Large Lipoma Research Articles

Intraoral Lipoma

Lipomas, benign tumours of mature fat cells, typically appear in the head-and-neck region, with rare occurrences in the mouth. This case involves an unusually large intraoral lipoma exceeding 1.8 cm. Lipomas, usually painless, may go unnoticed for an extended period. Recognition of atypical presentations is crucial for accurate diagnosis and management. A surgical procedure under local anaesthesia removed a 1.8 cm × 1.7 cm × 1.3 cm gingival growth. Using a 15 No, an incision was made on the BP blade to preserve the attached gingiva. Coe-Pak dressing safeguarded the treated area, ensuring optimal recovery. The soft-tissue section’s histopathological examination revealed an encapsulated lesion with mature adipocytes arranged in lobules, separated by fibrous connective tissue. Adipocytes displayed polygonal shapes with clear cytoplasm, eccentrically placed nuclei and compressed membranes. Deeper observations included dilated blood capillaries, extravasated red blood cells, muscle fibres and minimal inflammatory cells. Lobules of mucous salivary acini were also identified as intraoral lipomas, rare but detected during dental check-ups. They usually lack pain, which causes delayed treatment. Patients focus on aesthetics or mild discomfort. Clinicians must use modern diagnostics to identify and conservatively manage intraoral lipomas. Ongoing trials explore non-surgical treatments, potentially shaping future standards of care.

Complete encasement of the radial nerve by a giant lipoma: illustrative case.

Among the spectrum of adipose lesions associated with peripheral nerves, complete circumferential encasement of the nerve by the lesion is a very rare entity. The authors report the first case of a giant lipoma that completely and circumferentially encased the radial nerve. A 57-year-old woman presented with a large left-arm mass that she had noticed over a year following significant weight loss. She had hypersensitivity and dysesthesias in the left posterior arm but no weakness or other symptoms. Magnetic resonance imaging of the left upper limb demonstrated a large lipoma completely encasing the radial nerve, originating at the level of the spiral grove proximally and extending distally to the lateral epicondyle. The lesion was completely resected at surgery with total preservation of radial nerve function. Lipomas encasing peripheral nerves can be difficult to manage while preserving function. This case adds to the intriguing spectrum of adipose lesions associated with peripheral nerves. https://thejns.org/doi/10.3171/CASE24148.

Adherent Right Atrial Cardiac Lipoma with Obstructive Symptoms: An Unusual Case Report

Abstract Benign cardiac tumors are rare, and cardiac lipomas constitute a small proportion. Since the majority of these lipomas vary in morphology, size, clinical presentation, and diagnosis, it is difficult to diagnose them until they become symptomatic. Management of large adherent cardiac lipomas presenting with obstructive symptoms can be challenging. It can be arduous to excise them completely, as they may involve vital structures and may sometimes need debulking only, leading to the possibility of recurring tumors. We report a case of a 60-year-old male with complaints of chest pain and dyspnea on exertion, diagnosed with a large right atrial mass, extensive involvement of the right atrial wall, and impingement on the tricuspid valve and was managed by surgical resection with a positive clinical result. This case highlights that obstructive or symptomatic cardiac lipomas can be effectively resected with favorable outcomes.

Extraction of terminal ileal lipomas to cecum can facilitate endoscopic resection: A case series with video.

Large ileal lipomas over 2 cm can cause symptoms, that may require a resection. Due to the narrow lumen and thin walls of the ileum, endoscopic treatments can have a high risk of adverse events and require technical expertise, thus surgical resection is currently the mainstay of treatment. To overcome the technical challenges, we developed a novel method to endoscopically resect terminal ileal lipomas. The technique involves extracting the lesion into the cecum, which creates sufficient space to maneuver, and a better field of view. The lipoma is resected with endoscopic mucosal resection or endoscopic submucosal dissection. The appearance of the lipoma protruding out of the ileocecal valve resembles that of a tongue sticking out of the mouth, thus we named this the "tongue out technique". To assess the technical feasibility of this method, we retrospectively analyzed seven cases of terminal ileal lipoma that were endoscopically resected using the "tongue out technique" at NTT Medical Center Tokyo between January 2017 and October 2023. Technical success was 100% and en bloc resection was achieved in all cases. The median size was 31 (14-55) mm. Three cases were resected with endoscopic mucosal resection while endoscopic submucosal dissection was performed on the other four cases. There was one case of delayed post-endoscopic mucosal resection bleeding, which was caused by clip dislodgement. There were no perforations. No recurrence of the lipoma or associated symptoms have been observed. This new technique can allow more ileal lipomas to be treated with minimally invasive and organ-preserving endoscopic procedures.

An unusual cause of adult transverse colonic intussusception with obstruction: Multiple large submucosal lipomas in a 50-year-old male

Intussusception is a gastrointestinal condition that predominantly affects the pediatric population. Although uncommon, it can occur in adults and is typically due to a pathological lead point that causes telescoping of the intestine during peristalsis. In this case, a 50-year-old male presents with abdominal pain, distension, diarrhea, and unintentional weight loss, which was revealed to be caused by intussusception that originated at a cluster of submucosal lipomas in the transverse colon. This patient had recently immigrated to the U.S. from Africa, and had missed his colorectal screening, which is recommended at age 45 for every person. It is crucial to accurately screen for, diagnose, and surgically treat this condition to prevent downstream complications such as bowel infarction or perforation.

