左臀部软骨样脂肪瘤1例

正患者,男,56岁,因偶发左臀部肿物2周于2017年8月28日入院。患者2周前偶发左臀部肿物,1周前就诊于当地医院行彩超见:左臀部肌层探及低回声,大小30 mm×24 mm,形态规则,边界欠清,其内回声不均匀;CDFI:未见明显血流信号。为求进一步诊治,来我院治疗。既往胃溃疡史10年,9年前因上消化     

胆囊脂肪瘤1例

患者　男 ,70岁。 1999年 1月16日入院 ,患者于 5个月前出现反复右上腹痛 ,伴畏寒 ,寒战 ,发热 ,黄疸 ,经Ｂ超、ＣＴ检查示 :胆囊炎胆石症 ,胆囊癌待删。巩膜 ,皮肤轻度黄染 ,腹平软剑突下及胆囊区轻压痛 ,其余阴性。白细胞 10 8× 10 9 Ｌ ,中性粒细胞 0 6 3;血红蛋白 12 8ｇ Ｌ。血清总胆红素 2 8 4μｍｏｌ Ｌ ,直接胆　　 收稿日期 :2 0 0 0 0 3 2 7。　　 作者简介 :丁伟钺 ( 195 2 ) ,男 ,江苏锡山人 ,江苏省锡山市新乡镇卫生院主治医师 ,主要从事腹部外科研究。红素 14 9μｍｏｌ Ｌ ,谷丙转氨酶 2 2 0Ｕ Ｌ ,γ 谷氨酰转肽酶 1…     

升结肠脂肪瘤1例

患者　男 ,71岁。因腹痛半年、加重伴腹泻半个月入院。 4个多月前曾行胆囊切除术。体查 :心肺正常。全腹软 ,右侧中腹部压痛 ,无明显反跳痛 ,未扪及确切包块 ,肠鸣活跃。白细胞 6 3× 10 9/Ｌ ,中性 0 71;血红蛋白 12 6ｇ/Ｌ。大便隐血 ( )。Ｂ超示右中腹腔内查及 7ｃｍ× 5ｃｍ实性占位团块 ,内部回声均质 ,与肝、肾、胰无关。ＣＴ示盲肠内见同心圆状软组织影以及脂肪影 ,并与回肠末端相连 ,考虑为回盲部套叠 ;盲肠内侧有一大小约 4ｃｍ× 4ｃｍ之脂肪影 ,两者之间有软组织影相连 ,且该脂肪影左侧紧贴一段肠壁 ,该病变性质待定 (脂肪瘤 …     

阴囊内巨大脂肪瘤1例

患者男,78岁.右侧阴囊无痛性,渐进性增大肿物伴下坠感3年.因影响行走于2001年1月10日入院.体查:右侧阴囊明显增大,右阴囊内可触及约20cm×15cm×14cm大小肿物表面光滑,无囊性感,无压痛,右侧睾丸附睾触不清,透光试验阴性.     

肝圆韧带巨大脂肪瘤1例

病人男性 ,15岁。 3年前发现上腹部有一包块。进食后有饱胀感 ,卧位时有压迫感 ,侧卧位可减轻症状。无呕吐 ,大便正常。随着时间推移 ,上述症状加重而住院。查体 :上腹部呈圆形隆起 (立位时更明显 ) ,可扪及包块 ,边界清 ,约 18ｃｍ× 16ｃｍ ,质中偏软 ,活动度好 ,无压痛 ,无血管杂音 ,脐上 3ｃｍ见脐样凹陷。Ｂ超提示 :上腹部实性占位 ,17ｃｍ× 15ｃｍ。ＣＴ提示 :上腹部脂肪瘤 ,17 5ｃｍ× 15 4ｃｍ ,胃体受压 ,肿物来源不明确。初步诊断 :上腹部脂肪瘤。剖腹探查 :肝、胆、脾、胃及余脏器未见异常 ,肝圆韧带沿着腹膜 (腹白线 )向下延…     

