Parosteal lipoma of the forearm: A case report and a literature review

Rationale:Parosteal lipomas are rare neoplasms comprising mature adipocytes situated in a proximity to bone. Although these tumors follow a benign course, the reactive osseous changes that may occur with such lesions might raise the suspicion of malignancy.Patient Concerns:Here we present a case of a 33-year-old male patient complaining of pain and swelling in the right anterior forearm without history of trauma.Diagnosis:An magnetic resonance imaging of the region revealed a lobulated intramuscular fat intensity mass within the supinator muscle. Bony projection inseparable from the anterolateral radial diaphyseal cortex and periosteum was also seen. The radiological features suggested the diagnosis of parosteal lipoma.Intervention:After the radiological diagnosis of a parosteal lipoma, the patient was offered a total surgical excision of the mass.Outcomes:The mass was removed successfully. Histopathology showed mature benign adipose tissue bordered by thin fibrous septa confirming the diagnosis of parosteal lipoma. Follow-up magnetic resonance imaging after 6 months did not reveal any signs of complications or recurrence.Lessons:Distinction of the features of parosteal lipomas is needed to establish the accurate diagnosis, discriminate it from malignant lesions, predict potential neurovascular compromises, and follow up until a curative action is planned.     

Left atrial spindle cell sarcoma: A case report and literature review

Rationale:Cardiac primary spindle cell sarcoma is 1 of the rarest cardiac malignancies, with only a few cases reported so far. Herein, we reported a case of left atrial spindle cell sarcoma diagnosed and treated by a multidisciplinary approach, and retrospectively reviewed other reported cases.Patient concerns:A 49-year-old woman presented to our hospital with 2 weeks of gradual onset of dyspnea on exertion, dry cough and subacute fever.Diagnosis:The patient was initially revealed a left atrium mass by 2-dimensional transthoracic echocardiography. Based on the contrast-enhanced echocardiography and cardiac magnetic resonance imaging, she was subsequently suggested to have a cardiac malignant tumor. And the post-operative histopathology confirmed the tumor to be a cardiac primary spindle cell sarcoma.Interventions:The tumor was completely resected using autotransplantation. The patient was referred for polychemotherapy afterwards.Outcomes:Our patient underwent the tumor resection, with subsequent adjuvant polychemotherapy, and the tumor has not recurred during 12 months of follow-up.Lessons:Due to the rarity of these tumors and nonspecific symptoms, they are often difficult to diagnose preoperatively and missed occasionally. Thus, improving our understanding of the disease and facilitating its early diagnosis are essential.     

肺脂肪瘤1例报道并文献复习

目的 分析肺脂肪瘤的流行病学特征及临床特点,提高临床医师对肺脂肪瘤的诊治水平.方法 报道宁波大学附属医院呼吸科1例经病理确诊支气管脂肪瘤病例并对国内54例肺脂肪瘤病例进行回顾性分析.结果 患者女性,57岁,因“咳嗽、咯痰2个月,发热3周”于2010年8月24日入院,当地医院考虑“肺炎”,给予抗菌药物治疗,疗效欠佳转入我院.入院后行纤维支气管镜检查发现左下叶开口处肿物,后转入胸外科手术治疗,确诊为支气管脂肪瘤.到目前为止,国内能检索到的确诊为肺脂肪瘤的病例共54例.54例患者包括男性44例,女性10例,平均年龄(51.7±11.6)岁,支气管内脂肪瘤44例,肺内脂肪瘤10例,48例患者存在症状,主要症状无特异性,包括咳嗽、咯痰、发热、气促、咯血.50例患者存在异常影像表现,肺不张26例,渗出或实变13例,肿块18例,CT扫描下肿块呈低密度灶,CT值范围在-83～-122 Hu之间.23例患者行纤维支气管镜检查,但仅有6例(26.1％)得到正确诊断.34例患者描述手术方式,其中3例进行内镜下切除,术后恢复良好.结论 肺脂肪瘤以中老年男性为主;胸部CT发现脂肪密度肿块,需考虑脂肪瘤;硬质支气管镜镜下切除为支气管腔内脂肪瘤首选的治疗方式,肺内脂肪瘤或支气管脂肪瘤已发生肺实质的不可逆损害应手术切除.     