A large cheek lipoma misdiagnosed as a dental infection: a rare case report

Abstract The most frequent benign tumor is lipoma. About 1–4% of people have intraoral lipomas. This uncommon case report shows a large cheek lipoma misinterpreted as dental infection. A 14-year-old girl with a right cheek tumor was diagnosed and treated for a dental infection. Multiple imaging examinations complete the diagnosis. A benign lipoma, common in subcutaneous tissues but unusual in the mouth, created the lesion. A histological investigation confirmed lipoma after extraoral excision under general anesthesia utilizing an external flap. The edema did not return after surgery, which restored face symmetry. This case study shows that diagnosing and treating oral and maxillofacial edema requires extensive clinical and radiographic testing. Lipomas should be evaluated in the differential diagnosis of mouth swelling even without usual risk markers to prevent excessive treatments and delays. Surgery is recommended for lipomas since it has a low recurrence and fewer risks.

Endoscopic resection of a large symptomatic duodenal lipoma

Endoscopic resection of a large symptomatic duodenal lipoma

Symptomatic Preperitoneal Lipoma Resected via Preperitoneal Approach: A Case Report and Review of the Literature

Introduction: Lipomas are benign adipose tissue tumors that can vary in size and location. Magnetic resonance images should be obtained for all soft-tissue masses that are deep to fascia or those >5 cm in subcutaneous tissue. In this case report, we present a minimal invasive technique to resect a large preperitoneal lipoma. Case Presentation: A 36-year-old woman presenting with left fossa pain caused by a large mass. MRI-imaging shows a large preperitoneal lipomatous lesion (61 × 58 × 40 mm) which compresses the bladder, tuba and surrounding vessels. We did a minimally invasive preperitoneal laparoscopic surgical resection. Postoperative follow-up was uneventful. The pathology report confirmed benign lipoma without signs of malignancy. Discussion: Preperitoneal lipomas should be considered in the diagnosis of lower abdominal pain and can be minimally invasive resected via preperitoneal laparoscopic approach in day clinic.

Minimally Invasive Resection of a Large Subcutaneous Lipoma: The 2.5-cm (1-inch) Method.

Minimally Invasive Resection of a Large Subcutaneous Lipoma: The 2.5-cm (1-inch) Method.

Anaesthesia management in a case of large lipoma on back of the neck with difficult positioning

Anaesthesia management in a case of large lipoma on back of the neck with difficult positioning

Plasmodium ovale infection in Sri Lanka: distant exposure and incidental detection of hyperparasitemia: a case report

BackgroundPlasmodium ovale malaria, which was previously endemic to tropical Africa and the Southwest Pacific islands is now being reported from parts of Asia. In Sri Lanka, the indigenous transmission of malaria has not been documented since October 2012. Since then, there have been several imported cases of malaria, including P.ovale, which have been detected sporadically. The reporting case of P. ovale was imported and detected incidentally in 2021, with several atypical presentations.Case presentationA 40-year-old Sri Lankan medical doctor developed continuous fever with chills, rigors, and dysuria a day following removal of a large lipoma at the root of the neck under general anaesthesia. When the fever has been responding to antibiotics, on the 4th postoperative day a mild thrombocytopenia on complete blood count was detected. A blood smear which was done on the 5th postoperative day incidentally found a malaria parasite and confirmed as Plasmodium ovale with a density of 6535 parasites/microliter on the same day. He never had malaria in the past, but he had worked in South Sudan 1 year ago and visited India six months ago. On the 6th postoperative day, he was treated with chloroquine, and hyperparasitemia reduced rapidly by the next day. As the fever recurred with clinical deterioration, he was treated with different antibiotics. During the course of the illness, he did not develop pallor, or icterus except for a palpable soft spleen. The parasite count was zero on the 9th postoperative day and his fever subsided on the next day. Further, he was treated with primaquine to prevent future relapse and transmission.ConclusionA long incubation period, incidental detection of P ovale in a blood smear, and hyperparasitaemia are the atypical presentations of this case. Postoperative bacterial infection and stress may have reactivated the dormant malaria (hyponozoites) in this patient with an unusual picture. Coinfection of malaria with bacterial sepsis is a challenge in the management of the patient. As the Anopheles mosquito vector exists in Sri Lanka, the risk of indigenous transmission is high from such imported cases of P. ovale.

Use of simple endoscopic ligation to successfully remove a large torsional colonic lipoma causing intussusception.

Use of simple endoscopic ligation to successfully remove a large torsional colonic lipoma causing intussusception.

Aspiration of lipoma: Effective use of liposuction

AbstractLipomas tend to be surgically excised leaving big scars which often are not liked by patients. Liposuction offers an alternative solution especially for large lipomas, wherein complete resolution can occur with hardly any complications and above all minimal scar at wound site.

