Simple Lipoma Research Articles

Review of Hard Palate Lipoma and Retrospective Clinicopathological Analysis of Patients With Oral Lipomas.

Lipomas occurring in the hard palate are extremely rare, and treating lipomas in this area presents challenges due to the thinness of soft tissue and the risk of postoperative bony surface exposure. We present a case of hard palate lipoma that was successfully removed using the partial thickness flap dissection technique. In addition, we reviewed the clinicopathological features of 20 reported cases of hard palate lipomas worldwide and retrospectively analyzed the clinical characteristics and pathological types of 68 oral lipomas in China. The use of a partial thickness flap demonstrates potential effectiveness in excising benign masses located in the hard palate. Regarding 68 patients with oral lipomas, the most commonly affected sites were the buccal region, tongue, and floor of the mouth. Histologically, simple lipomas and fibrolipomas were the predominant types observed.

Case Report: Thigh hidradenoma masquerading as lipoma

Background: Hidradenomas are benign adnexal neoplasms which were recently been subdivided into two groups: eccrine differentiation (poroid hidradenomas) or apocrine differentiation (clear cell hidradenomas) with the latter being rarer. These types of tumors have been associated with recurrence and malignant transformation, however; recurrence and malignancy are considered very rare. We present a case report of a 35-year-old male who presented with two lumps, clinically representing simple lipomas but one of them turned to be a hidradenoma.

A radiological diagnostic approach to tumours and tumour-like lesions of the calcaneus.

The calcaneus is a rare location for the development of primary bone tumours. The purpose of the study is to review the imaging findings in a cohort of patients presenting with tumours and tumour-like lesions of the calcaneus and to develop a more structured approach to the diagnosis of calcaneal lesions. A retrospective study with a collection of 167 cases of calcaneal tumours and tumour-like lesions from our tertiary orthopaedic oncology institution over a period of 13 years. Cases were reviewed by two consultant musculoskeletal radiologists and the location of the lesion within the calcaneus and demographics of the patient were noted for each case. A diagnostic algorithm, which is based on patient age and tumour location, was then extrapolated. Out of the 167 cases, we identified 24 different calcaneal pathologies which included both tumours and tumour-like lesions. The most common being simple bone cysts (18.3% of cases) and intra-osseous lipoma (15% of cases) sited in the diaphyseal equivalent of the calcaneus. A diagnostic algorithm was formulated, which describes the most common location of the different pathologies including both benign and malignant pathologies, subdivided by age. Our algorithm should help the radiologist narrow down the differential diagnosis when evaluating calcaneal lesions. This article provides a radiological approach to calcaneal lesions.

Lipomatous Soft Tissue Masses of the Extremities: A Spectrum From Benign to Malignant

Fat-containing masses are the most common solid, soft tissue masses encountered by radiologists and clinicians in everyday practice. The vast majority of these are benign. The imaging appearance of many fat-containing masses is frequently characteristic enough to suggest a specific diagnosis such as lipoma. However, there is a spectrum of benign and malignant fat-containing tumors with overlapping features. It is important to differentiate simple lipomas from well-differentiated liposarcomas due to differences in treatment, prognosis, and long-term follow-up. As molecular markers are increasingly being used for definitive characterization of tumors, we discuss their role and histopathologic characteristics of fat-containing soft tissue masses.

