Differential Diagnosis Of Tumors Research Articles

Pediatric pleuropulmonary blastoma: analysis of four cases

BackgroundPleuropulmonary Blastoma (PPB) is an extremely uncommon, highly aggressive tumor that arises from either the lungs or pleura. According to Dehner, PPB was classified into three groups: type I (cystic), type II (mixed), and type III (solid). Type I tends to occur more commonly in infants and has a more favorable prognosis compared to types II and III. This tumor is very rare in pediatric age group; hence, there is no consensus on the optimal treatment regimen for it to date. Type I tumors, which resemble congenital lung cysts, can eventually progress to more aggressive type II and type III tumors. This article aims to increase general awareness of this pathology, clinical presentation, and differential diagnosis in order to identify this rare entity early in its course. By presenting 4 such cases, we highlight that PPB can be missed early in diagnosis and it is important to be alert when putting this rare tumor in differential diagnosis of cystic lung lesions.MethodsA retrospective study was conducted between 2015 and 2020 involving patients who had a definitive diagnosis of PPB with emphasis on clinical presentation, preoperative imaging studies, intra-operative findings, pathological reports, ancillary treatment, and outcomes. All patients were followed up every 6 months to monitor local recurrence and distant metastasis by undergoing physical exam and non-contrast enhanced CT of the chest. The primary outcome is to identify the mortality and morbidity (recurrence and distant metastasis) of PPB for cases admitted in our institute.ResultsFour children were diagnosed with PPB during the study period. Clinically, patients presented with manifestations ranging from respiratory distress, fever to obstructive shock and radiologically, 2 cases were presented with mediastinal mass and the other 2 presented with pneumothorax. Regrettably, none of the cases were diagnosed pre-operatively. One lesion proved to be type I, 2 were type II and one was type III. All cases underwent chemotherapy using the combination of vincristine, Adriamycin and cyclophosphamide (VAC regimen). Recurrence was detected in a type II case, around 2 years after operation, and the other type II case developed brain metastasis that was discovered 3 years after operation. Type I case showed no local or distant metastasis.ConclusionA prompt preoperative diagnosis and workup of cases of PPB is crucial to enable optimal intervention intraoperatively and early postoperative treatment. Though it is uncommon, PPB should be considered in the differential diagnosis of cystic lung lesions.

КЛИНИЧЕСКИЙ СЛУЧАЙ ДИАГНОСТИКИ ЗЛОКАЧЕСТВЕННОГО ОБРАЗОВАНИЯ ЯИЧКА

All the main processes associated with testicular masses and focal testicular changes in men. The etiology of tumors in the gonads is demonstrated. The diagnostic methods and differential diagnosis of tumors are highlighted. The tumor identified in the presented clinical case is considered from the point of view of diagnostic, morphofunctional, pathological sections of medicine.

Texture analysis of contrast enhancement CT in the differential diagnosis of tumor and tumor-like cystic lesions of the pancreas: possibilities in texture preprocessing and various segmentation parameters

Texture analysis of contrast enhancement CT in the differential diagnosis of tumor and tumor-like cystic lesions of the pancreas: possibilities in texture preprocessing and various segmentation parameters

Ewing Sarcoma of the Female Genital Tract: Clinicopathologic Analysis of 21 Cases With an Emphasis on the Differential Diagnosis of Gynecologic Round Cell, Spindle, and Epithelioid Neoplasms.

Ewing sarcoma is an uncommon neoplasm considered in the differential diagnosis of tumors with "small round cell" morphology, but its occurrence in the gynecologic tract has only been sporadically documented. Herein, we describe the largest cohort of Ewing sarcoma localized to the female genital tract to date, and emphasize their clinicopathologic resemblance to more common gynecologic neoplasms. Ewing sarcoma (n=21) was retrospectively identified from 5 institutions. The average patient age was 35 (range 6-61) years. Tumor sites included uterus (n=8), cervix (n=4), vulva (n=5), vagina (n=1), broad ligament (n=1), inguinal area (n=1), and pelvis (n=1). Nine of 18 cases in which slides were available for review demonstrated only classic round cell morphology, with the remainder showing a variable combination and prominence of variant ovoid/spindle or epithelioid appearance. Tumors showed diffuse membranous reactivity for CD99 (20/20) and were positive for NKX2.2 (8/8, diffuse) and cyclin D1 (7/7, of which 3/7 were patchy/multifocal and 4/7 were diffuse). They were negative for ER (0/6) and CD10 (0/6). Three cases were initially diagnosed as endometrial stromal sarcomas. EWSR1 rearrangement was confirmed in 20/21 by fluorescence in situ hybridization (n=15) and/or sequencing (n=8). Of the eight tumors that underwent sequencing, 6 harbored FLI1 , 1 ERG, and 1 FEV as the fusion partner. Of 11 patients with available follow-up, 5 died of disease, 1 developed lung metastases and 5 are alive with no evidence of disease. Ewing sarcoma of the gynecologic tract is a rare, aggressive entity that shares some morphologic and immunohistochemical features with other more common gynecologic neoplasms. In addition to the typical round cell appearance, variant spindled/ovoid to epithelioid morphology may also be observed and should prompt consideration of this entity with appropriate immunohistochemical and/or molecular studies.

