1/128. An unusual case of cephalocele associated with lipoma of corpus callosum.Cephalocele is a part of the family of neural tube defects. Although the frequency has ranged from 1 per 2,400 to 1 per 12,500 live births, the true incidence has been hidden in stillborns, underreferral of massive defects and early pregnancy losses. It has been suggested that the size, the content of the sac and associated hydrocephalus were unfavorable factors for the prognosis. Cephaloceles may occur as isolated malformations or together with other anomalies, and associated abnormalities are present in up to 50% of the cases. We report an unusual case of encephalocele associated with lipoma of corpus callosum, and the features of magnetic resonance imaging are discussed.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
2/128. Giant cervico-mediastinal lipoma. A clinical case.The lipoma is a circumscribed mesenchymal tumour originating from adipose tissue. The lesion is usually small and asymptomatic, and is most frequently located in the neck region. The case of a 77-year-old woman with chronic extrasystolic arrhythmia caused by a non-specified ischemic cardiopathy is reported. The woman presented a swelling at the front of her neck, observed for the first time about 6 months previously. This swelling progressively increased in size, provoking dysphagia, dysphonia, persistent cough, dyspnea, light jugular turgor and palpitations. Chest x-rays showed and opaque area at the front of the neck, which extended beyond the jugular incisure by about 2 cm. NMR of the neck showed a gross lipomatous formation at the front, mainly of the left, continuing in the front mediastinal region; the trachea was dislocated to the right and compressed at the back; the vasculo-nervous fasciculus, especially on the left, was compressed and enveloped by the adipose formation. The Holter test confirmed the presence of ventricular and supra-ventricular extrasystoles. Surgery was carried out under local anaesthesia because the displacement of the laryngo-tracheal axes precluded intubation. Histological analysis of the 9 x 4 x 2.2 cm mass confirmed the diagnosis of lipoma. After removal of the mass all the symptoms, which had been provoked by compression, as well as the cardiac arrhythmias disappeared. The prompt disappearance of the latter was particularly surprising. The possibility of the external compression of the nervous structures of the neck should be taken into consideration in cases of ventricular arrhythmia of unknown origin, and systematic study of the region carried out.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
3/128. Mediastinal hibernoma.A 46-year-old asymptomatic male was detected to have a posterior mediastinal mass on a routine check-up. He underwent thoracotomy to remove the mass, which was found to be a hibernoma. The mediastinum is an extremely rare site for an even rarer tumor like the hibernoma. An additional unique feature was the very large tumor size despite which the patient was asymptomatic. Imaging studies are not helpful in revealing its clinically indeterminate nature, hence a surgical specimen is necessary to establish the correct diagnosis. Total excision is advocated for cure, as there is no known malignant potential.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
4/128. teratoma in the region of adrenal gland: a unique entity masquerading as lipomatous adrenal tumor.BACKGROUND: The aim of this study was to establish the clinical and pathologic aspects of 3 atypical lipomatous lesions in the region of the adrenal gland. methods: Three young Chinese patients (ages 18, 18, and 37 years) were seen for nonspecific back pain. Radiologic examination revealed a lipomatous lesion in the region of the adrenal gland, and hormonal assessment was normal. Calcification was noted in 2 of the 3 lesions. adrenalectomy was performed because of the size (diameter 7.5, 10, 11 cm) of the tumors with suspected local symptoms. RESULTS: On gross examination 2 tumors were cystic and 1 was solid. In all 3 patients the diagnosis was mature teratomas. The tumors were composed of mature tissues arising from more than 1 germinal layer. There was no evidence of immature elements or malignancy. adipose tissue was the predominant component in the tumors. There was no evidence of recurrent diseases in all these patients during follow-up. CONCLUSIONS: To our knowledge, this is the first report of teratomas occurring in the adrenal region. teratoma should clinically and radiologically be included in the differential diagnoses of lipomatous adrenal lesions. Excision of the teratoma is advocated.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
5/128. leptin and leptin receptor expression in a lipoblastoma in an 8-year-old girl.leptin is a hormone that is produced by adipocytes. leptin acts on specific receptors in the hypothalamus. rna was isolated from a lipoblastoma of an 8-year-old girl and the expression of leptin and leptin receptor mRNA was analyzed by RT-PCR. The lipoblastoma tumor, a rare form of childhood tumors, expressed leptin and leptin receptors in a fashion similar to normal adipose tissue. We hypothesize that the peripheral action of leptin via its receptors could play a role in the development and/or progression of lipoblastoma. Whether or not leptin and leptin receptor expression play a role in the development and/or progression of lipoblastoma and other tumors is not clear to date. Copyrightz1999S.KargerAG, Basel- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
