1291/2006. Lipofibroma of the median nerve. Tumors arising within the median nerve in the region of the distal forearm, wrist, and palm are rare and their exact pathological nature has not been well clarified. One case is reported in a 47-year-old woman, in whom a mass of 3 years' duration was located in the thenar eminence of the right hand without causing any sensory or motor deficit. The tumor was surgically excised, and the continuity of the nerve branches was preserved. The diagnosis of lipofibroma of the median nerve is recommended for this entity. Other pathological lesions of the median nerve are mentioned. ( info) |
1292/2006. Retroperitoneal lipoma in children. A case of retroperitoneal lipoma in a 23-mo old girl is reported together with a brief review of the 11 previously documented cases. It has been encountered through age 8 yr and twice as frequently in girls. The majority had an enlarged abdomen of long duration. The others were asymptomatic and found incidentally or at the time of examination for abdominal pain. Most lipomata were large. The possibility of their being congenital cannot be excluded. None have recurred. ( info) |
1293/2006. Intrathoracic lipomas. Report of three cases and review of the literature with emphasis on endobronchial lipoma. Intrathoracic lipomas are rare, benign neoplasms of unknown origin, with symptoms depending primarily on their location and size. They frequently represent on incidental roentgenographic finding and are clinically significant in that they may simulate malignant tumors and, when located endobronchially, may cause irreparable lung damage. Three cases of intrathoracic neoplasms are reported herein, and the English literature on the subject reviewed. In some cases, bronchoscopic examination may yield the diagnosis of endobronchial lipoma but, in general, thoracotomy is required for diagnosis. A more complete classification is suggested and the preferred mode of treatment is discussed. ( info) |
1294/2006. Some new results of investigation of tuberous sclerosis. The authors describe the case of a patient with tuberous sclerosis. The occurrence of M-protein with antigenous appurtenance of IgM not only in the patient himself but also in some of the healthy blood relations in the family is pointed out. The question of clinical and biochemical-immunological peculiarities occurring in connection with this disease is discussed. ( info) |
1295/2006. Lipoma of the thumb in a child. Lipomas occur anywhere in the body but are rarely found in the fingers. This report describes a lipoma of the dorsum of the thumb in a 9-year-old boy. We have been unable to find a previously reported case. ( info) |
1296/2006. Lipofibroma of the median nerve in the palm and digits of the hand. Lipofibroma of the median nerve or its cutaneous branches is a rare benign tumor. The diagnosis is usually made at surgical exploration of a mass in the distal part of the forearm, the wrist, the palm, or the digits of the hand, which may be asymptomatic or associated with symptoms of carpal-tunnel syndrome. The diagnosis should be made when exploration reveals fusiform enlargement of a segment of the median nerve or its cutaneous branches without hypertrophy of the regional tissues. The tumor is limited to within the epineurial sheath, which is intact, shiny, orange-yellow, firm, thick, and non-resilient to dissection. The nerve tumor does not infiltrate the surrounding tissues nor do the surrounding tissues infiltrate the nerve. If the epineurium is opened, the nerve fibers are found to be inseparably infiltrated by fibrous and fatty tissues. Histologically, these are of epineurial, perineurial, and endoneurial origin. A forzen-section biopsy of a palmar cutaneous branch is suggested to confirm the diagnosis. Once the diagnosis is confirmed, the treatment should be limited to release of the fascia over the involved nerve. The tumorous part of the median nerve was partly or completely excised in seven of twenty-six cases reviewed in the literature and this report. It is to emphasize a conservative approach when such a tumor of the median nerve is encountered at surgery that we describe two more cases. ( info) |
1297/2006. CT scanning in two cases of lipoma of the spinal cord. Two cases of lipoma of the spinal cord are presented. CT gives a specific diagnosis in this condition without any contrast being given. It is important to make a preoperative diagnosis, as in lipoma of the spinal cord biopsy is dangerous and frequently makes the patient worse. CT is also valuable as the length of the required decompression laminectomy can be assessed. ( info) |
| A case is presented of a 2 cm. renal angiomyolipoma. Computerized tomography demonstrated a region of low attenuation coefficient within this tumor, while B-mode ultrasound visualizes the tumor as a cluster of high amplitude echoes. The diagnosis of a renal angiomylipoma may be suspected preoperatively when this combination of findings is present with computerized tomography and ultrasound. ( info) |
1299/2006. Intrarachidian lipomas. Observations on 4 cases and pathogenetic considerations. The Authors report 4 cases of spinal lipomas: 2 intradural, 2 completely intrarachidian extradural. The intradural lipomas observed were 2 cases in the lumbo-sacral area, both operated on by the partial removal of the lesion with very good clinical results; histologically they were found to be 2 fibrolipomas. The 2 cases of extradural lipomas, completely intrarachidian, were situated in the thoracic and lumbar areas. Both were operated on with very good results and it was possible to remove all the lesion. They were found to be an angiolipoma and a mature lipoma. On the basis of the literature, the Authors maintain that, for these cases of intradural lipoma, the disembryogenetic hypothesis (such as embryological ectopia) should be accepted as etiopathogenesis. They point out the nature and origin of extradural lipomas, arising in a site where adipose tissue is abundant, have never aroused interest on their origin, but they too can be considered malformative lesions of the hamartomatous type and not neoplastic lesions. These data are confirmed by the remarkable frequency in these cases of the mixed variety of lipoangiomato or angiomiolipomatosis. The Authors thus underline the importance of the relationship between the presence of a subcutaneous lipoma in cases of completely intrarachidian extradural lipomas to support the hypothesis of malformative origin. ( info) |
| A case of corpus callosum lipoma with presumptive diagnosis is presented. review of the literature disclosed 84 cases with such diagnoses. Lipoma of the corpus callosum is a rare intracranial lesion, perhaps congenital and often asymptomatic, but can present with seizure disorder, headache, mental changes, paresis or paralysis. Twenty-one patients had been operated upon. Surgical treatment seems to be of no value in this disease. ( info) |