Cytomorphology of metastatic colonic MXD4::NUTM1-rearranged sarcoma.

This report describes the cytologic features of a recently described MXD4::NUTM1-rearranged colonic sarcoma metastatic to the midclavicular soft tissue. Thirteen years ago, a 65-year-old woman presented with a cecal mass and subsequent liver mass. The cecal mass was diagnosed as malignant undifferentiated spindled and epithelioid neoplasm based on morphology and lack of tumor immunoreactivity with a panel of epithelial, smooth muscle, skeletal, melanoma, hematologic, and GIST markers. The liver mass showed morphologic and immunophenotypic similarity to the epithelioid component of the patient's cecal mass, albeit devoid of the spindled component. Fine needle aspiration of the midclavicular soft tissue mass showed singly scattered to clustered epithelioid to rhabdoid tumor cells with centrally to eccentrically located nuclei, prominent nucleoli, and moderate eosinophilic cytoplasm. Immunohistochemical stains performed on the concurrent biopsy showed the tumor cells were positive for NUT and negative for all other additional markers with retained normal expression of SMARCA2 and SMARCA4. Next-generation sequencing showed the presence of MXD4::NUTM1 gene fusion. Due to the identical cytomorphologic findings with the epithelioid component of the patient's prior cecal and liver masses, the tumor was deemed as consistent with a NUTM1-rearranged sarcoma. To our knowledge, this case represents the first reported cytologic features of a NUTM1-rearranged sarcoma on fine needle aspiration. Familiarity with the cytologic features, inclusion of this entity in the differential diagnosis of tumors with epithelioid and/or rhabdoid morphology, and performance of ancillary tests (immunohistochemistry and molecular) will be helpful in arriving at the right diagnosis.

Sequencing of cerebrospinal fluid cell-free DNA facilitated early differential diagnosis of intramedullary spinal cord tumors

Pre-surgery differential diagnosis is valuable for personalized treatment planning in intramedullary spinal cord tumors. This study assessed the performance of sequencing cell-free DNA (cfDNA) in cerebrospinal fluid (CSF) for differential diagnosis of these tumors. Prospectively enrolling 45 patients with intramedullary spinal cord lesions, including diffuse midline glioma (DMG), H3K27-altered (14/45), glioblastoma (1/45), H3-wildtype-astrocytoma (10/45), ependymoma (11/45), and other lesions (9/45), CSF samples were collected via lumbar puncture (41/45), intraoperative extraction (3/45), and Ommaya reservoir (1/45). Then, these samples underwent targeted sequencing along with paired tissue DNA. DMG, H3K27-altered patients exhibited a higher ctDNA positivity (85.7%, 12/14) compared to patients with H3-wildtype-astrocytoma (0/8, P = 0.0003), ependymoma (2/10, P = 0.003), and glioneuronal tumor (0/3, P = 0.009). The histological-grade-IV (P = 0.0027), Ki-67 index ≥10% (P = 0.014), and tumor reaching spinal cord surface (P = 0.012) are also associated with higher ctDNA positivity. Interestingly, for patients with TERT promoter mutant tumors, TERT mutation was detectable in the CSF cfDNA of one DMG case, but not other five cases with histological-grade-II tumors. Shared copy number variants were exclusively observed in DMG, H3K27-altered, and showed a strong correlation (Correlation = 0.95) between CSF and tissue. Finally, H3K27M mutations in CSF exhibited high diagnostic efficiency for DMG, H3K27-altered (Sensitivity = 85.7%, Specificity = 100.0%, AUC = 0.929). Notably, H3K27M was detectable in CSF from patients with recurrent tumors, making it easily applicable for postoperative monitoring. In conclusion, the molecular profile from ctDNA released into CSF of malignant tumors was more frequently detected compared to relatively benign ones. Sequencing of ctDNA in CSF exhibited high efficiency for the differential diagnosis of DMG, H3K27-altered.