Submucous colon lipoma： A case report and review of the literature

Colon lipoma is remarkably rare in clinical practice. We reported a case of ascending colon lipoma in an 83-year-old woman. She was asymptomatic with a lipoma of 35 mm×30 mm×24 mm in size which was found by routine colonoscopy. Right hemicolectomy was performed uneventfully. The diagnosis was made by histological examination. Reviewing the literature and combining with our experience, we discussed the clinical features, diagnosis and treatment of this uncommon disease.     

Primary spindle cell sarcoma of gallbladder: An unusual case report and a literature review

Introduction:Primary spindle cell sarcoma of the gallbladder is a rare condition.Patient concerns:A 67-year-old woman was admitted to a local hospital with a chief complaint of abdominal pain in the right upper quadrant for the past 2 months.Diagnosis and intervention:Surgical resection was performed following the diagnosis of primary gallbladder sarcoma with local hepatic metastasis. Histological examination confirmed a diagnosis of primary spindle cell sarcoma and hepatic metastasis with simultaneous cholecystolithiasis.Outcomes:Adjuvant chemoradiation therapy was not performed because the patient refused treatment. Three months after the surgery, a relapsed lesion was diagnosed. The patient underwent transcatheter arterial chemoembolization.Conclusions:The disease should be differentially diagnosed from gallbladder carcinoma or carcinosarcoma with hepatic metastasis. An aggressive surgical approach should be based on a balance between the risk of surgery and the outcome.     

Cecal lipoma with pseudomalignant features： A case report and review of the literature

Colonic lipoma is a well-documented benign neoplasia, endoscopically appearing as a smooth round yellowish polyp with a thick stalk or broad-based attachment. We describe a 63-year old woman with persistent abdominal pain, in whom colonoscopy revealed a cecal mass with malignant features. Based on the colonoscopy findings, right hemicolectomy was laparoscopically performed for a presumptive diagnosis of a cecal adenocarcinoma, but histological examination revealed a colonic lipoma with overlying mucosal ulceration.     

回盲部脂肪瘤致肠套叠1例

肠道脂肪瘤是一种较少见良性肿瘤。其临床表现缺乏特异性,因此难以在术前明确诊断。我院收治1例结肠肿块导致肠套叠患者,经外科手术后病理诊断为结肠脂肪瘤。复习文献后对关于结肠脂肪瘤的临床表现、诊断以及治疗进行总结。     

Granular cell tumor of stomach： A case report and review of literature

Granular cell tumor (GCT) was described for the first time by Abrikosoff in 1926. It is a relatively rare neoplasm that may occur at many sites, but most commonly in the skin or soft tissues. The occurrence of GCT in the gastrointestinal tract is rare, accounting approximately for 8% of all tumors, among which the most common site is the esophagus, whereas gastric localization is very rare. Gastric GCTs can be solitary or, more frequently, associated with other gastrointestinal localization. Although GCTs are usually clinically and histologically benign, some malignant cases have been reported. Histologically, these tumors consist of polygonal and fusiform cells disposed in compact "nests" and immunohistochemical staining for S-100 protein supports the proposed derivation from Schwann cells. A correct preoperative diagnosis of this tumor can only be made in 50% of all patients and it is always based on endoscopic biopsy. Laparoscopic or conventional wedge resection represents the treatment of choice. In this study, the authors reported a case of a 49-year-old woman with a solitary granular cell tumor of the stomach with infiltrative pattern, successfully treated with surgical resection. A review of literature is also presented with emphasis on diagnostic criteria concerning the malignant form.     

Rare malignant spindle cell sarcoma of the left atrium diagnosed with TEE: A case report

