Subperiosteal lipoma: a case report

Lipomas are the most common benign mesenchymal tumor. They can occur in various locations such as subcutaneous tissue, muscle, nerve, synovium, different periosteal layers, and bone [Diagnosis of bone and joint disorders. 3rd ed. Philadelphia: Saunders, 1995. p. 3814, 3947; Skeletal Radiol 27 (1998) 375]. To our knowledge, however, lipomas arising in a subperiosteal location have not been described previously. We present a patient with two subperiosteal lipomas of the femur.     

Intraosseous glomus tumor of the fibula

Glomus tumor is a rare, benign vascular tumor and intraosseous glomus tumor, which arises primarily within bone, is even rarer. Fewer than 20 cases have been reported in the literature. We present the case of a 34-year-old woman with glomus tumor primarily in the midshaft of the fibula that radiologically mimicked chondromyxoid fibroma, aneurysmal bone cyst or adamantinoma, together with a review of other reported cases. Received: 5 July 2000 Revision requested: 10 August 2000 Revision received: 28 August 2000 Accepted: 28 August 2000     

Bilateral lipoma arborescens of the subdeltoid bursa

Lipoma arborescens is a rare cause of chronic monoarticular arthritis. It is most commonly seen in the knees, but only a few cases involving other joints, especially the subdeltoid bursa, have been described. To our knowledge, this is the first reported case of lipoma arborescens involving bilateral subdeltoid bursae. Although it is associated with joint effusion, synovial cysts and erosions, the presence of reactive bone formation has not been reported. Magnetic resonance imaging is a very effective method for the diagnosis of this rare condition because of its ability to do tissue characterization.     

Incremental Value of Live/Real Time Three-Dimensional Transthoracic Echocardiography in the Assessment of Right Ventricular Masses

This case series demonstrates the incremental value of three-dimensional transthoracic echocardiography (3D TTE) over two-dimensional transthoracic echocardiography (2D TTE) in the assessment of 11 patients with right ventricular (RV) masses or mass-like lesions (three cases of RV thrombus, one myxoma, one fibroma, one lipoma, one chordoma, and one sarcoma and three cases of RV noncompaction, which are considered to be mass-like in nature). 3D TTE was of incremental value in the assessment of these masses in that 3D TTE has the capacity to section the mass and view it from multiple angles, giving the examiner a more comprehensive assessment of the mass. This was particularly helpful in the cases of thrombi, as the presence of echolucencies indicated clot lysis. In addition, certainty in the number of thrombi present was an advantage of 3D TTE. Also, sectioning of cardiac tumors allowed more confidence in narrowing the differential diagnosis of the etiology of the mass. In addition, 3D TTE allowed us to identify precise location of the attachments of the masses as well as to determine whether there were mobile components to the mass. Another noteworthy advantage of 3D TTE was that the volumes of the masses could be calculated. Additionally, the findings by 3D TTE correlated well with pathologic examination of RV tumors, and some of the masses measured larger by 3D TTE than by 2D TTE, which was also validated in one case by surgery. As in the case of RV fibroma, another advantage was that 3D TTE actually identified more masses than 2D TTE. RV noncompaction was also well studied, and the assessment with 3D TTE helped to give a more definitive diagnosis in these patients.     

Cutaneous lesions associated to multiple endocrine neoplasia syndrome type 1

Background  Multiple endocrine neoplasia type 1 (MEN1) is a genetic disease that predisposes to endocrine tumour development. Some cutaneous lesions (angiofibromas, collagenomas, melanosis guttaca, lipomas, melanomas, 'cafe au lait macules') have been associated to this syndrome. We compare the prevalence of cutaneous lesion in affected patients with their non-carrier relatives.
Patients and method  We studied 9 patients with MEN1 and 20 non-carrier, first-degree relatives. Genetic screening was realized in all of them. Patients were examined by dermatologist, and biopsy was performed when necessary.
Results  Patients with MEN1 presented hyperparathyroidism (100%), neuroendocrine tumours of pancreas (66%) and pituitary adenomas (44%); their relatives were free of endocrine features of MEN1. The studied cutaneous lesions were more prevalent in affected patients than in non-carriers (55.5% vs. 25%; P  = 0.029). Odds ratio of developing cutaneous lesions in MEN1 patients was 6.6 (95% confidence interval, 1.09–40.43). The frequency of angiofibromas was lower (22.2%) than the reported in other studies (43–88%), and we did not find any collagenoma.
Conclusions  MEN1 is associated to some cutaneous lesions and could be useful for detecting MEN1 carriers in an affected family. Cutaneous lesions should be assessed in MEN1 patients.     

改良ESD联合橡皮圈套扎切除胃小脂肪瘤的疗效和安全性

 目的 探讨改良内镜黏膜下剥离术(endoscopic submucosal dissection, ESD)联合橡皮圈套扎切除胃小脂肪瘤的疗效和安全性。方法 选择经超声内镜明确肿物(6 mm≤长径≤13 mm)来源于胃黏膜下层的37例患者,在对患者实施静脉麻醉下,先采用改良ESD剥离小肿物,暴露到一定程度后,采用橡皮圈套扎肿物,然后进行圈套器套扎切除。观察术中出血、穿孔情况,观察肿物切除的完整性、标本大小,对标本进行病理组织学检查,术后对患者进行6及12个月的胃镜及EUS随访。结果 37例胃小脂肪瘤均一次完整切除,手术操作时间(12.6±2.5)min,术中平均出血量＜2 ml,术中无穿孔,术后观察1周均无迟发性出血、穿孔等情况发生;标本大小5 mm×6 mm～12 cm×13 mm,术后病理诊断均为胃脂肪瘤;术后随访12个月,均未见残留、复发等情况。结论 改良ESD联合橡皮圈套扎切除治疗胃小脂肪瘤的疗效确切、安全,可完整切除病变,获取完整的病理学诊断资料,弥补了单纯套扎治疗或单纯高频电圈套切除等内镜治疗方法的不足。     

Endoscopic submucosal dissection of a large colonic lipoma:Report of two cases

A colonic lipoma is a very rare benign tumor that is usually asymptomatic and is found incidentally by colonoscopy.Patients with a large colonic lipoma may present with symptoms such as abdominal pain,bleeding,and colonic obstruction or intussusceptions.We report two patients with large colonic lipomas and symptoms.Standard endoscopic submucosal dissection(ESD) was performed to remove the lipomas instead of conventional surgical bowel resection.No complications were observed during or after the procedure.The tumors were resected en bloc,and the patients were discharged 2 d after ESD with a regular diet.The results indicate that ESD can be applied as safe and effective treatment for a large colonic lipoma.     

Fetal pericallosal lipomas – Clues to diagnosis in the second trimester

Introduction

Pericallosal lipomas (PCL) are congenital soft masses of adipose cells encapsulated by a thin layer of fibrous tissue, appearing adjacent to the corpus callosum (CC). The lipomas are usually diagnosed prenatally during the third trimester. The purpose of this study was to identify 2nd trimester ultrasound findings that may hint to a later diagnosis of PCL and to evaluate their MRI evolution.