Two entities in angiolipoma. A study of 459 cases of lipoma with review of literature on infiltrating angiolipoma.
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Adult↗
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Diagnosis: subcutaneous angiolipoma, anterior abdominal wall in a patient with multiple subcutaneous angiolipomas.
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Abdominal Muscles↗
Spinal angiolipomas: report of a case and review of the cases published since the discovery of the tumour in 1890.
Angiolipomas of the spinal canal are extremely uncommon benign neoplasms composed of mature lipomatous and angiomatous elements. A case of thoracic spinal extradural angiolipoma producing progressive spinal cord compression in a 54-year old housewife is presented and 74 previously reported cases in the world literature over a period spanning nearly one century from 1890 to the present are analysed. The 75 total cases (46 females and 29 males) ranged in age from 6 to 73 years (mean 42.7, SD 15.9; median 43). The angiolipomas were located in the extradural compartment in 72 patients and intradural compartment in 3; 14 of the extradural lesions infiltrated the surrounding bone (infiltrating subgroup). Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the fat-density lesions in all the cases that we studied. The findings indicate that spinal angiolipomas predominantly affect women. Their preponderance in peri- or postmenopausal women, and their fluctuating clinical course during the pregnancy support a role of hormonal influence on the development of the lesion. They often involve the thoracic region, and produce symptoms and signs of spinal compression and, in some cases, bone involvement. MRI is the investigation of choice for the diagnosis of these lesions. Non-infiltrating angiolipomas can usually be removed easily through a laminectomy, but infiltrating angiolipoma can be only partially resected. However, outcome is not worse in the infiltrating than in the non-infiltrating lesions and appears to be relatively independent of the completeness of the surgical removal. Subtotal resection usually provides substantial symptomatic relief, because these lesions are slow growing and do not undergo malignant transformation. The results of this review show that angiolipomas of the spinal canal have a good prognosis after surgical removal, even if infiltrating.
Angiolipoma↗
Spinal angiolipomas revisited: two case reports.
Approximately 60 cases of spinal angiolipomas have been described in the medical literature. Extradural tumours predominate. Lesions with a bony component, the infiltrating subgroup, were reported in 10 patients. Intradural angiolipomas were found three times. Several excellent review articles are available, but a systematic comparison of the characteristics of the two major varieties, infiltrating and non-infiltrating spinal extradural angiolipomas, has not so far been made. The authors operated on two patients with spinal angiolipomas and found one of them the infiltrating and the other the non-infiltrating type. Then, they proceeded to a review of all publish cases of infiltrating angiolipomas. With a knowledge of recently reported data on the subject the authors compared essential clinical features of both varieties of tumours. They share identical clinical characteristics. Differences found in age, sex or location were not statistically significant. Mode of onset and signs and symptoms present on admission were essentially similar. As could be anticipated, removal was more often complete in non-infiltrating tumours, but outcome was good or fair in more than 85% of cases in both groups. Involvement of bone by spinal angiolipomas does not imply a worsening in the prognosis.
Adult↗
Angiolipoma of suprasellar region.
An angiolipoma of the suprasellar region occurred in an 8-year-old boy. Review of 5 intracranial angiolipomas, including the current case, revealed that four were in the sellar region of one man and three women. One was in the thalamus of a man. The average age of the patients was 49 years, and average size of the tumors was 2.5 cm across. The angiolipomas associated with the sellar region often created abnormalities of the eye viz exophthalmos, decreased vision, and palsy of the oculomotor nerve. Sudden onset has ensued in a massively hemorrhagic thalamic angiolipoma. The characteristic low density with negative Hounsfield unit values in CT scan and hyperdensity in MRI of the brain suggested adipose tissue component of the angiolipoma. The angiography has depicted the angiomatous component of the latter. The combined characteristic CT scan, MRI, and angiographic features should demonstrate both vascular and adipose tissue elements of the angiolipomas before pathologic examination.
Adult↗
Case report: gastric angiolipoma with chronic hemorrhage and severe anemia.
Lipomas are benign tumors that are common in other sites but rare in the stomach. They are usually submucosal and, when symptomatic, are most often accompanied by gastrointestinal hemorrhage. Angiolipoma is a not uncommon benign lipomatous neoplasm with a characteristic vascular component that almost exclusively occurs in the subcutaneous tissue. A case of gastrointestinal angiolipoma, which appears to be only the second one reported, is discussed. The patient, a 69-year-old man, presented with signs and symptoms of chronic hemorrhage and severe anemia (hemoglobin 6, hematocrit 19.9). The patient's condition was found to have resulted from ulceration of the gastric mucosa overlying a submucosal angiolipoma, and the anemia resolved after local surgical resection of the tumor. Electron microscopic studies supported the light microscopic diagnosis of angiolipoma. The absence of fibrin thrombi in this and other nonsubcutaneous angiolipomas and the possible significance of the vascularity of these tumors is discussed. The literature regarding gastric lipoma and angiolipoma is reviewed.
Aged↗
Cellular angiolipoma.