胆囊脂肪瘤1例

患者,女,63岁。因右上腹间隙性胀痛,伴背部放射痛一个月来诊。腹痛与进食油腻食物有关。发病时无寒战、高热、黄疸。以往无类似发作。入院体检:巩膜及皮肤无黄染。腹软,右上腹轻压痛,可扪及-4cm×3cm×3cm肿块,质软,边界清,可活动,无压痛。发病后,B超检查示慢性胆囊炎,胆囊结石;腹腔内占位,脂肪瘤可能。CT示腹腔内肿块,脂肪瘤可能;肿瘤边缘不规则,与周围组织有粘连;胆囊结石。实验室检查,血、尿常规及肝功能均正常,CEA正常。     

左心多发脂肪瘤1例

左心多发脂肪瘤１例朱洪玉，张仁福，李新民，孙善权，周凯病人男，４０岁。２０年前体检发现心脏杂音。３周前突然昏厥。查体：心尖部有３／ＶＩ级收缩期反流性杂音，第一心音低钝。心电图示左房肥大。Ｘ线胸片示双肺瘀血，心胸比率０．５０。超声多普勒检查见左室内有４...     

腹壁巨大脂肪瘤侵入腹腔1例

患者　女 ,47岁。因腹部逐渐增大 7年 ,感疲惫 ,食欲减退。排尿次数增多 ,于 2 0 0 3年 11月 7日入院。体查 :全腹膨隆 ,腹部可触及一肿物 ,界不清 ,无明显触痛。叩诊呈实音。B超示 :腹腔内见一不均匀实性团块 ,上至剑突下至耻骨联合 ,边界清晰。CT示 :腹腔内见有 40cm× 3 5cm× 10cm大小低密度影 ,使小肠向左右移位 ,此块状影突入盆腔 ,使膀胱和子宫受压后移。诊断 :腹膜外巨大肿物。手术中见腹腔外巨大肿物。肿物起于下腹部 ,在脐下突破腹膜进入腹腔 ,将小肠挤到上腹部。肿物上至剑突下达盆腔 ,有完整包膜 ,与腹腔内脏器无明显粘连 ,完…     

小肠脂肪瘤1例

1病历摘要 患者，女，28岁，既往无腹痛病史。该患者因“间断腹绞痛5天”由外院转来我院，在当地医院行腹透、腹部彩超、CT检查，均为阴性，血常规、尿常规、血尿淀粉酶及红、白细胞计数正常。未明确诊断，查体：一般情况可，痛苦面容，腹平软无压痛，肝脾未触及肿大，墨菲征（-），未触及包块，无移动性浊音。肾区叩击痛阴性，肠鸣音略亢进。     

一例罕见手部巨大脂肪瘤

一例罕见手部巨大脂肪瘤刘瑞波，孔令英患者，男，３８岁，农民。左手虎口肿物进行性增大３０年，近两周左拇指麻木，影响工作，于１９８９年６月２４日住院。检查：左手虎Ｑ部１０Ｘ９．５Ｘｓｃｍｔ性感肿物，拇指外展，对掌受限，手部痛党正常（附图）。在臂丛麻醉下手...     

Carpal tunnel syndrome caused by a giant lipoma of the hand: A case report

Introduction and importanceLipomas are common benign tumours which occur in up to 2% of the population. They are classified as giant when larger than 5 cm. Although they are usually asymptomatic, giant lipomas of the hand may cause compression of the underlying tissues.Case presentationA 62-year-old Caucasian male presented to the Plastic and Reconstructive Surgery outpatient clinic with numbness and pain in his left hand. The numbness in his fingers pointed to compression of the median nerve, as well as the ulnar nerve. He presented with a rapidly progressive swelling in his left palm. An MRI scan of the hand was made, which showed a lipoma of approximately 8,5 cm in diameter. The swelling was surgically removed and sent for histopathological analysis, which confirmed the diagnosis of benign giant lipoma of the hand. Two weeks postoperatively, pain and numbness significantly decreased.Clinical discussionNeural injury in carpal tunnel syndrome is related to the duration and degree of compression. A giant lipoma is considered malignant until proven otherwise since variants with high potential for metastasizing exist. Distinguishing between a benign tumour and a malignant lipoma is essential, since a more radical treatment plan might be required.ConclusionGiant lipomas of the hand are a rare cause of carpal tunnel syndrome and a malignant variant should always be suspected. A preoperative MRI scan should be performed. Rapid en bloc excision is necessary in case of compression of the underlying tissues.     