6/128. Encephalocraniocutaneous lipomatosis: a new case report and review of the literature.Encephalocraniocutaneous lipomatosis is a rare neurocutaneous syndrome characterized by lipomatous hamartomas ranging in size from a few millimeters to several centimeters and affecting the head. Ocular anomalies and a variable degree of mental retardation with or without convulsions are usually observed. This disorder should be distinguished from other mosaic neurocutaneous phenotypes such as proteus syndrome, oculocerebrocutaneous syndrome, and nevus sebaceous syndrome. We report the clinicopathologic findings of a 4-year-old Brazilian girl affected by this syndrome and review the literature. To our best knowledge, this is the first documented case of encephalocraniocutaneous lipomatosis occurring sporadically in south america.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
7/128. Ossifying lipoma independent of bone tissue.A 46-year-old Japanese male was referred to a local hospital because of a firm, nontender mass on his neck. On physical examination, the tumor was soft, well demarcated, 3 x 2 cm in size and located in the submucosal region. It was entirely separate from the vertebrae. The resected tumor was shown to be a lipoma with focal ossification. Ossifying lipomas are rare, and the cases which are independent of bone even more so. A literature review revealed that ossifying lipoma independent of bone tissue has been reported in only 8 cases, and, interestingly, all of them occurred in the head and neck region.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
8/128. Diagnostic pitfalls in fine needle aspiration cytology of pleomorphic lipoma. A case report.BACKGROUND: Pleomorphic lipoma is an unusual pseudosarcomatous condition with characteristic morphology. Despite its pleomorphic appearance, it follows a benign course and does not recur or metastasize if completely excised. CASE: A 66-year-old man presented with swelling in the back of the neck of approximately six months' duration. The focally cellular aspirate revealed round to oval, hyperchromatic cells, rare multinucleated cells and fragments of mature adipose tissue. On initial evaluation, the smear pattern suggested a malignant neoplasm. However, upon review of the cytologic material along with histology, the characteristic pattern, including floret cells, was recognized. CONCLUSION: The rarity of pleomorphic lipoma and the atypical cellular features of the aspirate can cause difficulty in diagnosing this entity. awareness of this rare but not-uncommon entity, along with clinical correlation, is crucial in arriving at the correct diagnosis.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
9/128. Massive localized lymphedema: additional locations and association with hypothyroidism.We report the second series of a new entity called "massive localized lymphedema in morbidly obese patients" (MLL), recently described in medical literature. Our 6 cases present additional locations as well as an association with hypothyroidism. Huge masses, of longstanding duration ranging from 9 months to 8 years, afflicted the thigh, popliteal fossa, scrotum, suprapubic and inguinal region, and abdomen of morbidly obese adults. Although clinical impressions were generally of a benign process, including lipoma and recurrent cellulitis, the possibility of a malignant neoplasm could not be eliminated. Poorly defined and non-encapsulated, these skin and subcutaneous lesions were most remarkable for their sheer size, measuring 50.6 cm in mean diameter (range, 38-75 cm) and weighing a mean of 6764.5 g (range, 2,060-12,000 g) The overlying skin exhibited the induration and peau d'orange characteristic of chronic lymphedema. Grossly and histologically, a prominent marbled appearance, rendered by fibrous bands intersecting lobules of adipose tissue, simulated sclerosing well differentiated liposarcoma. However, the absence of atypical stromal cells, atypical adipocytes, and lipoblasts precluded the diagnosis of well differentiated liposarcoma. Instead, reactive features, encompassing lymphatic vascular ectasia, mononuclear cell infiltrates, fibrosis, and edema between the collagen fibers, as well as ischemic changes including infarction and fat necrosis, established the diagnosis of MLL. Although the pathogenesis of MLL may be as simple as obstruction of efferent lymphatic flow by a massive abdominal pannus and/or prior surgery, the presence of hypothyroidism in 2 of our patients suggests an alternative pathogenesis. Recognition of this entity by both clinicians and pathologists should avert a misdiagnosis as a low-grade liposarcoma.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
10/128. Lipomatous myofibroblastoma: a potential diagnostic pitfall in the spectrum of the spindle cell lesions of the breast.We report on two cases of myofibroblastoma (MFB) of the breast comprised predominantly of a mature fatty component, representing approximately three quarters of the entire tumour area. Both tumours consisted of a well-circumscribed lipomatous tumour mass containing dispersed nodular or irregularly shaped spindled cellular areas. The fatty component was represented exclusively by mature adipocytes, uniform in size and shape, lacking nuclear pleomorphism. The cellular areas contained spindly to oval cells with morphological and immunophenotypical features typical of MFB. The two components were so intimately admixed that a finger-like infiltrating growth pattern was apparent. The cases reported here as "lipomatous MFB" aim to clarify further the morphological spectrum of MFB of the breast. Lipomatous MFB may potentially mimic other benign or aggressive tumour-like lesions or even bland-looking malignant spindle cell tumours such as fibromatosis, nodular fasciitis, spindle cell lipoma, spindle cell liposarcoma, spindle cell variant of metaplastic carcinoma, spindle cell malignant myoepithelioma, and low-grade fibrosarcoma/malignant fibrous histiocytoma. The histogenesis of the present bimorphic mesenchymal tumours could be explained as the result of a dual, myofibroblastic and lipomatous, differentiation from a common pluripotential mesenchymal precursor cell, probably represented by the vimentin /CD34 fibroblast of the mammary stroma.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
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