Three examples of cellular angiolipoma are presented. They occurred as part of multiple, occasionally painful, subcutaneous nodules on the extremities and trunk of healthy men. There was no familial tendency. Grossly, the cellular angiolipomas were small lesions, approximately 1 cm. Histologically, dense cellular angiomatous tissue comprised more than 95% of the lesions. Much of this component contained prominent spindle cells. Lesser degrees of involvement in the other subcutaneous nodules illustrated the continuum of histology between cellular angiolipomas and more typical angiolipomas. The differential diagnosis of cellular angiolipomas includes spindle cell lipoma, Kaposi's sarcoma, and other vascular tumors. The most important distinguishing features are encapsulation, intravascular fibrin thrombi, septation, association with other more typical angiolipomas, and occurrence in healthy individuals.
Adult↗
Spinal angiolipomas: MR features.
PURPOSE: To determine the MR features of spinal angiolipomas and to compare these findings with their histologic appearance. METHODS: The MR examinations of three patients with surgically proved angiolipomas were reviewed for tumor location and extent, signal characteristics, and pattern of contrast enhancement, and were then compared with the histologic findings. RESULTS: Four tumors were found in the three patients, all located in the posterior epidural compartment, averaging about 2.5 vertebral bodies in length. On noncontrast T1-weighted images, all lesions were inhomogeneous and hypointense relative to epidural fat. Inhomogeneous enhancement was seen in three lesions on postcontrast T1-weighted images obtained with fat-saturation techniques. Angiolipomas were least conspicuous on T2-weighted images. A high vascular content correlated with the presence of large hypointense regions on T1-weighted images. CONCLUSION: Spinal angiolipomas are typically hyperintense on noncontrast T-1-weighted images relative to other tumors. Angiolipomas that contain large hypointense foci on noncontrast T1-weighted images can be expected to have a high degree of vascularity.
Adult↗
Angiolipoma of the parotid: case report and review.
An angiolipoma is a benign adipose tissue tumor that can occur as either a circumscribed or an infiltrating lesion and represents up to 17% of all lipomas. Most angiolipomas occur in teenagers and young adults, and are rarely described in younger children. Angiolipoma generally arises on the extremities or trunk, and it is unusual when found in the head and neck. An angiolipoma of the parotid region was suspected in an infant girl after contrast-enhanced computerized tomographic scan, and was confirmed when the mass was surgically excised. The clinical characteristics, radiological appearance, and histopathology of angiolipoma are discussed.
Female↗
Infiltrating angiolipoma in the foot.
A case of infiltrating angiolipoma of the right lower extremity is reported. Angiolipomas are benign neoplasms of adipose tissue with a rich vascular component and are classified as either infiltrating or noninfiltrating. Noninfiltrating angiolipomas are seen in young individuals, present as painful, soft, subcutaneous nodules and are treated by enucleation. Infiltrating angiolipoma is a rare neoplasm with only 23 previously reported cases. These lesions are usually unencapsulated or rarely partially encapsulated and tend to infiltrate bony, neural, muscular, and fibrocollagenous tissue. Treatment of infiltrating angiolipomas is aimed at wide excision with radiotherapy indicated for cases of recurrence.
Amputation, Surgical↗
A case of paranasal sinus angiolipoma.
OBJECTIVE: To present the first documented case of an angiolipoma of the maxillary sinus, our treatment of the patient, and the 1-year follow-up results. At the conclusion of the report, the reader should be able to discuss the incidence, treatment options, and long-term prognosis of angiolipomas of the paranasal sinuses. STUDY DESIGN: A case study reporting on a single patient with the diagnosis of maxillary sinus angiolipoma. METHODS: Review of diagnostic studies, the operative technique, and the patient's chart for the 1-year period after treatment. RESULTS: The patient remains free of disease 1 year after definitive surgical treatment. CONCLUSIONS: Angiolipomas are exceedingly rare in this location. The accepted treatment for this disease in other regions of the body consists of wide local excision with close follow-up. The extent of the disease found in this patient required a medial maxillectomy for en bloc resection. We would advocate such an approach for other physicians who are faced with a patient with this rare diagnosis.
Adult↗
Subacute paraparesis induced by venous thrombosis of a spinal angiolipoma: a case report.
STUDY DESIGN: A case report of spinal extradural angiolipoma, a rare tumor that can cause spinal cord compression, is presented with a complete review of the literature related to this disorder. OBJECTIVES: To discuss venous thrombosis involving the angiolipoma in the development of subacute paraparesis. SUMMARY OF BACKGROUND DATA: This case shows that venous thrombosis of a spinal angiolipoma can precipitate the subacute onset of paraparesis. METHODS: Medical history, physical findings, and the results of imaging and histopathologic studies were analyzed to elucidate the pathogenesis of the patient's subacute onset of paraparesis. A bilateral T3-T7 laminectomy was performed, and although the tumor was extremely hemorrhagic, it was mobilized easily off the compressed dura to achieve resection. RESULTS: The postoperative course was uneventful. One month after her surgery, the patient's myelopathic symptoms had resolved, and the she was able to return to work. CONCLUSION: Because the prognosis after surgical management of these lesions is favorable, the diagnosis of thrombosis involving a spinal angiolipoma should be considered in the differential diagnosis of subacute spinal cord compression.