Introduction:One of the purposes of echocardiography is to determine the nature of a space-occupying lesion. The conventional transthoracic echocardiogram (TTE) is the preferred method for the diagnosis of cardiac space-occupying lesions as it can reveal the baseline information. For patients with poor conditions, however, TTE cannot clearly display the boundary, it has a limited role in determining the nature of the lesions.Patient concerns:A 47-year-old woman presented with intermittent fever for 7 days and chest distress/shortness of breath for 5 days.Diagnosis:In our current case, we inferred the nature of space-occupying lesions in the left atrium more accurately using transesophageal echocardiography (TEE) than TTE, which may offer diagnostic evidence for surgical treatment.Interventions:The patient underwent surgical resection of the left atrial tumor and reconstruction of the left atrial wall. However, the patient''s posterior lobe of the mitral valve was infiltrated by tumor, which was difficult to completely remove.Outcomes:Echocardiography was performed 3 months after surgery and the tumor recurred in the posterior lobe of the mitral valve. Although almost all tumors have been removed by surgery, the average survival time is often less than 1 year, as it is difficult to completely remove and easy to relapse with poor prognosis.Conclusion:Transesophageal echocardiography (TEE) plays a relatively more important role in the determination and differential diagnosis of cardiac space-occupying lesions     

Presacral ganglioneuroma: A case report and review of literature

Presacral ganglioneuromas are so rare benign tumors that only 17 cases have been reported in the literature. They are abdominal masses growing slowly and differential diagnoses have to be considered. Surgical resection is important for definitive diagnosis because it represents the only therapeutic choice. Because of the benign nature of ganglioneuroma, adjuvant chemo-or radiotherapy is not indicated but regular follow-up is necessary for an early diagnosis of potential local recurrence. We report a case of a 64-year-old man with a presacral ganglioneuroma.     

Endobronchial lipoma with tracheobronchial aspergillosis: A case report

Introduction:Benign neoplasm of the endobronchial tree is quite rare, while endobronchial lipoma is extremely rare. Tracheobronchial aspergillosis is a relatively uncommon but severe form of invasive aspergillosis involving the tracheobronchial tree.Patient concerns:A 54-year-old male presented to our hospital for investigation and treatment of a cough and hemoptysis.Diagnosis:The diagnosis was confirmed as endobronchial lipoma with tracheobronchial aspergillosis.Interventions:The patient received pneumonectomy and voriconazole treatment.Outcomes:The patient''s postoperative course was uneventful, and he was discharged 10 days after surgery. The patient had no evidence of the fungal infection and recurrence during 1 year of follow-up.Conclusion:Endobronchial lipoma is a rare benign lung tumor, and this is the first report of endobronchial lipoma with tracheobronchial aspergillosis. In patients with suspected endobronchial lipoma, especially those who present with hemoptysis as the initial symptom, it is advisable to exclude coexistent aspergillosis.     

Small pancreatic lipoma: case report and literature review

Pancreatic lipomas are very rare and only 19 cases have so far been reported. We present a case of small asymptomatic pancreatic lipoma found incidentally in a 45-year-old man with findings of ultrasonography, computed tomography, and magnetic resonance imaging, including fat-suppressed proton-density-weight imaging. We also provide a brief review of the literature.     

Multiseptate gallbladder: A case report and literature review

Rationale:Multiseptate gallbladder (MSG) is a rare congenital gallbladder anomaly. Between 1963 and June 2021, only 56 cases were reported. There is currently no treatment guideline for pediatric or adult cases of MSG.Patient concerns:A 14-year-old woman visited our out-patient clinic in September 2020 for epigastric pain that last for 6 months. Honeycomb appearance of the gallbladder was noted under ultrasonography.Diagnosis:The patient was diagnosed with MSG. The diagnosis was confirmed through computed tomography and magnetic resonance cholangiopancreatography.Interventions:Cholecystectomy was performed.Outcomes:Epigastric pain showed limited improvement after the surgery. Since she was diagnosed with gastritis at the same time, a proton-pump inhibitor was prescribed. Epigastric pain was eventually resolved.Lessons:MSG cases can undergo cholecystectomy and show good recovery without complications. However, concomitant treatment may be required to resolve in the presence of other symptoms such as epigastric pain.     

Mycobacterium genavense‐induced spindle cell pseudotumor in a pediatric hematopoietic stem cell transplant recipient: Case report and review of the literature

We describe the first reported pediatric patient to our knowledge with a spindle cell pseudotumor caused by Mycobacterium genavense in a hematopoietic stem cell transplant recipient, and review the literature of such an entity in the transplant population.     

