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Nagpal A, Gharde P, Navandhar PS, Singh C, Sapkale B. Hidden in Muscles: A Case Study of Intramuscular Lipoma. Cureus 2024; 16:e61278. [PMID: 38947713 PMCID: PMC11212837 DOI: 10.7759/cureus.61278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/28/2024] [Indexed: 07/02/2024] Open
Abstract
This case report presents a 64-year-old male with a giant intramuscular lipoma on the right lumbar region's latissimus dorsi muscle. The patient presented with painless swelling, which gradually increased over six years. Magnetic resonance imaging (MRI) confirmed the presence of the lipoma, prompting surgical intervention. The surgical procedure involved meticulous dissection and complete excision of the tumor. Histopathological examination validated the diagnosis. Comparative analyses with similar cases highlighted variations in surgical approaches and the challenges in managing intramuscular lipomas. This case emphasizes the importance of considering intramuscular lipomas in soft tissue mass differentials and the significance of comprehensive management strategies for optimal patient outcomes.
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Affiliation(s)
- Ashna Nagpal
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pankaj Gharde
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratik S Navandhar
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Chahat Singh
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Bhagyesh Sapkale
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Tamura R, Hirotani T, Yasui Y, Okajima H. Rapidly growing intramuscular lipoma: a unique entity of benign lipomas in children. BMJ Case Rep 2024; 17:e253408. [PMID: 38417947 PMCID: PMC10900357 DOI: 10.1136/bcr-2022-253408] [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] [Indexed: 03/01/2024] Open
Abstract
This report presents a case of an intramuscular lipoma observed in the left back of a healthy female toddler. It was resected after 3 months of observation because of rapid enlargement, raising suspicion of malignancy. Histopathological examination confirmed a diagnosis of intramuscular lipoma without malignant and blastemal components. Intramuscular lipomas are benign neoplasms that mostly appear as a rapidly growing tumour. Several hypotheses regarding the pathogenesis of this characteristic growth pattern have been proposed, including atrophy of the surrounding muscle, reactive adipocytic neoformation and multiple contractive interactions between the lipoma and the surrounding muscle.
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Affiliation(s)
- Ryo Tamura
- Pediatric surgery, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Taichi Hirotani
- Pediatric surgery, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Yoshitomo Yasui
- Pediatric surgery, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Hideaki Okajima
- Pediatric surgery, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
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Alsaket LZ, Gehani SA, Ingvarsson MJ, Alobadli AM. Intramuscular intercostal lipoma in the left axillary tail: A case report and discussion. Radiol Case Rep 2023; 18:4389-4392. [PMID: 37929049 PMCID: PMC10624767 DOI: 10.1016/j.radcr.2023.09.003] [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: 07/10/2023] [Revised: 08/29/2023] [Accepted: 09/01/2023] [Indexed: 11/07/2023] Open
Abstract
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.
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Affiliation(s)
- Lina Z. Alsaket
- Department of Radiology, Hamad Medical Corporation, Doha, Qatar
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A rare case of chest wall lipoma growing into the pleural cavity: a case report. J Cardiothorac Surg 2021; 16:197. [PMID: 34247638 PMCID: PMC8274025 DOI: 10.1186/s13019-021-01576-x] [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: 09/03/2020] [Accepted: 07/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Several cases of lipoma in unusual locations in the thorax have been reported. Appropriate surgical treatment depending on the location and shape is often required. Case presentation We herein report an extremely rare case of a chest wall lipoma growing into the pleural cavity. The tumor was successfully removed without damaging the capsule by a combination of direct and thoracoscopic approaches. Conclusions Chest wall lipomas growing into pleural cavity can be successfully treated by a combination of direct and thoracoscopic approaches.
