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PubMed2003

Multiplication of infantile spinal lipomas after surgical untethering. Report of two cases.

The authors reviewed 63 cases of patients with spinal lipomas who had undergone surgical untethering in childhood and found two infants in whom multiplication of the lipomas occurred within 1 year postoperatively. More importantly, the lipomas dramatically increased in size during infancy. In each case, the pathological findings on reoperation were identical to those in the first surgery. Subsequent imaging revealed no change in size of the lesions by 10 and 7 years after reoperation, respectively. This potential for growth of the lipomas should be kept in mind in infants with spinal lipomas who should undergo follow-up neuroimaging.

Female↗
PubMed2006

Tethered spinal cord with double spinal lipomas.

Although lumbosacral lipoma is reported to occur in 4-8 of 100,000 patients, and 66% of lipomyelomeningoceles in young patients are accompanied by hypertrophic filum terminale, it is very rare to find two isolated spinal lipomas simultaneously. A 3 month-old baby girl was admitted to the hospital for a protruding, non-tender, soft, subcutaneous 2.5 cm mass of the lumbosacral area that had been present since birth. Simple radiography showed a spinal posterior arch defect from L3 to L5, and magnetic resonance imaging (MRI) demonstrated two isolated spinal lipomas, a transitional type from L3 to L5, and a terminal type below S1 without dural defect. The cornus medullaris was severely tethered descending to the S1, but there was no cerebellar or brain stem herniation on the MRI. We suggest that the presence of a combined spinal lipoma should be a point for careful differentiation in an infant with spinal lipoma.

Female↗
PubMed2001

The contribution of image cytometry to the characterization of clinical subgroups of lipomas.

The aim of the present study was to investigate whether biological features determined through image cytometry are able to characterize clinical subpopulations of lipomas. Forty lipomas excised from 36 patients were studied. On the one hand, the tumors were clinically characterized by means of patient-related and pre- and post-operative features. On the other, the tumors were analyzed by means of the computer-assisted microscopy analysis of Feulgen-stained nuclei. This analysis generated 3 groups of biological quantitative variables describing morphonuclear aspects (i.e. the chromatin pattern of the cell nuclei), the nuclear DNA content (DNA ploidy level), and architectural features (such as the cell density and the topographical cell nuclei organization). Possible relations between the clinical and the biological features of the lipomas were investigated by means of univariate and multivariate statistical analyses. The results show the existence of such relations, in particular between the morphonuclear and architectural features of lipomas, on the one hand, and their consistency, volume and weight, on the other. Furthermore, multivariate analysis made it possible to distinguish two subpopulations of lipomas exhibiting different biological characteristics in terms of morphonuclear patterns.

Adult↗
PubMed2001

[A case of cervical subpial lipoma].

The authors report the rare case of a 48-year-old woman with a cervical subpial lipoma unassociated with spinal dysraphism. Her symptoms were progressive weakness and numbness in the four extremities and the neurological symptom of mild cervical myelopathy. Plain radiographs of the cervical spine showed diffuse widening of the spinal canal, which was occupied by a large low-density mass revealed by axial CT scan. MR imaging identified the mass as being dorsolateral to the cord in the intradural region. It was hyperintense on both T1- and T2-weighted images. Axial images with fat suppression sequence clearly showed dorsal nerve roots traveling through the lesions, but the interface between the spinal cord and lesion was not well demarcated. A cervical laminectomy between C3-6 revealed a yellowish subpial mass after the dura was opened. The mass was only partially resected and intraoperative SEP monitoring data remained normal including N20 latency. Histological examination found mature adipose tissue covered by thickened pia mater, which was compatible with a diagnosis of lipoma. After surgery, no complications occurred and the patient's myelopathy subsequently improved. Subpial spinal lipomas unassociated with dysraphism are uncommon and they are reported in only 1% of all spinal cord tumors. They are thought to arise from premature dysjunction of the cutaneous ectoderm during neural tube formation. Without any invasive procedure, MR imaging is indispensable to show their longitudinal dimension as well as their infiltrative extension into the spinal cord. The main purpose of surgery is to decompress the lipoma from the adjacent neural structures, because it is benign in nature and there is no cleavage plane identifiable between the lipoma and the spinal cord.

Female↗
PubMed2001

Spindle cell lipoma of the female genital tract. A report of two cases.