Pancreatic perivascular epithelioid cell tumor: A case report with clinicopathological features and a literature review

Perivascular epithelioid cell tumor(PEComa) of the pancreas is an unusual tumor deriving from mesenchyma. This paper described a case of pancreatic PEComa, which was initially suspected as neuroendocrine carcinoma by biopsy, and therefore surgical treatment was recommended due to undetermined diagnosis. Examination of the surgical specimen under a microscope showed that the tumor cell's morphology was epithelioid or spindle-shaped, and ranged in a nested pattern. Additionally, these cells had a large extent of acidophilic cytoplasm, no mitotic figures, and expressed HMB-45, melan-p, and smooth muscle actin immunohistochemically. Pathological examination indicated that PEComa originated from the pancreas, but symptoms related to tuberous sclerosis were absent. Since PEComa is extremely rare in the pancreas, it is likely to be ignored in differential diagnosis. In conclusion, our article highlighted the clinicopathological features of PEComa, and we conducted a literature review focusing on PEComa so as to deepen the understanding of this tumor type.     

Granular cell tumor of the rectum: a case report and review of the literature

A 47-year-old Japanese woman with a 5-year history of alcoholism was admitted to the Ryukyu University Hospital for the treatment of the alcoholism. For evaluation of observed changes in her bowel habits, she underwent colonoscopy, which revealed seven small polyps spread throughout the entire large intestine. Six of the polyps were in the colon; one was an adenoma and five were hyperplastic polyps. The remaining polyp, in the rectum, was an 8-mm submucosal tumor. Pathological analysis of a biopsy of the lesion in the rectum indicated a possible diagnosis of adenocarcinoma. Endoscopic ultrasonography (EUS) demonstrated a submucosal hypoechoic nodule, involving the mucosa and the muscularis propria. Subsequently, the patient underwent a radical low anterior resection of rectum. The lesion was a submucosal tumor with ulceration. The tumor consisted of granular tumor cells which were positive for S-100 protein, neuron-specific enolase, and periodic acid schiff (PAS) stain, but negative for desmin and vimentin. Granular cell tumor is rare in the gastrointestinal tract. As a result, such tumors can be misinterpreted to indicate a possible malignancy on either a biopsy or EUS. Received: July 9, 1999 / Accepted: December 17, 1999     

A new cytogenetic subgroup in lipomas: loss of chromosome 16 material in spindle cell and pleomorphic lipomas

Six spindle cell lipomas and two pleomorphic lipomas were analyzed cytogenetically. One spindle cell lipoma had a supernumerary ring chromosome as the sole anomaly. The other five spindle cell lipomas and both pleomorphic lipomas had hypodiploid stemlines with monosomy 16 or unbalanced aberrations leading to loss of 16q13-qter, a feature distinguishing these lipoma subtypes from other benign and borderline adipose tissue tumor histotypes. Unbalanced aberrations of chromosomes 13 and 10 were found in five and three cases respectively; 13q12 was lost in all of these cases, whereas there was on common deleted segment in chromosome 10. No aberrations involving 12q13–15, which are frequent in typical lipomas, were found. Both pleomorphic lipomas, but none of the spindle cell lipomas, had hypotetraploid sidelines, multiple nonclonal aberrations, and telomeric associations. The present findings reveal a new cytogenetic/histopathological association in adipose tissue tumors.     

肝脏神经内分泌肿瘤报道1例并文献回顾

背景肝脏可疑恶性肿瘤行手术切除后病理诊断肝脏神经内分泌肿瘤(hepatic neuroendocrin neoplasmas,HNENs)病例,此病例易与肝癌混淆,了解转移性和原发性HNENs的特性,对临床治疗手段有很好的指导意义.病例简介一名56岁男性患者体检发现肝脏占位性病变复查腹部增强CT提示肝脏转移性恶性肿瘤可能;胃部包块考虑良性.手术切除胃部包块并行术中冰冻病理检查提示梭形细胞肿瘤;完整切除肝脏包块术后石蜡病理检查结果提示NENs(G2),患者术后恢复佳.结论本文报道了一例HNENs,考虑转移性.术前诊断不能排除肝脏转移性恶性肿瘤可能.通过对患者病情的详细分析,最终行手术切除治疗并行病理检查确诊.同时我们对HNENs相关文献进行了分析,进一步了解原发和转移性HNENs的临床特征、治疗方案以及预后,以期对此类疾病有更深入的了解,对临床治疗方案决策做证据支撑作用.