Loop-and-let-go technique for the management of symptomatic large colonic lipoma.

Video 1We depict (1) identification of a large lipoma in the sigmoid colon; (2) radial echo endoscopy confirming diagnosis; (3) removal with the loop-and-let-go technique; (4) exvivo demonstration of the technique; and (5) an interval follow-up demonstrating healing of the lesion.

Do the Clinical Characteristics of Lipomas Influence the Incision Length During Minimal Incision Extraction?

Minimal incision extraction technique is widely accepted for the surgical removal of lipomas, but no consensus for the incision length has been made yet. To investigate the clinical characteristics of lipomas which affect the minimal incision length during the minimal incision extraction. We retrospectively analyzed 50 patients who underwent minimal incision extraction for 55 medium-sized (3-5 cm) or large lipomas (> 5 cm) between March 2020 and May 2022. If the mass is not fully dissected, or adequate visual field for hemostasis was not provided through the initial one-third incision, the incision was extended to the minimal extent. There were 33 males and 17 females with a mean age of 53.5 ± 12.7 years. There was no statistical difference in the minimal % incision length, defined as [(incision length) / (tumor diameter)] x 100, between the medium-sized (n = 31) and large lipomas (n = 24). Lipomas of the long incision group (minimal % incision length ≥66.7%, n = 21) had a higher frequency of head and neck location than lipomas of the short incision group (minimal % incision length <66.7%, n = 34) (odds ratio = 14.5, P < .05). However, no association was found between the tumor diameter or depth and the minimal % incision length. The occurrence of postoperative complications was not associated also (P = .296). The minimal % incision length for lipoma removal does not show statistical difference between medium-sized and large lipomas, and is affected by its anatomical location, but not by tumor diameter or depth.

Liver Lipoma in a Dog: Case Report and Literature Review

ABSTRACT Lipoma of the liver has not been reported in dogs. An 8 yr old spayed female Great Dane was referred for diagnostic workup of abdominal distention. Computed tomography showed fat-attenuating masses with negative attenuation values (variable between −60 to −40 Hounsfield units) and minimal contrast uptake within the left cranial abdomen. Left lateral and right medial liver lobectomies were performed to remove two liver masses. Histopathology showed large lipomas arising from within the hepatic parenchyma. Immunohistochemistry for smooth muscle actin was negative, consistent with true lipomas. The dog was euthanized 8 mo later because of causes likely unrelated to the liver lipoma. This is the first case report of lipoma in the liver of a dog. The purpose of this case report and brief literature review is to provide evidence that surgical excision of fat-attenuating masses within the liver that are consistent with lipoma using immunohistochemistry can be curative.

Ultra-diluted Atropine Belladonna Managed Lipoma: A Study of Two Cases

A lipoma is a benign tumor of fatty tissues. It is usually harmless; however, may sometimes need laboratory examinations to confirm diagnosis. Conventional medicines are mostly ineffective in diminishing fat spar, therefore surgical removal is preferred. This article is to report case studies of two individuals of a fairly large lipoma, which were treated with ultra-diluted atropine belladonna. In both cases the lipoma wall punctured within few days, drained all the debris and healed lesion surface observed within four weeks. This alternative treatment evidenced that ultra-diluted atropine belladonna may have significant role in lipoma management. More extensive research is needed to understand the mode of action of ultra-diluted atropine belladonna in managing lipomas.&#x0D; Bioresearch Commu. 9(2): 1357-1360, 2023 (July)

Endoscopic debulking of a large colonic lipoma causing recurrent intussusception using endoscopic mucosotomy technique.

Endoscopic debulking of a large colonic lipoma causing recurrent intussusception using endoscopic mucosotomy technique.

V-049 THE IMPORTANCE OF PROCTORING- MISSING THE “TEN GOLDEN RULES” OF TAPP

Abstract Claus in 2020 published the “Ten golden Rules” for a minimally Invasive safe approach to the Myopectineal Orifice. During the first proctoring session of a TAPP procedure for the repair of a left side inguinal hernia we revised the application of the rules by the trainee. The proctor invited the trainee to study the paper before the session of surgery. The first and the last 3 rules were followed by the trainee but there was a lack of the 4-5-6-7 rules. The knowledge of the anatomy of the inguinal region allows the surgeon to create a preperitoneal box for a mesh at least 15×15cm covering all the possible origins for hernia. In particular we focused our attention to the rule 7. The trainee was missing to check the emptiness of the deep inguinal ring that was covered, in the iliopubic tract, by fat sliding to the scrotal region. After dissection a big cord lipoma was reduced in the abdomen. Missing this rule should be a problem because the patient could feel,after the inguinal hernia repair, a bulging and discomfort in the inguinal region. The imaging could not be helpful and the clinical visit could report a “false Positive” for the presence of bulging without a real hernia. In a similar case we reoperate a man after a TAPP procedures for a bulging in inguinal region, pain and discomfort miming a recurrence but we only found a large cord lipoma that we resected.

Endoscopic resection of a large symptomatic duodenal lipoma

Endoscopic resection of a large symptomatic duodenal lipoma