Intraosseous Lipoma of the Calcaneus: Report of a Case and a Short Review of the Literature

One case of an intraosseous lipoma of the calcaneus bone is presented together with a short review of the literature. Only 20 cases of tumors in the extremities have so far been published. The typical X-ray picture shows a cystic, sharply demarcated cavity, which macroscopically at operation is filled with yellowish, adipose tissue. in the present case and one previously published a central sclerotic mass was observed. The histological picture is typical, with mature adipose tissue mixed with a few degenerated bone trabeculae.     

An Intraosseous Lipoma of the Calcaneus: A Case Report

Intraosseous lipomas are one of the rarest bone tumors found in the body. The incidence has been reported to be <0.1% of all primary bone tumors. The differential diagnoses of an intraosseous lipoma in the calcaneus include plantar fasciitis, retrocalcaneal bursitis, gout, stress fracture, unicameral bone cyst, aneurysmal bone cyst, osteoblastoma, enchondroma, chondromyxoid fibroma, nonossifying fibroma, giant cell tumor, chondroblastoma, fibrous dysplasia, and chondrosarcoma. It has been reported that 60% to 70% of patients with an intraosseous lipoma present with symptoms. This article describes a case of a pathologic fracture secondary to a large intraosseous lipoma, the surgical treatments, and the subsequent resolution of symptoms. The purpose of our report was 3-fold: (1) to increase awareness of intraosseous lipomas and their potential to cause pathologic fractures in the calcaneus; (2) to suggest a possible treatment protocol for intraosseous lipomas in the calcaneus; and (3) to describe a rare case of an intraosseous lipoma of the calcaneus not located exclusively in the neutral triangle.     

Pleomorphic Lipoma: Case Report and Literature Review

BACKGROUND: Pleomorphic lipoma is a rare, benign, pseudosarcomatous, soft tissue neoplasm typically involving the subcutis of the neck and shoulder in middle-aged to elderly men. It is characterized histologically by atypical, multinucleated giant cells and grossly as a well-circumscribed mass. Since this neoplasm can resemble a sarcoma, histopathologic diagnosis is critical in preventing unnecessary surgery. OBJECTIVE: To describe a case of pleomorphic lipoma in the neck and to review the clinical and histopathologic characteristics of this neoplasm. METHODS: We present a case report and review of the literature. RESULTS: Local excision to completely extirpate this neoplasm has proven curative at 10 months of follow-up. CONCLUSION: Pleomorphic lipoma is superficially located and may be encountered in a dermatologic setting. Thus the dermatologist should become familiar with its clinical presentation and microscopic appearance.     

Surgical Treatment of Confirmed Intraosseous Lipoma of the Calcaneus: A Case Series

Intraosseous lipoma of the calcaneus is a benign lesion formed by mature adipose tissue. When the lesion is symptomatic, the most frequent presentation is localized pain and soft tissue swelling. Because these lesions can regress spontaneously, conservative treatment methods are recommended. Operative excision is mostly required for painful lesions and pathologic fractures. The data from 14 patients with calcaneal intraosseous lipoma, who had undergone surgery in our clinic, were evaluated retrospectively. Using Milgram’s classification system, 9 lesions were classified as stage 1, 4 as stage 2, and 1 as stage 3. All lesions were occupying 100% of intracalcaneal cross-section in the coronal plane and >30% in the sagittal plane of magnetic resonance imaging sections. The mean preoperative visual analog scale score was 5.29 ± 1.14 (range 4 to 7), and the mean postoperative visual analog scale score at the last follow-up visit was 1.14 ± 0.36 (range 1 to 2), which was significantly better (p < .01). The mean Maryland foot score at the last follow-up visit was 97.71 ± 2.02 (range 95 to 100). The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale score was 97.86 ± 2.11 (range 94 to 100) at the last follow-up visit. The differences between the pre- and postoperative values were statistically significant (p < .01). No recurrence had been detected within a median follow-up period of 84 months. Operative management of symptomatic lesions related to intraosseous lipoma of the calcaneus provides better results compared with the preoperative state.     