A REVIEW ON LIPOMA AND ITS GENETIC INTERVENTIONS

Lipomas are benign soft tissue fatty tumours that most commonly appear in the third decade of life when fatty tissue accumulates. Histologically, lipoma is composed of mature fat cells with a thin fibrous capsule. Simple lipomas account for 80% of adipose tissue tumours. The aetiology may be genetic like Familial Multiple Lipomatosis. Some tumours, like the well differentiated Liposarcomas never metastasize unless they undergo de-differentiation. They can be introduced as Atypical Lipomatous Tissue, ALT. Southern blot analysis is performed by obtaining DNA from ALT, cases in which most of them are characterized by the presence of supernumerary ring and long marker chromosomes. The complex chromosome region contains genes MDM2, CDK4, HMGI- C, SAS, GLI, CHOP, OS4 and OSP. Most of ALTs, after analysis revealed amplification of CDK4 and MDM2 proto- oncogenes that play major role in permitting over ride of block operated on cell proliferation. Immuno-histochemical results have shown MDM2 over expression in about 50% of ALTs along with weak CDK4 immuno-positivity. Also the lipomas with Gene fusion transcripts have the expression of certain genes, HMGA2/LPP, HMGA2/RDCI and HMGA2/NFIB. Of these 98% of cases were analyzed for the possible expression of HMGA2/LPP and LPP- HMGA2 fusion genes using reverse transcription polymerase chain reaction. Over all these cases, shows non-enhanced adipocyte apoptosis and enhanced adipogenesis in lipoma tissue. Thus studies provide insights into molecular pathogenesis of lipomatous tumour and representation of distinctive subset of mesenchymal neoplasms with mature adipocyte differentiation.

Lipomas: A Case Series

Aim: This report aims to present 5 cases of intraoral lipoma with clinical findings, surgical treatment and histopathological features. Case Report: Provisional diagnosis of minor salivary gland neoplasm, fibroma and lipoma was made for all of the cases according to clinical examination. Excisional biopsy was performed with blunt dissection. Lobular, yellowish, encapsulated masses were obtained from the patients and excised specimens were sent to pathology laboratory for histopathological analysis. Results: After histopathological examination, all cases were diagnosed with simple lipoma. Successful healing of the oral mucosa was observed in postoperative period. Conclusion: The most important feature of these tumours is that they are asymptomatic. Differential diagnosis is important as it includes malign tumours and some genetic diseases that may be related to tumour. Key Words: Lipoma, Oral Surgery Intraoral Lipom: Vaka Serisi Öz Amaç: Bu çalışmada 5 intraoral lipom olgusunun klinik bulguları, cerrahi tedavisi ve histopatolojik özellikleri sunulmaktadır. Olgu Sunumu: Tüm olgularda klinik muayene sonrasında minör tükürük bezi neoplazmı, fibrom ve lipom tanısı düşünülmüştür. Vakaların eksizyonel biyopsileri künt diseksiyon ile yapılmıştır. Eksize edilen örnekler lobüler, sarımsı, kapsül ile çevrili kitleler olarak gözlemlenmiştir ve histopatolojik analiz için patoloji laboratuvarına gönderilmiştir. Bulgular: Histopatolojik inceleme sonrasında tüm olgulara basit lipom tanısı konulmuştur. Postoperatif dönemde oral mukozanın başarılı şekilde iyileştiği görülmüştür. Sonuç: Bu tümörlerin en önemli özelliği, asemptomatik olmalarıdır. Ayırıcı tanı, malign tümörleri ve tümörle ilişkili olabilecek bazı genetik hastalıkları içermesi sebebiyle önemlidir. Anahtar Kelimeler: Lipom, Oral Cerrahi