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Parikh RN, Aziz F, Rutagengwa D, Hamilton AE. Large Intermuscular Lipoma Presenting as a Groin Hernia. Cureus 2020; 12:e11584. [PMID: 33364108 PMCID: PMC7749841 DOI: 10.7759/cureus.11584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 11/05/2022] Open
Abstract
Lipomas are the commonest benign mesenchymal tumours, commonly seen as a subcutaneous lump. However, intermuscular lipomas are uncommon and can remain asymptomatic until they attain larger sizes. We discuss a rare case of a large symptomatic intermuscular lipoma in a 34-year-old woman who presented with acute on chronic groin pain. Clinical examination findings were consistent with an incarcerated inguinal hernia and imaging confirmed a large intermuscular lipoma of the anterior abdominal wall, the tip of which herniated into the inguinal canal. She underwent open primary repair of the hernia along with excision of the lipoma. An intermuscular lipoma presenting as an incarcerated inguinal hernia at the first instance is an uncommon finding. Due to lack of obvious clinical findings, uncomplicated intermuscular lipomas can be challenging to diagnose until they become symptomatic, and a high degree of suspicion in patients reporting atypical abdominal and groin pain, or abdominal wall fullness is required.
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Affiliation(s)
| | - Fadie Aziz
- General Surgery, Campbelltown Hospital, Sydney, AUS
| | - Damacent Rutagengwa
- General Surgery, Liverpool Hospital, Liverpool, AUS
- General Surgery, Western Sydney University, Campbelltown, AUS
| | - Auerilius E Hamilton
- Colorectal Surgery, Campbelltown Hospital, Sydney, AUS
- Macarthur Clinical School, Western Sydney University, Campbelltown, AUS
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Abstract
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.
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Affiliation(s)
- Heng Tian
- Hand Surgery, the Second Hospital of Jilin University, No. 218, Lane Ziqiang, Nanguan District, Changchun City, Jilin
| | - Wen-rui Qu
- Hand Surgery, the Second Hospital of Jilin University, No. 218, Lane Ziqiang, Nanguan District, Changchun City, Jilin
| | - Junbo Pan
- Hand and Foot Surgery, the Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Middle Road, Yangzhou City, Jiangsu, PR China
| | - Zhe Zhu
- Hand Surgery, the Second Hospital of Jilin University, No. 218, Lane Ziqiang, Nanguan District, Changchun City, Jilin
| | - Jun Liu
- Hand Surgery, the Second Hospital of Jilin University, No. 218, Lane Ziqiang, Nanguan District, Changchun City, Jilin
| | - Rui Li
- Hand Surgery, the Second Hospital of Jilin University, No. 218, Lane Ziqiang, Nanguan District, Changchun City, Jilin
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Özşen M, Yalçınkaya U, Yazıcı Z, Sarısözen MB. Lipomatous Tumors in Pediatric Patients: A Retrospective Analysis of 50 cases. Turk Patoloji Derg 2020; 36:1-10. [PMID: 31282548 PMCID: PMC10512668 DOI: 10.5146/tjpath.2019.01464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/01/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Although lipomatous tumors are the most common type of mesenchymal tumors in adults, they account for less than 10% of all soft tissue lesions in pediatric patients. In this descriptive study, we aim to present our series of pediatric lipomatous tumors consisting of lipoma, neural fibrolipoma, lipoblastoma, atypical lipomatous tumor, myxoid liposarcoma and pleomorphic liposarcoma, and to evaluate the clinicopathological characteristics of these tumors in reference to the literature. MATERIAL AND METHOD In this study, pediatric lipomatous tumor cases diagnosed between 2002 and 2018 were screened from pathological archives and retrospectively evaluated. RESULTS A total of 50 cases were diagnosed with lipomatous tumor within the mentioned period. Of the total cases, 24 were female (48%) and 26 were male (52%), with age distribution ranging from 1 to 204 months. Histopathological examination revealed lipoma in 26 cases (52%), lipoblastoma in 19 (38%), atypical lipomatous tumor in 2 (4%), myxoid liposarcoma in 2 (4%), and pleomorphic liposarcoma in 1 case (2%). CONCLUSION Although lipomatous tumors are the most common type of mesenchymal tumors; they rarely occur in children. Since there is a limited number of studies on pediatric lipomatous tumors in the literature, there is insufficient data on the prevalence and incidence of these tumors. These tumors may slowly enlarge to greater sizes, especially those localized in deep tissues, and may cause various clinical symptoms by compressing surrounding tissues. Local recurrences may occur, even after total excision, and require close monitoring.
