11/166. Fatty tumors of the thorax demonstrated by CT.The radiographic signs previously described for fatty tumors of the thorax although helpful are nonspecific. In the past, the diagnosis of benign fatty tumors of the chest in asymptomatic patients required surgical intervention. This report illustrates the gamut of fat-containing tumors of the thorax encountered over a recent 1 year period. CT proved to be helpful in the diagnosis and management on these cases. When the CT numbers of the fatty lesion was around -55 EMI units, intervention was felt to be unnecessary. However, when the CT number of the mass ranged from --10 to--20 EMI units, intervention was felt to be necessary since a malignancy could not be excluded on the basis of the CT findings alone.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
12/166. Preoperative diagnosis of ileal lipoma by endoscopic ultrasonography probe.The occurrence of tumor in the small intestine is relatively rare. It has been demonstrated that lipoma of the ileum is a cause of intussusception. We report a 59-year-old man admitted to our hospital for lower abdominal pain. diagnosis of intussusception was made by abdominal x-ray and ultrasonography. enema contrast studies revealed ileocolic intussusception. colonoscopy revealed a tumor with an submucosal tumor (SMT)-like head and coil-spring appearance in the ascending colon. Endoscopic ultrasonography (EUS) revealed a hyperechoic submucosal lesion with features compatible with lipoma. Subsequently, this was confirmed histopathologically after resection. To our knowledge, this is the first report of preoperative diagnosis of ileal lipoma by EUS.- - - - - - - - - - ranking = 7.2238984252525keywords = abdominal pain (Clic here for more details about this article) |
13/166. Spindle cell lipoma of the oral cavity. Report of a rare intramuscular case with fine needle aspiration findings.BACKGROUND: Spindle cell lipoma (SCL) is a benign neoplasm characterized by a mixture of mature fat, bland spindle cells and wiry collagen in a variably myxoid background. Oral SCLs are rare, and only four cases of intramuscular SCL exist in the literature. We report the first case of intramuscular SCL of the oral cavity with fine needle aspiration (FNA) findings. CASE: A 61-year-old woman presented with a 3-cm mass in the right gingivobuccal sulcus. Papanicolaoustained FNA smears were hypocellular and contained loose collections of spindle cells in a myxoid background, numerous mast cells, rare capillary fragments and portions of skeletal muscle. The spindle cells had mild nuclear enlargement, focal nuclear irregularities, rare intranuclear inclusions and occasional small nucleoli. No lipoblasts or mitoses were identified. There was intermingling of the spindle cells with the skeletal muscle fragments. CONCLUSION: Intraoral SCL is a rare lesion but should be considered in the differential for a benign spindle cell neoplasm in the oral cavity. Clues to diagnosis on cytology include mature fat, bland spindle cells, a myxoid background and mast cells.- - - - - - - - - - ranking = 2.8017089188617keywords = back (Clic here for more details about this article) |
14/166. Spindle cell lipoma of the parapharyngeal space: first report of a case.Spindle cell lipomas are usually located in the subcutaneous tissue of the back, shoulders, and neck. To our knowledge, the presence of such a tumor in the parapharyngeal space has not yet been described. We evaluated a 45-year-old man with a tender swelling of the right parotid area that had reached the submandibular area. Clinical examination and magnetic resonance imaging revealed the presence of a tumor that coated the parotid area laterally and extended into the center of the parapharyngeal space, thus causing a dislocation of the pharyngeal muscles and mucosa. We performed a total parotidectomy and submandibulectomy on the right side and extirpated the parapharyngeal tumor. We were able to spare the facial nerve, and no facial paralysis occurred. Histologic examination revealed an atypical lipomatous tumor with a remarkably large portion of spindles.- - - - - - - - - - ranking = 0.93390297295389keywords = back (Clic here for more details about this article) |
15/166. Sonographic findings in intussusception caused by a lipoma in the muscular layer of the colon.Lipomas of the gastrointestinal tract are uncommon tumors. Almost all gastrointestinal lipomas are submucosal or subserosal, and most are asymptomatic, although they may cause abdominal pain, bowel obstruction, and gastrointestinal bleeding. The diagnosis of gastrointestinal lipoma is usually not made before surgery. We present a case of colonic intussusception caused by a lipoma that was located in the muscular layer of the colon and was diagnosed preoperatively by sonography. The descending colon appeared edematous and thick. There was layering within the lumen of the descending colon, mimicking the target sign. At the distal end of the intussusception, there was a 4.7-cm, hyperechoic, rounded lesion with a smooth margin. Surgery revealed a polypoid mass originating from the splenic flexure and causing intussusception of the colon, and pathologic analysis confirmed the diagnosis of lipoma of the muscular layer of the colon.- - - - - - - - - - ranking = 7.2238984252525keywords = abdominal pain (Clic here for more details about this article) |