BACKGROUND: Lipomas presenting in the female genital tract are most commonly seen in the vulva or myometrium as a component of a leiomyoma. These lesions have the gross appearance of a typical lipoma. CASES: Two cases of spindle cell lipoma occurred, one incidentally encountered in the cervix and the other presenting as a vulvar mass. Both lesions demonstrated histologic features characteristic of spindle cell lipomas normally found elsewhere, and the diagnosis was supported by immunohistochemical staining patterns. CONCLUSION: This is the first report of spindle cell lipomas diagnosed in the female genital tract.

Diagnosis, Differential↗
PubMedDate not supplied

[Lipoma of the cerebral convexity and refractory focal epilepsy].

INTRODUCTION: Intracranial lipomas make up approximately 0.1% of all cerebral tumours. They are considered to be congenital malformations, caused by poor differentiation and abnormal persistence of the primitive meninges, which has become adipose tissue during the development of the subarachnoid space. They are usually found in the midline, often in the cisterna pericallosa. It is very unusual for them to be in the fissure of Sylvius and cerebral convexity. Most cerebral lipomas are aymptomatic. Epileptic seizures are the commonest symptom, and are sometimes refractory to treatment. CASE REPORT: A 20 year old man with no previous clinical history. From the age of three years he had frequent senso-motor seizures of the lower half of the right side of his body, which were resistant to anti-epileptic drugs. On magnetic resonance there was an extra axial lesion in the left posterior parietal and parasagittal convexity. This was hyperintense in T(1) sequences, not seen in STIR sequences, and was compatible with fatty tissue. Subtotal removal of the tumour was carried out and the histopathological diagnosis was lipoma. The patient had no seizures in the year after operation. CONCLUSIONS: Lipomas of the cerebral hemispheres are very uncommon. The usual symptoms are focal epileptic seizures, as a result of the cortical irritation caused by close adherence of the lipoma to the cerebral cortex or associated cortical or vascular dysplasias. They have easily recognized characteristics on computerized axial tomography and magnetic resonance. Treatment should be conservative unless it is associated with refractory epilepsy, in which case careful resection may be considered, although this is rarely complete.

Adult↗
PubMed1992

[Cervicobulbar intramedullary lipoma. Apropos of a case with review of the literature].

The authors report a case of cervical intramedullary lipoma extending into the bulbomedullary junction. 99 cases of cervical and/or dorsal intramedullary lipomas without spinal dysraphism, reported since 1884, are reviewed. There is poor correlation between lipoma's length and age of onset. Only lipoma extended to all the spinal cord begin in the first years of life. Clinical presentation is in 58% of cases a slowly compressive myelopathy, a syringomyelic syndrome in 9.5% of cases, a Brown Sequard syndrome in 6.5% of cases or atypical clinical features in 26% of patients. Finding of a subcutaneous lipoma at the level of the lesion helps for diagnosis. C.T. scan and magnetic resonance imaging (M.R.I.) precise lipomatous constitution of the tumor, its limits and relations with neighbouring tissues. Surgery is necessary when clinical features are advanced. Surgery indication is debatable when neurological manifestations are poor or absent. Post operative course is generally good and is not related with type of intervention.

Brain Neoplasms↗
PubMed2004

Computed tomography diagnosis of post-obstructive atelectasis by an endobronchial lipoma.

Endobronchial lipoma is a rare benign tumor in the bronchial tree. We report a case of endobronchial lipoma in a 73-year-old man with hemoptysis. Chest radiograph revealed atelectasis of the right upper lung. Bronchoscopy revealed a well-defined endobronchial lesion in the right upper lobe bronchus with near total occlusion, but a biopsy was not performed. An endobronchial tumor was identified on CT scan with demonstration of fat within the tumor. Endobronchial lipoma was diagnosed and a sleeve lobectomy of the right upper lobe bronchus was performed. The pathological diagnosis was submucosal lipoma. The patient's symptoms improved during follow-up of more than 1 year. CT scan can be used to diagnose endobronchial lipoma and can help in the development of a management plan.

Aged↗
PubMedDate not supplied

Well-differentiated liposarcoma associated with benign lipoma.