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Affiliation(s)
- Mine Özşen
- Department of Pathology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Ulviye Yalçınkaya
- Department of Pathology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Zeynep Yazıcı
- Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Mehmet Bartu Sarısözen
- Department of Orthopedics and Traumatology, Uludag University Faculty of Medicine, Bursa, Turkey
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Schicchi N, Tiberi M, Fogante M, Andolfi M, Giovagnoni A, Refai M. Chest wall lipoma mimicking intrathoracic mass: Imaging with surgical correlation. Radiol Case Rep 2019; 14:956-961. [PMID: 31193853 PMCID: PMC6543187 DOI: 10.1016/j.radcr.2019.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 12/28/2022] Open
Abstract
Lipoma is the most frequent benign soft-tissue tumor. It originates from fat cells. According to position, it is distinguished in superficial, typically subcutaneous lipoma, or deep, such as intramuscular lipoma. This latter form is infrequently and may resemble well-differentiated liposarcoma. For this reason, early radiological detection and characterization are necessary to obtain a wide complete resection and histopathologic evaluation to differentiate benign from malign lesions. We report an extremely rare case of an intrathoracic intramuscular lipoma of the chest wall detect and characterize with chest X-ray and computed tomography examinations, resected with thoracoscopic intervention and confirmed with histopathologic analysis.
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Affiliation(s)
- Nicolò Schicchi
- Radiology Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Michela Tiberi
- Thoracic Surgery Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Marco Fogante
- Radiology Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Marco Andolfi
- Thoracic Surgery Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Andrea Giovagnoni
- Radiology Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Majed Refai
- Thoracic Surgery Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
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Unusual Location of Intramuscular Lipoma Presenting as an Extensor Tendon Tear: A Diagnostic Dilemma. Am J Phys Med Rehabil 2019; 96:e162-e163. [PMID: 28157132 DOI: 10.1097/phm.0000000000000684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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10
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Kenny EM, Egro FM, Acartürk TO. Intramuscular Lipoma within a Free Myocutaneous Flap: Systematic Review and Management. J Hand Microsurg 2018; 10:101-104. [PMID: 30154624 DOI: 10.1055/s-0038-1626686] [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: 09/02/2017] [Accepted: 12/02/2017] [Indexed: 10/17/2022] Open
Abstract
Lipomas are a common finding often of little clinical significance, but they can pose a challenge to the microsurgeon if discovered during flap harvesting, especially if found within the muscle along the pedicle or perforators. Here the authors report a case in which a well-circumscribed intramuscular lipoma was discovered within the muscle of a free myocutaneous right anterolateral thigh (ALT) vastus lateralis free flap. To the authors' knowledge, the management of lipoma during flap harvesting has not been previously discussed in the literature. A systematic review was performed, and an approach for the management of myocutaneous flaps containing a lipoma was described. Underappreciated considerations including lipoma location, growth pattern, and proximity to pedicle and perforators must be taken into account when evaluating a lipoma during flap harvest.
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Affiliation(s)
- Elizabeth M Kenny
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Francesco M Egro
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Tahsin Oğuz Acartürk
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
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Sri D, Karthik K, Compson J, Tavakkolizadeh A. Intercompartmental giant lipoma of the arm: a case report. Orthop Surg 2015; 7:74-6. [PMID: 25708039 DOI: 10.1111/os.12153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 04/28/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Denosshan Sri
- Department of Trauma and Orthopaedics, Kings College Hospital, London, UK
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McTighe S, Chernev I. Intramuscular lipoma: a review of the literature. Orthop Rev (Pavia) 2014; 6:5618. [PMID: 25568733 PMCID: PMC4274454 DOI: 10.4081/or.2014.5618] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 10/04/2014] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- Shane McTighe
- West Virginia School of Osteopathic Medicine , Lewisburg, WV
| | - Ivan Chernev
- West Virginia School of Osteopathic Medicine , Lewisburg, WV ; Beckley Appalachian Regional Healthcare , Beckley, WV, USA
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