胫骨骨内脂肪瘤1例

正患者,男,21岁,因"无明显诱因出现左小腿下段间歇性疼痛4年余"入院。患者于4年前长时间站立后出现左小腿下段疼痛,当时未行治疗,后症状逐渐加重,就诊于当地医院,行X线、MRI等检查,当时考虑病变较小,建议定期复查。2018年2月26日患者在剧烈运动后疼痛加重就诊我院。入院查体:左小腿远端前内侧压痛阳性,未触及肿块,局部皮肤无红肿、发热、破溃等异常,肢体远端足趾颜色红润、毛细血管反应良好,足背动脉可扪及。     

Intraosseous lipoma: a clinical study of 12 patients

We studied 12 patients (13 bones) with intraosseous lipoma to elucidate the clinical features of this disease. The patients ranged in age from 14 to 54 years. Eleven patients were men and 1 was a woman. The involved bones were the calcaneus in 6 patients (7 bones), humerus in 3, ischium in 2, and sacrum in 1. Three bones were in Milgram's stage I, 8 were in stage II, and 2 were in stage III. On plain radiographs, all bones showed a well-circumscribed radiolucent area. Nine bones showed calcification or ossification. Computed tomography or magnetic resonance imaging showed low density or high signal intensity, respectively, identical to the findings in normal adipose tissue. The tumor was curetted in 3 patients (3 bones), in whom local recurrence was not seen thereafter. In the remaining 9 patients (10 bones), we observed the natural course; in 1 of these patients, incisional biopsy was performed. During the follow-up period, only 1 patient showed slight enlargement of the lesion, while the findings in the others remained unchanged. Three patients had pain, which disappeared after the surgery or during the course of the observation. Partly because intraosseous lipoma tends to undergo spontaneous involution, and partly because diagnosis is easy from the radiological findings, surgery does not seem to be necessary in most patients. Received: August 6, 2001 / Accepted: October 30, 2001     

A case report of a rare nasopharyngeal myoepithelial dominant pleomorphic adenoma

IntroductionPleomorphic adenoma is the most common benign salivary gland neoplasm. The majority of cases occur in the major salivary glands; however, they can also originate from the minor salivary glands. The nasopharynx is an uncommon site, but it has been reported in the literature. The characteristic difference of our report from the literature is the young age of our patient and his previous unremarkable medical or surgical history.The objective of this report is to present a case of salivary gland pleomorphic adenoma, discuss radiological and histopathological findings and treatment options.Case presentationHerein we report a case of a 25-year-old male patient presenting with a long-term history of snoring, mouth breathing, and progressive left nasal obstruction. After examining the patient and confirming the diagnosis, patient successfully underwent tumor resection using a combined transnasal/transoral endoscopic approach with no complications following surgery and significant improvement of the previously reported symptoms.DiscussionPleomorphic adenoma of the minor salivary glands can occur anywhere throughout the distribution sites of these glands such as: along the upper aerodigestive tract, parapharyngeal fat spaces, soft palate, the sinonasal, and nasopharyngeal areas.ConclusionThe occurrence of pleomorphic adenoma in uncommon sites has been reported in the literature, and the nasopharynx is considered to be one of these uncommon sites. The mainstay of treatment for nasopharyngeal pleomorphic adenoma is surgical excision as they can grow to giant sizes if left untreated.     