Diagnostic Importance of Clinic-Pathologic Features and p16, CD34, MDM2 Expression in Differential Diagnosis of Tumors

Background: The large majority of soft tissue tumors are benign. Malignant mesenchymal neoplasm amount toless than 1% of the overall human burden of malignant tumors but they are life threatening and may pose asignificant diagnostic and therapeutic challenge since there are more than 50 histological subtypes of STS, whichare often associated with unique clinical, prognostic and therapeutic features.Methods: The study was undertaken in department of Pathology, King George’s Medical University, Lucknow.The Study Design was Retrospective and prospective study carried over a period of two year from September2018 to august 2020 including 70 cases. Results. Most common diagnosis of malignant cases was Synovial saroma(21.4%) followed by Leiomyosarcoma (19.0%) and Undifferentiated pleomorphic sarcoma & Fibromyxoid sarcoma(11.9% each). Less common diagnosis were Ewing’s sarcoma, Liposarcoma and Rhabdomyosarcoma (9.5% each),1 (2.4%) case each was diagnosed as Chondrosarcoma, MPNST and Myxoid liposarcoma.Conclusions: Genetic alterations involving the 12q13-15 chromosomal region are common in musculoskeletalsarcomas, and many bone and soft-tissue malignant tumors showed amplification of various genes located in thisregion.

Morphological and immunohistochemical features can potentially help with the differential diagnosis of rare oral mesenchymal tumors

ObjectiveThe aim of this study was to evaluate the features of rare oral and maxillofacial benign and malignant tumors of fibroblastic, myofibroblastic and fibrohistiocytic origin in an attempt to contribute to the diagnosis of these tumors. MethodsThe sample consisted of 16 cases of benign fibrohistiocytic (BFH) tumor, myofibroma (MF), solitary fibrous tumor (SFT), fibrosarcoma (FS), dermatofibrosarcoma protuberans (DFSP), and myofibroblastic sarcoma (MFS), obtained from a laboratory of oral pathology. They were submitted to morphological, histochemical (Masson’s trichrome), and immunohistochemical (α-SMA, vimentin, desmin, CD34, Bcl-2, S100, CD68, CD99, and Ki-67) analysis. ResultsMorphological analysis revealed variable features in the tumors studied. Masson’s trichrome resulted in blue staining in most cases. Regarding the immunohistochemical features, all cases were positive for vimentin and negative for desmin. The BFH tumors exhibited positive staining for CD68 and S100, while MFs were positive for α-SMA and SFTs were positive for CD34, CD99 and Bcl-2. With respect to malignant tumors, DFSP was positive for CD34 and Bcl-2 and MFS was positive for α-SMA and Bcl-2, while FS was negative for most of the antibodies analyzed. A higher proliferation index (Ki-67) was observed in malignant tumors. ConclusionsConsidering their similarity, the use of auxiliary techniques might help in the differential diagnosis of these tumors.

Improving Tumor Classification by Reusing Self-predicted Segmentation of Medical Images as Guiding Knowledge.

Differential diagnosis of tumors is important for computer-aided diagnosis. In computer-aided diagnosis systems, expert knowledge of lesion segmentation masks is limited as it is only used during preprocessing or as supervision to guide feature extraction. To improve the utilization of lesion segmentation masks, this study proposes a simple and effective multitask learning network that improves medical image classification using self-predicted segmentation as guiding knowledge; we call this network RS 2-net. In RS 2-net, the predicted segmentation probability map obtained from the initial segmentation inference is added to the original image to form a new input, which is then reinput to the network for the final classification inference. We validated the proposed RS 2-net using three datasets: the pNENs-Grade dataset, which tested the prediction of pancreatic neuroendocrine neoplasm grading, and the HCC-MVI dataset, which tested the prediction of microvascular invasion of hepatocellular carcinoma, and ISIC 2017 public skin lesion dataset. The experimental results indicate that the proposed strategy of reusing self-predicted segmentation is effective, and RS 2-net outperforms other popular networks and existing state-of-the-art studies. Interpretive analytics based on feature visualization demonstrates that the improved classification performance of our reuse strategy is due to the semantic information that can be acquired in advance in a shallow network.

HepPar1 and GATA-3 Expression in Neuroendocrine Neoplasms: A Potential Trap for Pathologic Diagnosis.