INTRAMUSCULAR VARIANT OF LIPOMA IN THE TONGUE: A CASE REPORT

Although 20% of lipomas occur in the head and neck, only 1% to 4% of these are in the oral cavity. Histologically, they are classified into simple lipomas, fibrolipomas, angiolipomas, pleomorphic lipomas, spindle cell lipomas, sialolipomas, atypical lipomas, and intramuscular or infiltrative lipomas. The objective of this work is to report a clinical case of intramuscular lipoma in the tongue, since it is an uncommon lesion and requires follow-up because of its greater potential for recurrence. Patient S.P.O.G. is 78 years old with a nodular lesion in the right border of tongue present for 5 years. The lesion had well-defined borders, soft consistency, mucosa-like staining, and absence of painful symptomatology. The treatment was performed as an excisional biopsy. The histopathologic examination reported intramuscular lipoma, presenting muscle fibers inside and at the periphery of the lesion. The patient continues in periodic follow-up. Although 20% of lipomas occur in the head and neck, only 1% to 4% of these are in the oral cavity. Histologically, they are classified into simple lipomas, fibrolipomas, angiolipomas, pleomorphic lipomas, spindle cell lipomas, sialolipomas, atypical lipomas, and intramuscular or infiltrative lipomas. The objective of this work is to report a clinical case of intramuscular lipoma in the tongue, since it is an uncommon lesion and requires follow-up because of its greater potential for recurrence. Patient S.P.O.G. is 78 years old with a nodular lesion in the right border of tongue present for 5 years. The lesion had well-defined borders, soft consistency, mucosa-like staining, and absence of painful symptomatology. The treatment was performed as an excisional biopsy. The histopathologic examination reported intramuscular lipoma, presenting muscle fibers inside and at the periphery of the lesion. The patient continues in periodic follow-up.

Pedunculated lipoma of palate - A case study

Introduction: Lipomas are a benign soft tissue neoplasm composed of mature adipocytes. They are most common soft tissue neoplasm in adults. These are usually subcutaneous tumors seen mostly on the trunk, back, shoulder and upper extremity. They are rarely seen in the oral cavity and account for less than 4% of all benign oral tumors. The patients usually present with an asymptomatic oral swelling. Histopathology shows many variants. Complete excision is curative with extremely rare recurrence. We report a case of a 40-year-old male with complaint of painless swelling in the oral cavity. The swelling was gradually increasing. On oral examination a pedunculated swelling was noted on the soft palate. The swelling was excised and was reported as a simple lipoma on histopathology. In conclusion, oral lipomas should be considered in differential diagnosis for the oral cavity swellings. A close follow-up is needed for deep intramuscular lipomas. We present this case for its rare presentation. Keywords: Lipoma, Benign, Oral cavity, Soft palate.

Small soft tissue masses indeterminate at imaging: histological diagnoses at a tertiary orthopedic oncology clinic.

To review histologic diagnoses of soft-tissue masses (STMs) ≤2cm with indeterminate imaging features encountered in musculoskeletal oncology clinic at a tertiary referral center. This was an IRB-approved retrospective review of patients with STMs ≤2cm, referred to our tertiary care orthopedic oncology clinic over 4.75 consecutive years. Maximum diameter was based on imaging measurement by a fellowship-trained musculoskeletal radiologist. Simple lipomas, synovial cysts, metastases, and cases without histologic confirmation were excluded. Patient demographics, tumor imaging features (location, depth, size, and tumor:muscle enhancement and T2 signal ratios), and histology were recorded and compared. Mean maximum diameter for 42 trunk/extremity STMs was 1.5cm (range, 0.7 to 2cm). Mean age was 48years (range, 18-83years). Nine (21%) of the masses were malignant, while 33 (79%) were non-malignant. Thirty-nine (93%) of masses were superficial; 7/39 (18%) of these superficial tumors were malignant. Malignancy was not associated with underlying vessels, tendon, or fascia (p = 0.19). The non-malignant vs. malignant tumor:muscle enhancement ratio was 2.15 vs. 2.32 (p = 0.58) and enhancement coefficient of variation was 0.14 vs. 0.10 (p = 0.29). Most common malignant histologic subtypes were synovial sarcoma (n = 3), fibroblastic/myofibroblastic sarcoma (n = 2), leiomyosarcoma (n = 2), myxofibrosarcoma (n = 1), and angiomatoid fibrous histiocytoma (n = 1). The majority (67%) of non-malignant lesions were: leiomyoma (n = 6), angiomyoma (n = 5), schwannoma (n = 4), benign fibrous histiocytoma (n = 4), and hemangioma (n = 3). At a tertiary musculoskeletal oncology referral clinic, primary STMs ≤2cm with indeterminate imaging features should be managed cautiously despite their small size and/or superficial location.