Colo-colic intussusception secondary to colon lipoma: A case report

Introduction and importanceIntestinal intussusception is rare in adults and it is associated with lead points affecting the colon in around 17% of patients. Lipomas are very rare benign tumors which may act as lead points for intestinal intussusception. Indeed, the incidence of intestinal intussusception is much rare when caused by lipomas.Case presentationOur patient is a 29-year-old male, previously healthy and admitted for severe right lower quadrant abdominal pain of 2-day duration. Computed tomography (CT) scan of the abdomen and pelvis showed large mass of fat consistency containing colon structure.Clinical DiscussionUrgent laparotomy was opted during which colo-colic intussusception was diagnosed and right hemicolectomy with primary ileocolic anastomosis was performed. Pathology report showed that intussusception was induced by a colon lipoma. Patient had an uneventful hospital stay and was discharged on post-operative day 5.ConclusionThus we recommend that colo-colic intussusception caused by lipoma be considered in the differential when diagnosing adults with right lower quadrant pain.     

Diaphragmatic lipoma in a 4-year-old girl: a case report

A lipoma of the diaphragm is extremely rare. Although most congenital diaphragmatic lipomas are encountered in middle or old age because of their typical asymptomatic nature, none have been reported in patients younger than 14 years. We report the case of a large diaphragmatic lipoma in a 4-year-old patient.     

Pediatric intrahepatic bile duct adenoma-rare liver tumor: A case report

BACKGROUND Intrahepatic bile duct adenoma(BDA) is one of the rarest of the rare benign tumors of the liver in the pediatric age group. It arises from the epithelial lining of intrahepatic bile ducts. The overall incidence of BDA is 1.3% of all primary benign liver tumors. Few case reports of this rare tumor occurring in adult population are present in the literature and to date, only one pediatric case has been reported worldwide.CASE SUMMARY An 18-month-old male child presented with chief complaints of mass per abdomen for 8 mo. Computerized tomography abdomen revealed a well-defined exophytic solid tumor arising from the posteroinferior margin of the right lobe of the liver with heterogenous enhancement and cystic changes, suggesting a suspicion of hepatoblastoma. Non-anatomical liver resection was done and a tumor of 10 cm × 9.5 cm was excised. Histopathology of the specimen was conclusive with the diagnosis of intrahepatic bile duct adenoma, which was further supported by immunohistochemistry panel testing. The post-operative period was uneventful. On follow-up, the child was doing well and had no postoperative complication.CONCLUSION Intrahepatic bile duct adenoma in children is very rare and to date only one case has been reported. This is the second pediatric case of intrahepatic bile duct adenoma in the world. Additionally this is the first ever case of such a large tumor presenting in a child.     

Perianal pseudolymphoma: A case report and review of the literature

IntroductionPerianal pseudolymphoma is a rare lymphoproliferative disorder that can mimic cutaneous lymphoma. The condition can present acutely with concerns of perianal sepsis. The purpose of this case review is to review the current literature on perianal pseudolymphoma and emphasise to the surgical community its presentation, suggested aetiology and management.Case presentationIn this case report, we detail the case of a 28-year-old female who presented with perianal pseudolymphoma. Malignant lymphoproliferative diseases required exclusion. Conservative management of this rare condition was successful.DiscussionWe highlight the differential diagnoses, investigations and treatment options for a rare condition. A review of the literature on the limited published data on perianal pseudolymphoma is briefly discussed.ConclusionThe aim of this case report is to highlight the existence of such a rare condition that can imitate an acute surgical presentation and its successful conservative management.     

Primary leiomyosarcoma of the greater omentum: a case report

IntroductionGreater omentum leiomyosarcomas are rare tumors with only a few cases reported in literature.Presentation of caseWe report the case of a 68-year-old man who consulted complaining of diffuse abdominal pain without a palpable mass at physical examination. Imaging studies revealed a solid-cystic lesion in the right lower quadrant. Surgical resection was performed and the tumor was diagnosed as a leiomyoscarcoma by histological and immunohistochemical examinations.DiscussionSurgical resection of all lesions seems to be a reasonable therapeutic approach if resection is feasible. Chemotherapy may be used in selected cases.ConclusionMore cases are needed to define the best treatment approach of this disease.