To investigate the expression and clinical significance of HepPar1 and GATA-3 in neuroendocrine neoplasms (NENs). The expression of HepPar1 and GATA-3 in 144 cases of NENs was detected using immunohistochemistry, and the relevant literature was reviewed. HepPar1 was localized in the cytoplasm, and the positive rate of HepPar1 was 6.25% (9/144) in 144 NENs, 9 of which were derived from gastrointestinal and pancreatic NENs, including 4 cases of neuroendocrine tumor, grade 1 (NET G1), 4 cases of NET G2, and 1 case of NET G3. GATA-3 was localized in the nucleus; the positive rate of GATA-3 was 7.62% (11/144), which was derived from 5 cases of gastrointestinal and pancreatic NENs, 2 cases of the lung, 2 cases of the liver, 1 case of the testis, and 1 case of the mediastinum. HepPar1 and GATA-3 were coexpressed in 4 cases: 2 cases of gastric NET G1, 1 case of gastric NET G2, and 1 case of pancreatic NET G3 with liver metastasis. HepPar1 and GATA-3 can be expressed in NENs, which are potential traps for the pathologic and differential diagnosis of tumors.

The Role of Pathogenesis Associated with the Tumor Microclimate in the Differential Diagnosis of Uterine Myocytic Tumors.

Myocytic tumors of the uterus present vast morphological heterogeneity, which makes differential diagnosis between the different entities necessary. This study aims to enrich the existing data and highlight new potential therapeutic targets regarding aspects related to the pathogenic process and the tumor microenvironment in order to improve the quality of life of women. We performed a 5-year retrospective study, including particular cases of uterine myocyte tumors. Immunohistochemical analyses of pathogenic pathways (p53, RB1, and PTEN) and tumor microclimate using markers (CD8, PD-L1, and CD105), as well as genetic testing of the PTEN gene, were performed. The data were statistically analyzed using the appropriate parameters. In cases of atypical leiomyoma, a significant association was observed between PTEN deletion and an increased number of PD-L1+ T lymphocytes. For malignant lesions and STUMP, PTEN deletion was associated with the advanced disease stage. Advanced cases were also associated with an increased mean CD8+ T cell count. An increased number of lymphocytes was associated with an increased percentage of RB1+ nuclei. The study corroborated clinical and histogenetic data, highlighting the importance of the differential diagnosis of these tumors to improve the management of patients and increase their quality of life.

ANCIENT SCHWANNOMA MASQUERADING AS CAROTID BODY TUMOR-A RARE CASE REPORT WITH REVIEW OF LITERATURE

The most common tumor at carotid artery bifurcation is a carotid body tumor causing widening of bifurcation, usually seen on conventional arteriography that can also be produced by schwannoma of the cervical sympathetic chain. Ancient schwannoma is the uncommon variety of schwannoma, a benign tumor that arises from the nerve sheath. It usually arises from any nerve except the optic and olfactory. Here we present a rare case of a male in his early 50s with lateral neck swelling diagnosed radiologically and excised as a carotid body tumor diagnosed as ancient schwannoma on histopathological examination. Although quite rare, cervical sympathetic chain schwannoma should be considered a differential diagnosis for tumors at the carotid bifurcation. Insight into morphological features of ancient schwannoma avoids misdiagnosis as a malignant nerve sheath tumor.

A rare case of thymus lipofbroadenoma

Purpose of the study: differential diagnosis of tumors arising from the mediastinum, as well as the analysis of the biological potential of the tumor, taking into account the relatively low incidence of these tumors among the population.Material and Methods. Macroscopic and microscopic examinations of the surgical specimen were performed using routine H&E staining. Immunohistochemical staining of paraffin-embedded tissue sections was performed using a Roche Ventana BenchMark Ultra system. The results obtained were evaluated taking into account the available literature data published on this nosology.Description. We present a rare case of a benign neoplasm of the thymus, lipofibroadenoma (LFA), which was localized in the left pleural cavity and originated from the anterior mediastinum with partial compression of the lower lobe of the left lung in a 59-year-old man. The tumor was revealed during a routine medical examination. The patient underwent left-sided thoracotomy with complete excision of the tumor and anterior mediastinal lymph node dissection. Macroscopic examination reveled that the tumor was predominantly composed of adipose tissue with fibrous layers. Histological examination showed a tumor composed of mature adipocytes of various sizes, among which remnants of the thymus with Hassal’s bodies and small number of lymphocytes and calcifications were found. Areas of fibrous stroma predominated over narrow strands of anastomosing epithelial cells with clear nuclei. Epitheliocytes formed slit-like structures infiltrated with lymphocytes, resembling the structure of breast fibroadenoma. Immunohistochemical examination revealed that epithelial cells were positive for PanKeratin and CK19, lymphocytes were positive for CD3 and CD20, and thymic cells expressed TdT. In this case, the neoplasm was almost asymptomatic, in contrast to previously published observations, which described an association with erythrocyte aplasia.Conclusion. Considering the clinical, histological and immunohistochemical data, it was feasible to make a differential diagnosis of the neoplasm and determine the histological type of the tumor as lipofibroadenoma.

