631/2006. Asymptomatic oropharyngeal lipoma complicating intubation. Oropharyngeal lipomas are rare tumours. We present the case of a young man with an asymptomatic lipoma almost completely occluding his supraglottic airway, found on magnetic resonance imaging (MRI) for a separate oral cavity lesion. Pre-operative anaesthetic assessment was undertaken because of the risk of airway obstruction at induction of general anaesthesia. We discuss the awake fibre-optic technique used for induction, as well as the treatment and follow-up of these tumours. This case highlights the need for formal anaesthetic assessment, in such cases, to avoid total airway obstruction at induction of general anaesthesia. It also emphasizes the extent of supraglottic obstruction that can be present without giving rise to any symptoms. ( info) |
632/2006. teratoma in human tail lipoma. We report a case of a rare congenital teratoma that developed in a lipoma attached to a remnant human tail. A male newborn baby presented with a large, 3-cm mass with an open margin, which pedunculated from a tail attached to the midline skin of the coccygeal area. Magnetic resonance images demonstrated multiple sacral spinal bifida without cord tethering, and also showed neural roots and a lipoma and teratoma with peripheral homogeneous high density and internal low density on T(2)-weighted images. Intraoperatively, we found and dissected two nerve roots from the filum terminale which extended into the mass. Pathologic examination of the mass revealed abnormal differentiation of respiratory epithelium and squamous cell metaplasia along the open margin of the mass, and mainly lipoma in the rest of the mass. We suggest that this case could support the hypothesis of transient teratomatous cells in the pathogenesis of the spina bifida with lumbosacral lipoma. ( info) |
633/2006. Lipoma arborescens of the knee. Lipoma arborescens (diffuse articular lipomatosis) is a rare, benign intra-articular lesion of unknown aetiology. It is characterised by villous proliferation of the synovium and diffuse replacement of the subsynovial tissue by mature fat cells. It forms part of the differential diagnosis for a slowly progressive chronically swollen knee. We present a very rare case of bilateral involvement of the knee and discuss the symptoms, diagnosis and treatment of this condition. ( info) |
634/2006. Multiple lipomas, alcoholism, and neuropathy: Madelung's disease or MERRF? We report a 51-year-old alcoholic man with a 10-year history of cervical lipomas and progressive symmetrical sensory neuropathy, initially diagnosed with Madelung's disease, an idiopathic syndrome often attributed to chronic alcoholism. The eventual development of proximal weakness led to pathological and genetic testing which identified a A8344G mutation in the mitochondrial tRNA lysine gene, associated with MERRF (myoclonic epilepsy with ragged-red fibers). This case demonstrates how the varied terminology for this syndrome has resulted in a lack of consistent recognition and assessment for mitochondrial cytopathy. ( info) |
635/2006. Focal FDG uptake in a pancreatic lipoma mimicking malignancy. Positron emission tomography (PET) using the glucose analog 18-F-fluoro-2-deoxy-D-glucose (FDG) is commonly obtained to stage patients with cancer. Benign lesions can be a source of false-positive PET examinations, leading to incorrect staging and treatment of tumors. Computed tomography can aid in distinguishing between certain benign and malignant lesions. The authors report a case of a pancreatic lipoma producing a false-positive PET examination. ( info) |
| We present a case of lipohyperplasia of the ileocecal valve causing episodes of intussusception, and visualized by abdominal ultrasound and CT as a "target-like" appearance. At surgery, a large yellow soft mass was in the region of the ileocecal valve, raising the suspicion of lipohyperplasia. Resection of the fatty tissue from the ileocecal valve was performed at operation, after histologic diagnosis on frozen section. Our case suggests that limited resection removing the terminal ileum is effective and preferable to more extensive resection. ( info) |
637/2006. Lower gastrointestinal haemorrhage secondary to an ileal lipoma protruding into the caecum. We report the case of a patient with lower gastrointestinal haemorrhage. The cause of the haemorrhage was a lipoma of the terminal ileum that protruded into the caecum. The diagnosis was made endoscopically and radiologically. It was surgically treated with local excision. ( info) |
638/2006. Lipoma of the floor of the mouth. A case of lipoma of the floor of the mouth presenting as an acute swelling in a 72-year-old man is reported. The clinical presentation and differential diagnosis are discussed. ( info) |
639/2006. Cardiac lipoma in a patient with proven arrhythmogenic right ventricular dysplasia: a case report. A huge intramyocardial lipoma. arrhythmogenic right ventricular dysplasia (ARVD) and primary cardiac tumours are rare conditions among heart diseases. In this case report we present an 18-year-old woman with ventricular tachycardia and intracardiac mass originating from interventricular septum. Clinical and pathological evaluation led to the diagnosis of invasive intramyocardial lipoma originated in an ARVD background. To our knowledge, this is the first case with a huge intramyocardial lipoma developed in a patient with ARVD. ( info) |
640/2006. Hibernoma. A case report. The clinicopathologic features of a hibernoma occurring in a 26 year-old female are reported. The tumor was located in the interscapular region and eventually became painful. Surgical excision was performed and to date, no recurrences have been detected. ( info) |