Cerebellopontine Angle Lipoma: Case Report and Review of the Literature

Intracranial lipomas located in the cerebellopontine angle are extremely rare. These tumours are mal-developmental lesions which can cause slowly progressive neurological symptoms. The clinical management of these tumours differs significantly from other lesions in this region. A 27 year old woman presented with a 2-month history of vertigo and a slowly progressive deterioration of hearing in the left ear. Computed tomography (CT) revealed a large low-density mass in the left cerebellopontine angle without any contrast-enhancement. In T1-weighted magnetic resonance imaging (MRI) the lesion was hyper-intense and did not enhance after application of gadolinium. Areas of lower signal intensity inside of the lesion were suggested as incorporated cranial nerves. A left retro-sigmoidal approach in a semi-sitting position was chosen to expose the tumour. After reducing the tumour mass, the tumour was dissected from the cranial nerves which were incorporated into the tumour. The residual tumour was adherent to the brain stem and the encased lower cranial nerves, allowing only a near subtotal resection of the highly vascularized tumour in order to avoid neurological deficits. The histological examination revealed a lipoma. Attempts at complete removal of cerebellopontine angle lipomas usually result in severe neurological deficits. Conservative treatment should therefore be preferred. Limited surgery is indicated if the patients suffer from disabling neurological symptoms and signs e.g., vertigo, nausea, trigeminal neuralgia, facial weakness or facial spasm.     

Aggressive Intraosseous Myofibroma of the Maxilla: Report of a Rare Case and Literature Review

Myofibroma (MF) is a benign mesenchymal myofibroblast-derived tumor, which occurs most frequently in children, and rarely affects the maxilla. We reported a case of an aggressive intraosseous lesion found in the maxilla of a 9-year-old female child. Intraorally, the swelling extended from tooth 12 to 16, causing displacement of teeth 13, 14, and 15. Computed tomography revealed a large osteolytic lesion causing thinning and cortical erosion. Microscopically, the lesion showed a proliferation of spindle-shaped cells, with elongated nuclei and eosinophilic cytoplasm, arranged in interlaced fascicles. The immunohistochemical analysis revealed cytoplasmic positivity for α-SMA and HHF-35, and negativity for desmin, laminin, S-100, β-catenin, and CD34. Ki-67 was positive in 8% of tumor cells. The diagnosis was MF. Herein, we describe an additional case of central MF arising in the maxilla, including clinical, imaging, microscopical, and immunohistochemical features, as well as a review of the literature.     

Parapharyngeal Lipoma Extending to Skull Base: A Case Report and Review of the Literature

Lipomas in the head and neck region usually occur in the immediate subcutaneous tissue. They are extremely rare in the parapharyngeal space. A rare case of a right parapharyngeal space lipoma extending to skull base in an 18-year-old male is reported. The literature is reviewed and the characteristics of disease are discussed.     

Spindle Cell Lipoma Arising from the Supraglottis: A Case Report and Review of the Literature

Lipomas are common benign mesenchymal neoplasms. Although 13% of lipomas are found in the head and neck, only 0.6% have been reported in the larynx. Of all lipomas, the spindle cell variant is the least common. In the present study, we report a case of supraglottic spindle cell lipoma and review the literature of laryngeal spindle cell lipoma. A 35-year-old male presented with dysphagia and dyspnea and was found to have bilateral supraglottic lesions causing airway obstruction. The masses were resected endoscopically. Final pathology demonstrated mature adipocytes and spindle cells, with immunohistochemical patterns supportive of spindle cell lipoma. Spindle cell lipomas have rarely been reported in the upper airway. To our knowledge, this is the youngest patient reported to date. These lipomas are uncommon benign neoplasms and should be distinguished from aggressive mesenchymal neoplasms such as liposarcoma variants to guide appropriate conservative but curative therapy.     

Intraosseous Lipoma: A Report of Two Cases

Intraosseous lipoma seems to be a rare condition as only some 20 cases have been reported so far. A further two cases are described the lesions being in the calcaneus and in the tibia. Radiographically the lesions appeared osteolytic and well delineated, containing calcified areas. The microscopic features were those of mature adipose tissue. Curettage and packing with autogenous bone grafts is recommended, if the lesion causes pain or a correct diagnosis cannot otherwise be obtained.     