Sialolipoma of Parotid Gland a Rare Histological Presentation.

Sialolipoma is a rare tumour found within both major and minor salivary glands, it is recently described as a variant of salivary gland lipoma. Sialolipoma was first described by Pusiol et al. (Indian J Pathol Microbiol 52(3):379-382, 2009). Sialolipoma is well circumscribed and contains mature adipose tissue admixed with benign salivary gland component. We report a case of 62years old female who presented with the complaint of swelling in the right parotid region for 5years duration. Apart from cosmetic reason she had no other complain. All specific investigations done were inconclusive and suggested a benign tumor. Histopathological examination after superficial parotidectomy suggested sialolipoma. As newly described tumor type, care should be taken to distinguish oncocytic sialolipoma from other salivary gland neoplasms such as simple lipoma, pleomorphic adenoma, or oncocytoma.

Intraoral lipomas: A clinicopathological study of 43 cases, including four cases of spindle cell/pleomorphic subtype.

BackgroundThe aim of this study was to describe the clinicopathological characteristics of 43 intraoral lipomas and classify them according to their microscopic variants.Material and MethodsAll the cases of intraoral lipomas diagnosed at an Oral Pathology service were selected for the study. Clinical data, such as age, gender, location, time of evolution, clinical presentation, clinical hypothesis of diagnosis, and treatment, were collected from the clinical files.ResultsOf the 43 cases analyzed, 24 (55.8%) occurred in women. The mean age was 77.4 years. The most affected site was the buccal mucosa (22 cases, 51.1%). The mean lesion size was 1.7 cm. Twenty-three cases (53.5%) were classified as simple lipoma, 14 (32.6%) as fibrolipoma, four (9.3%) as spindle cell/pleomorphic lipoma (SC/PL), one (2.3%) as lipoma of the salivary glands, and one (2.3%) as intramuscular lipoma. In one case of SC/PLs, lipoblasts were observed. No atypical lipoblasts or mitoses were noted. Lipoma was considered more often than other tumor histological subtypes among the clinical hypotheses of diagnosis when the final diagnosis was simple lipoma (p=0.01).ConclusionsIntraoral lipomas present different clinical presentation depending on the histological subtype. In SC/PLs, lipoblasts with vacuolated cytoplasm may be found and the presence of mature adipocytes is essential for diagnosis. Key words:Lipoma, mouth, spindle cell lipoma, pleomorphic lipoma.

Invasive Cardiac Lipoma: a case report and review of literature

BackgroundCardiac lipomas are rare benign tumors of the heart. They are usually asymptomatic and are thus most often diagnosed on autopsies. Symptoms, when present, depend upon the location within the heart. Typical locations are the endocardium of the right atrium and the left ventricle. Diagnostic modality of choice is cardiac MRI. Treatment guidelines have not yet been established due to the very low prevalence of these tumors and are thus guided by the patient’s symptomatology.Case presentationWe describe a case of an invasive cardiac lipoma, wherein the initial symptom of the patient was shortness of breath. Although the echocardiogram visualized the tumor in the right atrium, a cardiac MRI was performed for better tissue characterization. The MRI revealed a large, fat containing, septated mass in the right atrium with invasion into the inter-atrial septum and inferior cavoatrial junction. There was also invasion of the coronary sinus along the inferior and left lateral aspect of the posterior atrioventricular groove. Although the mass appeared to represent a lipoma by imaging characteristics, the unusual extension into the coronary sinus led to consideration of a low-grade liposarcoma in the differential. Thus a pre-operative biopsy was performed along with MDM2 gene amplification to rule out a liposarcoma preceding surgical excision.ConclusionCardiac lipomas are well-characterized on cardiac MRI, which is the diagnostic modality of choice. Typical locations are the right atrium and the left ventricle. However, in those with atypical features such as invasion of the coronary sinus, pre-operative biopsy for histopathologic confirmation is imperative to exclude well-differentiated liposarcoma. Our patient with a simple lipoma underwent partial resection to relieve symptoms. We discuss prognosis and treatment of symptomatic cardiac lipomas.