Acute Disease↗
Mast cells in angiolipomas and hemangiomas of human skin: are they important for angiogenesis?
To characterize the potential role of mast cells (MC) in angiogenesis, this study tests the hypothesis that MC may be more abundant in angiolipomas than in classic lipomas. MC counts were compared in 13 subcutaneous angiolipomas and 15 subcutaneous classic lipomas stained with Giemsa. Angiolipomas had ten times as many MC as did classic lipomas (25.34 +/- 2.83 versus 2.41 +/- 0.37 per mm2, mean +/- SE). To clarify whether this difference was primary (angiogenic activity) or secondary to the increased vascularity, MC were counted in 8 longstanding cutaneous capillary hemangiomas versus 13 cutaneous capillary hemangiomas of recent onset (pyogenic granulomas). If MC were mediating primary angiogenesis, one would expect them to be present in greater numbers in early than in late hemangiomas. To the contrary, however, long-standing hemangiomas were found to have significantly more MC than had those of recent onset (52.48 +/- 14.99 versus 6.59 +/- 3.37 per mm2, mean +/- SE). These results suggest that MC may not play an essential, early role in the proliferation of blood vessels in angiolipomas and hemangiomas, but rather may be related to maturation of blood vessels in these tumors.
Angiolipoma↗
Angiolipoma of the colon with right lower quadrant abdominal pain.
BACKGROUND/AIM: An angiolipoma is a common benign neoplasm with a characteristic vascular component that occurs in the subcutaneous tissue and rarely in the gastrointestinal tract. We report on a 69-year-old man with a submucosal angiolipoma in the cecum. METHODS: This patient was treated with a laparoscopy-assisted ileocecostomy, and a side-to-side anastomosis was performed extracorporeally. RESULTS: A light microscopic study supported the diagnosis of an angiolipoma of the colon. After 5 years of follow-up, the patient has no symptoms or signs of recurrence. CONCLUSION: The colonic angiolipoma was successfully removed using a minimally invasive laparoscopic technique.
Abdominal Pain↗
Lumbosacral angiolipoma: case report.
We present a case of a 46-year old woman with a ventral epidural angiolipoma at the lumbosacral level with erosion of the sacrum. About ninety cases of spinal angiolipomas have been previously described in the literature, most of them situated on the thoracic region, dorsal to the dural sac. Angiolipomas can be radically excised with a good prognosis even in the presence of bone erosion. We did not find any other angiolipoma at the sacral level surgically explored in the review of the literature.
Angiolipoma↗
[Oropharyngeal angiolipoma: a case study].
Angiolipoma is a histological variation of lipoma. It occurs in 17% of the cases of lipoma and the cervico-facial localization is quite rate. Indeed, in the literature 17 cases of angiolipoma have been presented in the head and neck region and none in the oropharygeal area. The present work reports a case of pedunculate angiolipoma in a 44-year-old male: the red-violaceous growth resting on the upper surface of the tongue--was 13 cm long and 1 cm in diameter. The implantation base corresponded to the left posterior-lateral wall of the oropharnyx, 1 cm below the lower tonsilar pole. A serreneoud loop was used to remove the angiolipoma in direct view, the patients mouth held open with an autostatic gag. Histologically it was a non infiltrating variant for which simple removal is curative and recurrences are rare. Viceversa, removal of the infiltrating type requires expanding there section edges to include surrounding tissues in an attempt to preventre currences which are quite frequent (occurring in approximately 50% of the cases).
Adult↗
Angiolipoma of thalamus presenting with abrupt onset suggestive of cerebrovascular disease.
A 25-year-old man had angiolipoma of the left thalamus producing sudden severe headache, coma, right hemiparalysis, and aphasia as usually observed in cerebrovascular disease. The patient remained right hemiparalytic and aphasic after removal of the thalamic lesion. A vascular lesion was also detected angiographically in the left lateral ventricular choroid plexus but was not excised. Only 3 intracranial angiolipomas including the current instance were on record. However, it was only in our patient that the lesion suddenly presented with intracerebral hemorrhage. The pathogenesis of the angiolipoma was suggested to be associated with maldifferentiation of mesenchyme and/or its derivatives toward the vascular and adipose tissue within the same mass, resulting in the formation of the angiolipoma.
Adult↗
Infiltrating angiolipoma of the M. temporalis.
Angiolipomas are rare benign mesenchymal tumours that are distinguished from common lipomas by a marked degree of vascularisation. They are differentiated into non-infiltrating and the even less frequent infiltrating angiolipomas. The present case is the 9th report of an infiltrating angiolipoma of the head and neck. The patient was a 63-year-old man with an infiltrating angiolipoma of the left M. temporalis. Microscopic examination showed univacuolated adipose cells mixed with capillaries invading skeletal muscle. The patient has been free of recurrence since excision of the tumor.
Humans↗