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Atypical lipomatous tumor in the ligamentum teres of liver:A case report and review of the literature

World Journal of Clinical Cases 2018年第12期6卷 548-553页

作者： Daisuke Usuda Kento Takeshima Ryusho Sangen Kisuke Nakamura Kei Hayashi Hideyuki Okamura Yasuhiro Kawai Yuji Kasamaki Yoshitsugu Iinuma Hitoshi Saito Tsugiyasu Kanda Sachio Urashima Department of Community Medicine Kanazawa Medical University Himi Municipal Hospital Department of Infectious Diseases Kanazawa Medical University Department of General and Digestive Surgery Kanazawa Medical University Himi Municipal Hospital Department of Gastroenterology Kanazawa Medical University Himi Municipal Hospital

A 61-year-old male was referred to our hospital with a three-month history of persistent epigastralgia and right hypochondralgia. Initial examination revealed a fist-size mass at the epigastric fossa. Ultrasonography showed a hemangioma and a mosaic echoic lesion in the ventromedian with poor blood-flow signal and linear hyperechoic part inside, and a clear border to the surroundings. Dynamic computed tomography revealed a highly enhanced effect from the portal-venous phase continuing to the equilibrium phase. T1-weighted gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced image revealed a high intensity effect at the early phase that continued to the next phase. On the other hand, it contained a low intensity area by a fat suppression of that image. In addition, a T2-weighted image did not show a high intensity effect. Laparotomy was performed on the second day of hospitalization. The tumor had arisen from the ligamentum teres of the liver, and no metastasis or invasion of other organs was noted. It consisted of a lipid component of mature adipocytes and a fibrous component of deep dyeing pleomorphic or multinuclear atypical stromal cells. Immunohistochemical study of the atypical stromal cells demonstrated that they were positive for MDM2 and CDK4. A pathological diagnosis of atypical lipomatous tumor(ALT) was made, and the patient was discharged on the eighth day following the procedure. At the 6-mo follow-up dynamic CT, the patient was free of recurrence or metastasis. We experienced a patient with ALT in the ligamentum teres of the liver. This case suggests the need for a careful and detailed examination when encountering patients presenting with a mass; when neoplastic lesion is confirmed by image inspection, we should thoroughly investigate, including further image investigations and pathologic examination. The latter is the most important.

关键词： Liposarcoma Atypical lipomatous tumor Malignant adipose mesenchymal tumor Ligamentum teres of liver Operation

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Diagnostic challenge of lipomatous uterine tumors in three patients

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World Journal of Radiology 2012年第2期4卷 58-62页

作者： Chi-Yeung Chu Yip-Kan Tang Tin-Sang Augustine Chan Yu-Hon Wan Kai-Hung Fung Department of Radiology Pamela Youde Nethersole Eastern Hospital Department of Radiology Union Hospital

lipomatous uterine tumors are uncommon benign neoplasms, with incidence ranging from 0.03% to 0.2%. They can generally be subdivided into two types: pure or mixed lipomas. A third group of malignant neoplasm has been proposed, which is liposarcoma; however, this is very rare. In this article, we report three patients having lipomatous uterine tumors, including one uterine lipoma and two uterine lipoleiomyomas. All our patients are postmenopausal women, which is the typical presenting age group. They did not have any symptoms and the tumors were only found incidentally on imaging. However, in some patients, symptoms may uncommonly occur. If symptoms occur, these are similar to those of leiomyoma. We illustrate the imaging features of the tumors in our patients with ultrasound, computed tomography (CT) scan and magnetic resonance imaging (MRI). The tumor typically appears as a well-defined homogenously hyperechoic lesion on ultrasound. It shows fat density on CT scan and signal intensity of fat on MRI. MRI is the modality of choice because of its multiplanar capability and its ability to demonstrate fat component of the lesion, as illustrated in our cases. We also discuss the importance of differentiating lipomatous uterine tumors from other lesions, especially ovarian teratoma which requires surgical intervention. Despite the rarity and the common asymptomatic nature of the tumors, we believe that this series of three cases demonstrates a review of a rare tumor which provides important knowledge for patient management.