Radiomics and artificial intelligence in the differential diagnosis of tumor and non-tumor diseases of the pancreas. Review

This work provides a comprehensive overview of the recent advancements in the field of radiomic diagnostics and artificial intelligence (AI) in the diagnosis of pancreatic diseases. The integration of radiochemical analysis and AI has allowed for more accurate and precise diagnoses of pancreatic diseases, including pancreatic cancer. The review highlights the different stages of radiomic analysis, such as data collection, preprocessing, tumour segmentation, data detection and extraction, modeling, statistical processing, and data validation, which are essential for the accurate diagnosis of pancreatic diseases. Furthermore, the review evaluates the possibilities of using AI and artificial neural networks in surgical and oncological pancreatology. The features and advantages of using radiochemical analysis and AI in the diagnosis and prognosis of pancreatic cancer are also described. These advancements have the potential to improve patient outcomes, as early and accurate diagnosis can lead to earlier treatment and better chances of recovery. However, the limitations associated with the use of radiometry and AI in pancreatology are also noted, such as the lack of standardization and the potential for false positives or false negatives. Nevertheless, this work highlights the potential benefits of incorporating radiochemical analysis and AI in the diagnosis and treatment of pancreatic diseases, which can ultimately lead to better patient care and outcomes.

68Ga-cyc-DX600 PET/CT in ACE2-targeted tumor imaging.

For the tumor-specific ACE2 expression, this research aimed to establish and verify ACE2-targeted PET imaging in differentiating tumors with distinct ACE2 expression. 68Ga-cyc-DX600 was synthesized as tracer of ACE2 PET. NOD-SCID mice were used to prepare the subcutaneous tumor models with HEK-293 or HEK-293T/hACE2 cells to verify ACE2 specificity, with other kinds of tumor cells to evaluate the diagnostic efficiency for ACE2 expression, additionally, immunohistochemical analysis and western blot were used to certify the findings on ACE2 PET, which was then performed on four cancer patients and compared with FDG PET. The metabolic clearance of 68Ga-cyc-DX600 was initially completed in 60min, realizing an ACE2-dependent and organ-specific background of ACE2 PET; meanwhile, tracer uptake of subcutaneous tumor models was of a definite dependence on ACE2 expression (r = 0.903, p < 0.05), and the latter served as the primary factor when ACE2 PET was used for the differential diagnosis of ACE2-related tumors. In pre-clinical practice, a comparable tumor-to-background ratio was acquired in ACE2 PET of a lung cancer patient at 50 and 80min postinjection; the quantitative values of ACE2 PET and FDG PET were negatively correlated (r = - 0.971 for SUVmax, p = 0.006; r = - 0.994 for SUVmean, p = 0.001) in an esophageal cancer patient, no matter the primary lesion or metastasis. 68Ga-cyc-DX600 PET was an ACE2-specific imaging for the differential diagnosis of tumors and added complementary value to conventional nuclear medicine diagnosis, such as FDG PET on glycometabolism.

Structural and Molecular Fusion MRI Nanoprobe for Differential Diagnosis of Malignant Tumors and Follow-Up Chemodynamic Therapy.

Enhanced imaging techniques using contrast agents enable high-resolution structural imaging to reveal space-occupying lesions but rarely provide detailed molecular information. To this end, we report a structural and molecular fusion magnetic resonance imaging (MRI) nanoprobe for differential diagnosis between benign and malignant tumors. This fusion nanoprobe, termed FFT NPs, follows a working mechanism involving a T1-/T2-weighted magnetic resonance tuning effect (MRET) between a magnetic Fe3O4 core and a paramagnetic Fe-tannic acid (Fe-TA) shell. The FFT NPs with an "always-on" inert T2 signal provide structural MRI (sMRI) contrast of tumors while affording an activated T1 signal in the presence of ATP, which is overproduced during the rapid growth of malignant tumors to enable molecular MRI (mMRI) of tumor lesions. We propose the use of the ratiometric mMRI:sMRI intensity to assist in the differential diagnosis of malignant 4T1 tumors from benign L929 fibroblast tumors. Furthermore, the dissociated FFT NPs were found to be able to catalyze H2O2 conversion in 4T1 tumors to generate excess reactive oxygen species (ROS) for chemodynamic therapy. The described fusion nanoprobe strategy enables the differential diagnosis of tumors from a combined spatial and molecular perspective with one-stop MRI imaging with potential applications in precision intervention.