Prevalence of oral lipomas in Indian population: An institutional retrospective study of 12 years and analysis of 49 published cases from 1976 – 2017 reported in Indian patients

Background:Lipomas are benign mesenchymal tumors of soft tissue that can be found anywhere in the body: However their presence in oral cavity is very rare (4.4%). Histopathologically lipomas are classified as simple lipomas and different variants. The present study describes the prevalence of oral lipomas with relation to patient’s age, their site of occurrence and histological pattern in Indian population.Methods:All cases of oral lipomas reported in the department of oral pathology and microbiology, N.I.M.S dental college Jaipur (India) from 2005 to 2017 for age, gender, site of occurrence, histopathological pattern and treatment mode were reviewed. The published case reports of oral lipomas reported in Indian patients from 1976 – 2017 also reviewed through pubmed by using MeSH word; oral lipoma and combined the data with the data of present study to analyze the prevalence and histopathological characteristic of oral lipomas in Indian population.Results:Total of 23 (14 males and 9 females) cases included in the study. The mean age was 34.3 years (range 17 – 71). The specific sites involved were buccal mucosa (n = 9) Tongue (n = 5) buccal vestibule (n = 2) Lip (n -= 3) Floor of mouth (n = 1), palate (n = 2) and retro molar pad (n = 1). Histopathological examination revealed 11 cases were diagnosed as simple lipoma, 6 cases were fibrolipoma, 2 cases were angiolipoma, 1 case each of osteolipoma, myxolioma, angiomyxolipoma and hibernoma. All cases treated with surgical excision only one case showed radiographical sign. This data was combined with the data of published cases (pubmed) of oral lipoma in Indian population.Conclusion:Oral lipomas are rare neoplasms of oral cavity; only 49 published cases have been found from 1976 – 2017 in Indian population. Oral lipoma should be considered as a differential diagnosis of oral soft tissue swelling. Surgical excision is the treatment of choice for all such tumors.

A Typical Presentation of Madelung Disease

We present a unique case of a sixty two year old woman with symmetric lipomatosis of the lower back, similar to cup C female breast. Lipoma is the most common type of soft tissue mesenchymal tumor, commonly found in the upper back, neck, shoulders and abdomen, and rarely in the face, hands or feet. When lipomatosis is symmetrical it is often termed Multiple Symmetrical Lipomatosis (MSL), also known as Madelung disease, a rare syndrome of unknown etiology. Our patient was referred with large symmetrical subcutaneous masses in her lower back similar to cup C female breast. Prior to her surgery, the patient was referred to ultrasonography of the lower back which demonstrated two large subcutaneous lesions with an average size of 12.5 × 3 × 14 cm. Lesions were excised undergeneral anesthesia, with the left lipoma weighing 535 gr’, and the right 425 gr’, and sent for pathological examination. Surgical drains were removed two days after the procedure, and the patient was discharged. Pathology confirmed our clinical diagnosis, and 18 months after the procedure-the surgical wounds healed to the patient’s satisfaction. We believe that although this disease remains rare, the deferential diagnosis between simple lipoma, MSL and obesity may contribute to current underdiagnoses of MSL. It is important to accurately diagnose MSL as it may be related to systemic comorbidities. Plastic surgeons should bear in mind that clinical presentation may vary, as for our patient, and must be familiar with this disease and its management.

Lipoma in Hard Palate—A Case Report

Lipoma is a benign neoplasm of the soft tissue that originates in mature adipocytes. Even though it is a very common tumor, it is relatively uncommon in oral cavity. It represents about 1% to 4% of all benign tumors in oral cavity (12). This article describes a case of a 39 years old male with an intraoral pedunculated mass in the right side of hard palate which was histopathologically proved as a simple lipoma.