Acute Calcaneus Tendon Rupture Associated with Ipsilateral Malleolar Fracture: Case Report and Literature Review

Malleolar fractures are rarely associated with lesions of the adjacent tendons or neurovascular structures. The association of ankle fractures with Achilles tendon rupture is even more infrequent, although both of these injuries are very common in and of themselves. To our knowledge, fracture of the lateral malleolus in association with an acute rupture of the ipsilateral calcaneus tendon has not been previously described. In this article, we describe a female patient who sustained an acute rupture of the Achilles tendon in conjunction with fracture of the ipsilateral lateral malleolus.     

Chondromyxoid Fibroma of the Calcaneus: Two Case Reports and Literature Review

Chondromyxoid fibroma occurs primarily in the long tubular bones of the lower extremity, with the foot representing the second most frequent location after the knee. This benign cartilaginous tumor of bone is currently the rarest reported neoplasm of cartilaginous origin. This mass can mimic other benign and malignant bone tumors owing to its variable histologic features. We report 2 cases of chondromyxoid fibroma of the calcaneus with varying presentations. Initially, advanced imaging studies pointed to a diagnosis of a unicameral bone cyst. Pathologic examination is difficult but can be used to differentiate this lesion from more serious conditions. A quick and accurate diagnosis of chondromyxoid fibroma can prevent unnecessary treatment that could be harmful to the patient.     

Axillary Giant Lipoma: a Case Report

Lipoma are the most frequent mesenchymal soft tissue tumours but rarely present huge sizes in their cutaneous localization. Some cases of so-called “giant lipomas” have been reported in the literature and here is presented a giant lipoma of the axillary area which is, to our best knowledge, the second report of such a giant lipoma in this localization.     

肾上腺横纹肌肉瘤1例及文献复习

目的：探讨肾上腺横纹肌肉瘤（RMs）的临床特征及诊治疗方法。方法：对1例肾上腺横纹肌肉瘤患者的临床资料进行总结,检索Pubmed和CBM数据库相关文献进行复习讨论。结果：患儿通过手术治疗,术后病理检查为右肾上腺区横纹肌肉瘤,免疫组化：Vim（＋）,Myogenin（＋）,axtin-横（＋）,CgA（-）,Syn（-）,S-100（-）,HHF35（-）,F8（-）,CD34（-）,EMA（-）。结论：肾上腺RMS是非常罕见的恶性肿瘤,其肿瘤结构、细胞形态都有一定的特征,确诊需免疫组化染色的帮助,横纹肌肉瘤的治疗和预后在很大程度上取决于手术切除的彻底性和组织类型。     

Spindle Cell Lipoma of the Scalp A Case Report and Review

Cutaneous surgeons frequently evaluate and manage soft tissue tumors arising on the head and neck of adults. Of these, the most common tumor is the lipoma, and specific mesenchymal variants of lipoma occur classically on the head and neck. We describe a case of a large spindle cell lipoma of the posterior scalp, in order to highlight the classic location and differential diagnosis of the lipoma variants presenting commonly in this anatomic region. In addition, we review the role of preoperative imaging studies of scalp soft tissue tumors and discuss how imaging may assist the dermatologic surgeon in establishing the diagnosis and designing a rational surgical approach.     

Preputial Calculi: a Case Report and Review of Literature

Preputial calculi are the rarest form of urolithiasis seen usually in an uncircumcised male with phimosis. We report a case in an elderly male who presented with azotaemia. Calculi are evident on clinical examination by palpation. Late presentation by the patient leads to complications. Treatment is by dorsal slit or circumcision. The case highlights the need of early recognition and treatment of this rare condition to prevent any complication.     

Madelung Disease: Report of a Case and Review of the Literature

Madelung disease is a rare disorder characterized by the presence of multiple, symmetric, nonencapsulated fatty accumulations diffusely involving the cheeks, the neck, the upper trunk, the shoulder girdle area, and the upper extremities. The cause of this syndrome is unknown, but it has been associated with alcoholism in 60% to 90% of patients. The long-term lipomatous deposits are often large and cosmetically deforming, and the upper aerodigestive tract and great veins may be compressed. We report the case of a man with MD, involving the cervical and upper dorsal regions, who underwent surgical treatment at our Department.