The objective of this study was to review the clinicopathological features of seven patients presenting with well-differentiated liposarcoma (WDL), which was associated with subcutaneous lipoma. From 1980 through 2002, 34 individuals displaying WDL were treated in our institutions. Lipoma was observed in seven of these 34 patients (five men and two women, mean age of 66.7 years). The rate of co-existence of lipoma in WDL [20.6% (7/34)] cases was significantly higher than the corresponding rate in the other liposarcoma subtypes [2.5% (1/40)]. Immunohistochemically, cdk4 was positive in all WDLs (100%). ki-67 was positive in 57.1% (4/7) and mdm2 and p53 were positive in 14.5% (1/7) of the WDL cases. Weak cdk4 immunoreactivity was detected in two lipomas. All lipomas were negative for mdm2, p53 and ki-67. Comparison of the expression profile in these malignant and benign tumors, which had arisen in identical genetic backgrounds, confirmed the involvement of these proteins, especially cdk4, in the tumorigenesis process of WDL.

Aged↗
PubMed2004

Lipoma of the greater omentum in a child.

Lipoma of the greater omentum is observed very rarely, particularly in the childhood. We report a case of large 10x11x8 cm asymptomatic lipoma of the greater omentum, which was diagnosed incidentally. Well-encapsulated mass with a homogeneous internal structure and high echogenicity--these signs of ultrasound and computed tomography allowed us to suggest a lipoma. At laparotomy lipoma of greater omentum in torsion was found. The excision of the tumor and omentectomy was performed. The histopathological diagnosis was lipoma with focal necrosis areas.

Child↗
PubMed2006

Peripheral intrapulmonary lipoma: a case report and review of the literature.

Lipomas are common benign tumours, but intrathoracic lipomas are rare and peripheral lung lipomas are exceptionally rare. Eight cases have been described in the world literature. We report a case of lipoma arising in the periphery of the left lower lung in a 54-year old woman. Grossly, it was presented as a well- circumscribed, thinly encapsulated, rounded, pale yellow mass. A wedge resection was done of the left lung and the microscopic findings revealed lipoma of the lung. The present paper recapitulates the macroscopic and microscopic features, the treatment and the differential diagnosis of this rare neoplasm.

Chest Pain↗
PubMed1990

[Successful repair of a cardiac lipoma of the left ventricular free wall--a case report].

We recently encountered a patient with a very rare type of cardiac lipoma, which occurred at the left ventricular free wall and grew into the left ventricular cavity. No surgical treatment of this type of cardiac lipoma has been reported in literature. The patient was a 63-year-old woman who visited our hospital with a chief complaint of palpitation. At the outpatient clinic of our hospital, a tumor of the left ventricle was disclosed by echocardiography. After hospitalization, the patient was diagnosed as cardiac lipoma by CT scans and MR images. She was operated as follows. The apex of the left ventricle was incised and the cardiac cavity was exposed. The lipoma had its root approximately in the center of the posterior free wall of the left ventricle and had grown into the left ventricular cavity with a size of 2.5 X 2.5 X 1.8 cm and a weight of 2.8 g. After removal, the postoperative course was uneventful, but the chief complaint (palpitation) still persisted. Postoperative Holter electrocardiography disclosed that the patient had suffered from sick sinus syndrome and that palpitation had not originated from the cardiac lipoma.

Female↗
PubMed1989

[Lipoma in the lower lip: report of a case].

Lipoma, well-circumscribed tumors of mature adipose tissue, are one of the commonest encountered benign neoplasms. In the oral cavity, lipomas almost always occur in the cheek, tongue, and floor, but rarely in the lips. In this paper a 73-year old woman with lipoma in the right lower lip and cases of lipoma in the oral regions that have been reported in Japan are discussed. Her past history was diabetes mellitus and the others had no abnormalities. The specimen was a spherical, encapsulated, soft, bright-yellowish mass measuring 1.5 x 1.0cm. Microscopically, the tumor consisted of matured adipose tissue histological diagnosis of the tumor was simple lipoma. Six months postoperatively there is no sign of recurrence.

Aged↗
PubMed1989

[Thoracic and lumbo-sacral spinal lipoma in an infant].

We reported a case of thoracic and lumbosacral spinal lipoma in an 8 month-old boy. He was born in asphyxia. Six months after birth, spastic paraparesis developed gradually at both lower extremities and secondary funnel chest due to shallow thoracic movement and scoliosis in the thoracic region was observed. MRI was then performed where tumor mass demonstrated by the high signals in both T1 and T2 in ages was confirmed in the thoracic and lumbo-sacral regions. Surgery was performed only for the thoracic lesion which was considered primary. The tumor in the Th3-4 level had developed subdurally, while the tumor in the Th5-10 extradurally. Only partial removal could be done for the subdural tumor because its boundary with the spinal cord was not clearly identified. Postoperative histological study revealed it as lipoma. During the following 6 months only slight recovery from paraparesis was observed. Surgical intervention against the mass in the lumbosacral region was not performed for the conus medullaris was found located in its normal position and no concomitant symptoms could be observed. In summary, it is considered that spinal lipoma is rare (1% of total spinal tumor) and commonly associated with other types of congenital anomalies (in 31% of spinal lipoma). Particularly in infants, spinal lipoma in the thoracic region as experienced in our case is extremely rare and any medical treatment started after clinical symptoms once developed seems ineffective.