Intramuscular lipoma of the tongue: A rare site for a common tumour

Lipomas are mesenchymal tumors of the adipose tissue described in various sites including the oral cavity but rarely the tongue. Based on the clinical appearance, color, consistency, invasion, oral lipomas, may be simple, angiolipoma, intra/inter muscular (infiltrating), lipoblastoma, spindle cell, pleomorphic, myxoid and atypical lipomas but 80% of these are classical lipomas and may cause functional and cosmetic disabilities. A case of intramuscular lipoma of tongue is reported for the rarity of site and number and to review the clinical, diagnostic and histopathologic findings.

Oncocytic sialolipoma of the submandibular gland.

Sialolipoma, a rare tumor of the salivary gland, is a recently described variant of salivary gland lipoma. Oncocytic sialolipoma was first described by Pusiol et al. in 2009. We report the case of an oncocytic sialolipoma of the submandibular gland in a 43-year-old female. Excision of the tumor was performed with preservation of the submandibular gland. The tumor had a thin, fibrous capsule and consisted of abundant adipose tissue, an oncocytic nodule, and scattered normal glandular structures surrounded by adipose tissue. Four cases of sialolipoma of the submandibular gland, including the present case, were reviewed. All 4 tumors were developed on the right submandibular glands, with a composition of adipose tissue as high as that of sialolipoma of the parotid gland; in contrast to previous reports, three cases were in females. As newly described tumor type, care should be taken to distinguish oncocytic sialolipoma from other salivary gland neoplasms such as simple lipoma, pleomorphic adenoma, or oncocytoma.

Parotid deep lobe lipoma in a child: Case report and literature review

Lipomas are benign tumors that are considered the most common subcutaneous tumor. It is a tumor of mature fatty cells that can be classified according to its morphology, location and other features. It can affect all age groups. Areas of the head and neck are commonly involved with lipomas. Children are rarely involved and the involvement of parotid gland in children is extremely rare. Here we report a case of a simple lipoma in the deep lobe of the parotid gland in a two-year-old boy. It was managed by total parotidectomy. Follow up for one year shows no recurrence.

Rare Massive Osteolipoma in the Upper Part of the Knee in a Young Adult

Lipoma is a common benign soft tissue tumor. This article describes a massive osteolipoma, an unusual lipoma that is fixed to the femoral periosteum. A 21-year-old man presented with a subcutaneous mass at the knee region, which had been present for more than 36 months, and a slight limitation of joint flexibility. On physical examination, a mass approximately 12×6×2 cm(3) in dimension was palpable beneath the skin at the knee proximal medial area when the knee was in flexion. The mass was ovoid, hard, nontender, well demarcated, large, subcutaneous, and relatively fixed to the femur. Medical imaging examination showed that the femur had a well-demarcated mass with a basement. No prominent body weight loss was noted. The excisional mass of 16×12×10 cm(3) was not well encapsulated by a thin, fibrous membrane and had an apparently osseous basal portion. Intraoperative rapid frozen section revealed that the tumor was derived from the adipose cells. The postoperative course was uneventful. The definitive pathologic diagnosis was intermuscular osteolipoma without evidence of malignancy. No recurrence was observed at 6-month follow-up. Osteolipoma with independent bone and an osseous basal portion is rare, especially in young adults. Osteolipoma has the same prognosis as simple lipoma, and surgical excision is the recommended treatment. To the authors' knowledge, such a massive osteolipoma has not been reported.

Multiple subcutaneous lipomatous lesions: imaging and clinical features

Purpose: To retrospectively analyse cases of multiple subcutaneous lipomatous lesions, which are invariably diagnosed as simple lipomas and to examine ultrasound and MRI scans to assess whether many of these cases actually represent angiolipomas.