关键词： Uterus Uterine neoplasms Magnetic resonance imaging Leiomyoma lipomatous

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lipomatous Medulloblastoma: A Case Report

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Open Journal of Modern Neurosurgery 2019年第4期9卷 452-456页

作者： Ibrahima Berete Alpha Boubacar Bah Seylan Diawara Hammas Nawal Mohammed Benzagmout Khalid Chakour Mohammed Faiz Chaoui Department of Neurosurgery University Hospital Donka Conakry Guinea Department of Pathology University Hospital Hassan II Fez Morocco Department of Neurosurgery University Hospital Hassan II Fez Morocco

lipomatous medulloblastoma is not a separate entity but apparently distinct variant of medulloblastoma. Since the first case report in 1978 by Bechtel et al. [1], few cases have been published. We report an additional case of a 52-year-old right-handed man presented to the emergency department with evaluation of progressive severe intracranial hypertension and ataxia. His past medical history was unremarkable. His physical examination showed cerebellar syndromes. He underwent magnetic resonance imaging (MRI) which revealed a unique mass in the posterior fossa, lying within a cerebellar hemisphere. The patient underwent a suboccipital craniotomy for with a complete resection and samples were sent for histologic examination, showing closely packed, and round to oval cells. The nuclei had an irregular shape with clumps of heterochromatin. Lipid accumulation was a prominent feature of neoplastic cells. Postoperatively the patient did not receive fractionated radiotherapy. He is alive without deficit and with no evidence of recurrence on neuroimaging.

关键词： Medulloblastoma lipomatous Liponeurocytoma Posterior Fossa Tumor Suboccipital Craniotomy

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Myxoid and lipomatous Solitary Fibrous Tumor of Soft Tissue: A Case Description

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Open Journal of Pathology 2017年第1期7卷 20-24页

作者： Javier Ortiz Rodríguez-Parets Cristina González Velasco Elisa Muñ oz Torres María Dolores Ludeñ a de la Cruz Departamento de Anatomía Patológica Hospital Universitario de Salamanca Salamanca Spain

We present a case of a myxoid and lipomatous solitary fibrous tumor that was observed in a 67-year-old man. The tumor, which had a maximum diameter of 10 cm, was located in the soft tissues of the dorsal region and appeared macroscopically well delimited and encapsulated. Upon cutting, a markedly gelatinous internal surface was observed. A microscopic study revealed an intense and diffusely myxoid neoplasia, with small areas of adipose aspect, in which histological (staghorn vessels, perivascular hyalinization, fusiform cells of benign aspect) and immunohistochemical (intensive positivity for CD34, Bcl-2 and Cd99 and negativity for muscle markers) data were consistent with a solitary fibrous tumor were observed. To conclude, the main characteristics of this lesion are discussed, and a differential diagnosis is established with other entities.

关键词： Solitary Fibrous Tumor Myxoid and lipomatous Differentiation Histopathology Immunohistochemistry

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Synovial lipomatosis: A rare cause of knee pain in an adolescent female

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World Journal of Orthopedics 2015年第3期6卷 369-373页

作者： Nicholas Miladore Mary A Childs Vani J Sabesan Department of Orthopaedic Surgery Western Michigan University Homer Stryker M.D.School of Medicine Department of Orthopaedic Surgery Wayne State University School of Medicine

Synovial lipomatosis is a benign proliferative disease of the subsynovial adipose which can lead to a variety of presentations. Cases of synovial lipomatosis in children or adolescents are rare. This case report describes an adolescent patient with a rare bilateral presentation of synovial lipomatosis. She had been treated for years prior to her presentation for juvenile idiopathic arthritis. She presented with chronic bilateral knee pain, swelling, and mechanical symptoms. Bilateral MR imaging demonstrated effusions, hypertrophy of the synovium, and polyp-like projections of tissue with the same signal intensity as fat which is pathognomonic for synovial lipomatosis. Arthroscopic synovectomy and extensive debridement of polyp like fat projections of the right knee was performed. Histopathology was consistent with the synovial lipomatosis diagnosis. Postoperatively, the patient was satisfied with her outcome with improved pain relief and function in her right knee.

关键词： Synovial lipomatosis Lipomatosis Knee arthroscopy Lipoma arborescens Arthroscopy Villous lipomatous proliferation of the synovial membrane Knee pain

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