Infraorbital mass long after dermal filler injection: A report of two cases.

Hyaluronic acid fillers have been increasingly used throughout the world in the management of aging skin in the periocular region and other areas. To evaluate very late-term orbital mass formation secondary to Hyaluronic acid filler injection into the inferior eyelid. We report two cases that presented with a subcutaneous palpable mass localized at the right medial lower infraorbital area. Following clinical and radiological examination, surgical excision was required for the differential diagnosis of tumor. After pathologic examination and the finding of a foreign-body granulomatous reaction, both patients recalled that hyaluronic acid filler had once been injected into their lower eyelids approximately 10 years prior. This is consistent with the fact that dermal-filler-related granuloma formation may occur even years later in the differential diagnosis of mass lesions. It is suggested that patients be informed about the possible but rare mass effect in the infraorbital region. Clinicians should also attend to delayed hypersensitivity reactions, since patients may not recall details due to the length of time since injection.

Multimodal algorithm for differential diagnosis of tumors and tumor-like diseases of the ocular fundus

Diagnosing pathologies of the ocular fundus and performing differential diagnosis of intraocular tumors along with conventional ophthalmoscopy can involve additional visualization methods such as ultrasonography, fluorescein angiography and optical coherence tomography (OCT). Many researchers note the importance of employing a multimodal approach in differential diagnosis of intraocular tumors, but there is no universally established algorithm for a rational choice of both the combination of visualizing methods, and the sequence of their application with consideration of the ophthalmoscopy findings and the results of first-line diagnostic methods. The article presents author's own multimodal algorithm developed for differential diagnosis of tumors and tumor-like diseases of the ocular fundus. This approach involves the use of such methods as OCT and Multicolor fluorescence imaging, with exact sequence and combination determined on the basis of ophthalmoscopy and ultrasonography findings.

Schwannoma of Common Peroneal Nerve in the Knee- A Case Report

Schwannomas are rare benign neurogenic tumors of peripheral nerves arising from neural sheath A 42-year-old male patient presented with the complaint of gradually increasing swelling in the posterolateral aspect of right knee for last 15-20 years. Initially it was painless but for last 10 years, it is painful especially after touching or pressing it and also on flexion and extension movements of the knee. For last 10-15 days, the pain is unbearable. His MRI revealed it to be Schwannoma of common Peroneal nerve. He was operated under spinal anesthesia .Enucleation of the tumor was done. Continuity of common peroneal nerve was ensured. After surgical intervention, the patient’s complaints completely disappeared in the post-operative period. Schwannoma of common peroneal nerve is a very rare tumor of knee and must be kept in differential diagnosis of tumor in the posterolateral aspect of knee joint and in cases of pain in knee.

Atypical Sites of the Lipoma on the Hand and Fingers: Clinical and Imaging Features and Surgical Outcomes.

Background: Lipomas are the most frequent benign soft tissue tumor that are rarely found in the hand and are exceptionally rare on the fingers. The aim of this study was to investigate lipomas of atypical locations, so that they can be taken into account when making a differential diagnosis of a tumor of the hand or fingers. Methods: We studied a group of 27 patients diagnosed with lipoma of the wrist, palm, and fingers. The diagnosis was made by clinical and imaging examinations. Surgical treatment was established based on symptoms of pain, paresthesias, functional impairment, or aesthetic concerns. Treatment outcomes were assessed clinically at 1.5 years post-intervention. Results: Sizes over 5 cm were recorded in five cases, with the largest lipoma being 8 by 5 by 3.5 cm in size and weighing 125 g, located in the palm. There was one case of spontaneous tendon rupture and one case of carpal tunnel syndrome. There was no recurrence recorded at 1.5-year follow-up. Conclusions: Lipomas in the palm and fingers are rare entities (with more men affected), and surgical treatment consists of complete removal of the tumor and providing definitive healing. Despite their rarity, clinicians should consider lipomas when making differential diagnoses of soft tissue tumors of the hand.