16/166. magnetic resonance imaging appearance of intradural spinal lipoma.Intradural spinal lipoma not associated with spinal dysraphism is a rare tumor often presenting with nonspecific symptoms and indolent clinical course. Its intradural location and fat component is the key for proper preoperative diagnosis, which could hardly be made by traditional imaging studies including plain film and myelography. Both CT and MRI can reveal the fat component of the tumor, but MRI is superior to CT in demonstrating its relationship with adjacent normal nerve tissue. We report a 32-year-old man who had back pain for years and the symptom progressed rapidly in recent two months. MRI revealed an intradural tumor at T12 level with high signal intensity on both T1- and T2-weighted images. The signal intensity dropped dramatically with fat saturation technique, which confirmed fat as its main component. The patient received surgery and the tumor was proved to be an intraspinal lipoma.- - - - - - - - - - ranking = 1.6737920768307keywords = back, back pain (Clic here for more details about this article) |
17/166. Symptomatic lipomas of the gastrointestinal tract.Eleven patients with symptomatic lipomas of the gastrointestinal tract have been observed. The lipomas generally are relatively large, and the signs and symptoms consist mainly of abdominal pain and chronic blood loss. These lesions most commonly are seen in the colon and in the region of the ileocecal valve and less commonly in the small intestine, stomach and esophagus. Distinguishing thest tumors from carcinomas or sarcomas may be difficult, and patients are generally in the same age range as those with cancer. Roentgenologic contrast studies are helphful in localizing the tumors, but accurate tissue diagnosis usually is not made until the lesions are excised. Operative management by either local excision or segmental resection is required, and the prognosis is excellent.- - - - - - - - - - ranking = 7.2238984252525keywords = abdominal pain (Clic here for more details about this article) |
18/166. Distinction of well-differentiated liposarcoma from lipoma in two patients with multiple well-differentiated fatty masses.This case report describes the features of gadolinium-enhanced MRI in well-differentiated liposarcoma with histologic correlation and addresses the usefulness of this imaging technique in distinguishing well-differentiated liposarcoma from lipoma. gadolinium-enhanced MRI revealed significantly enhanced signal in well-differentiated liposarcoma in a background of multiple well-differentiated benign fatty masses by showing the increased vascularity in the septa of well-differentiated liposarcoma. Although such signal enhancement can be seen in some types of benign lipomatous tumors with increased blood vessels, this technique is helpful in selection of biopsy site, especially in a clinical setting of multiple fatty masses.- - - - - - - - - - ranking = 0.93390297295389keywords = back (Clic here for more details about this article) |
19/166. appendicitis masquerading as tumor: a case of two diagnoses.Acute appendicitis remains one of the most difficult diagnoses to make in the Emergency Department. We present a puzzling and unusual case. A 47-year-old man had several hours of acute abdominal pain in the right upper quadrant, point tenderness in the right midquadrant on examination, and normal chemistries. Early appendicitis was suspected and a computed tomography (CT) scan of the abdomen was obtained. appendicitis was not seen. What was evident was a retroperitoneal lipoma estimated to weigh 10 pounds. The general surgeon was consulted who believed that operation was necessary in light of the patient's continuing abdominal pain and the presence of the mass. Masses this large could cause pain from local compression of structures, or ischemia of the mass from outgrowing its blood supply. In surgery, a lipoma was observed that filled most of the retroperitoneum and displaced all the contents of the abdomen, including the cecum and its appendix. Also present was an acute appendicitis. On retrospective analysis of the CT scan, the appendicitis was evident but atypically located in the epigastrium. This case illustrates once again that the CT scan is a useful diagnostic adjunct for the diagnosis of new onset abdominal pain and specifically for appendicitis.- - - - - - - - - - ranking = 21.671695275757keywords = abdominal pain (Clic here for more details about this article) |
20/166. Endoscopic balloon dissection for removal of lipomas via transaxillary route.Minimally invasive techniques and newer endoscopic surgical techniques are being introduced to aesthetic and reconstructive procedures at an accelerating pace. A new and modified technique of endoscopic excision of large encapsulated lipomas is presented and the versatility of creation of an optical cavity and incorporation of balloon dissection is discussed in two cases. Large encapsulated lipomas were removed endoscopically via transaxillary incisions and no immediate or late complication was observed. Endoscopic removal of lipomas offers several advantages over conventional direct excision and liposuction such as avoiding blind manipulation and fragmentation of lipoma mass, and unsightly scars. One drawback of this technique can be lengthy operation times, which have been near two hours for the presented cases. We conclude that endoscopic removal of tumors from a relatively remote site is beneficial in treating such encapsulated tumors and we speculate that endoscopy will prevent unsightly scarring in important areas while decreasing the operating time as experience is gained.- - - - - - - - - - ranking = 0.93390297295389keywords = back (Clic here for more details about this article) |
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