Humans↗
PubMed1988

[Radiological aspects of intestinal lipomas].

The radiological detection of intestinal lipomas is not unusual; however, in-depth studies of their radiological features have never been carried out, so far. Eighteen cases of intestinal lipoma were observed, out of different clinical histories. Through a careful survey of these cases, the authors describe the semiological characteristics of the lipomas, which were studied with radiographic contrast examinations of the small intestine and colon. In most cases the characteristics of the mass and--when present--the even more revealing features of its pedicle allowed the identification of such expansive lesions as lipomas. In some lesions detected by means of conventional methods CT proved extremely useful in diagnosing the nature of the lipomas. Such a diagnosis is extremely useful for it allows extensive surgery to be avoided and replaced with less extensive procedures--e.g. endoscopic removal of the lesion, or no specific treatment at all.

Adult↗
PubMed1988

[A case of lumbosacral lipoma and its interesting histological findings].

A case of 3-month-old girl with lumbosacral lipoma is reported. She had a large soft tissue mass (4 X 5 cm) in the lumbosacral region initially noted at birth. Interpendicular distances below L2 were dilated on X-P. CT image demonstrated a sharply outlined low density area (approximately -80 H. U.) which occupied the latter half of the spinal canal in the level of L2 to S1 level. Defect of vertebral arch was also seen. Lipoma was removed subtotally with laminectomy. CT image demonstrated clear sharp margin of the tumor, neural tissue free zone were not found intraoperatively. Post-operative course was uneventful. Specimen showed the mature adipose tissue which contained rich blood vessels and connective tissue. Connective tissue was composed of collagen fibers and elastic fibers. Small aberrant nerve fibers and smooth muscle fibers were sporadically noted in specimens obtained from nearby transitional area of its lipoma and spinal cord. Although there were a few reports about the morphology of lipoma, the existence of nerve cell, neuroglia, embryonic bone, cartilage, smooth muscle fiber, striated muscle fiber, respiratory-like cell and others were reported in the previous reports. Our histological findings also suggest that the lipoma possibly arise from pluripotential caudal cell mass which survived by disturbance of the 3rd stage of neural tube formation (retrogressive differentiation).

Female↗
PubMedDate not supplied

[Digestive lipomas: clinical and therapeutic aspects].

The authors present 6 cases of lipomas of the digestive pathways, five in females and one in a male. The patients were aged between 31 and 75 years and an average age of 51 years. The benign lipomatous tumor was unique in all the cases. It was located in the antrum in 3 of the patients and in the ileum, the right segment of the colon and on the sigmoid in each of the three other patients respectively. In all the cases the radiological examination confirmed the clinical diagnosis of digestive tumour. The radiological aspects were typical for benignity in four of the cases and suggested malignancies in the other two. Gastric lipomas were characterized from the clinical viewpoint by dyspeptic disturbances that were not systematized, as well as by bleeding while the ileal and the colic tumours were accompanied by repeated invagination. The sigmoid tumour was accompanied by colic and disturbances of the transit. The surgical solution consisted in 3 of the cases in a simple exeresis of the lipoma (two gastric lipomas and the sigmoid tumour). In one of the gastric lipomas a limited resection was performed, and for the colic and ileal tumours, complicated by invagination a right hemicolectomy was carried out.

Adult↗
PubMed1980

[Madelung's lipoma (an electron microscopic and autoradiographic study)].

In two cases of Madelung lipoma DNA and RNA synthesis in the material removed at operation was studied by electron-radioautographic techniques. Lipoma adipocytes were found to differ normal ones by incompleteness of the differentiation process. This is manifested by the retention of DNA and RNA synthesis in lipoma adipocytes. A faster rate of proliferation of stromal-vascular cells of lipoma which may be the source of formation of new adipocytes was observed. Intensified DNA and RNA synthesis in patients with Madelung lipoma was observed not only in the cells of the tumor itself but also in the adjacent fatty tissue.

Adipose Tissue↗