaedic Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Akira Makino
- Department of Orthopaedic Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Go Maruyama
- Department of Orthopaedic Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Shinro Takai
- Department of Orthopaedic Surgery, Nippon Medical School
| | - Naoyuki Higashi
- Department of Dermatology, Nippon Medical School Tama Nagayama Hospital
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