ABSTRACT
RESUMEN El lipoma intraóseo es un tumor mesenquimatoso poco frecuente que se presenta principalmente en el esqueleto apendicular. La localización dentro del cráneo, es aún más rara, y hasta la fecha solo se han descrito 6 casos en la literatura de lipomas intraóseos que comprometen la región esfenoclival. Por lo general, no presenta ningún síntoma y es un hallazgo incidental en el estudio de imágenes. Presentamos el caso de un paciente de 22 años de edad que consulta por obstrucción nasal y rinorrea mucosa de tres semanas de evolución. La tomografía computarizada y resonancia nuclear magnética evidenciaron una lesión en la región esfenoclival con características sugerentes de lipoma intraóseo. No se realiza estudio histopatológico. Con respecto al manejo, se decide hacer seguimiento radiológico. Se realizó una segunda resonancia magnética 4 meses después, sin cambios significativos.
ABSTRACT Intraosseous lipoma are a rare mesenchymal tumor that occurs primarily in the appendicular skeleton. Skull presentation is a rare finding, and only 6 cases have been described in literature so far of lipomas that compromise the sphenoclival region. In general, they are asymptomatic and occur as incidental findings in imaging studies. We present the case of a 22-year-old patient who consulted for nasal obstruction and mucous rhinorrhea of three weeks of evolution. Computed tomography and magnetic resonance imaging showed a lesion in the sphenoclival region suggestive of intraosseous lipoma. Histopathological study was not performed. Regarding management, radiological follow-up was decided. A second MRI was taken 4 months later, with no significant changes.
Subject(s)
Humans , Male , Adult , Young Adult , Brain Neoplasms/diagnostic imaging , Skull Base/diagnostic imaging , Lipoma/diagnostic imaging , Paranasal Sinuses/diagnostic imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Diagnosis, DifferentialABSTRACT
<p><b>OBJECTIVE</b>To investigate the diagnostic and therapeutic procedures of intraosseous lipoma.</p><p><b>METHODS</b>From June 1986 to January 2016, 19 patients with intraosseous lipoma were treated including 12 males and 7 females, aged from 24 to 76 years, a predilection aged was from 40 to 50 years in 13 cases. Symptoms presented with pain or swelling in 15 patients, the lesions were found incidentally in 3 patients, another case was bone defect lipoma replacement after curettage of bone cyst for 4 years. On plain X-ray flims of all bones showed a well-circumscribed radiolucent area. Diagnosis was established with CT or MRI. Among them, 16 cases were treated by surgical operation, 3 cases were treated by concervative treatment. All patients' clinical data, histologic findings and X-ray, CT and MRI were analysed.</p><p><b>RESULTS</b>Total 19 patients were followed up from 9 to 42 months with an average of 15 months. There was no local tumor recurrence in 16 patients after excising the tumors, the remaining 3 patients showed no enlargement of the lesion.</p><p><b>CONCLUSIONS</b>Surgical intervention is considered as an unnecessary in the patients diagnosied intraosseous lipoma by MRI or CT. Patients with symptomatic should adopt surgical treatment with curettage and bone grafting.</p>
ABSTRACT
Los lipomas intraóseos son considerados como los tumores óseos primarios benignos más raros por su muy poca frecuencia. Su incidencia es menor del 1 por 1.000 entre los tumores primarios y para 2002 se habían publicado menos de 100 casos a nivel mundial. El angiolipoma, es una variante histológica del lipoma aún menos frecuente, representando sólo del 5 al 17% de todos los lipomas intraóseos. Generalmente se trata de una lesión asintomática, un hallazgo radiológico en exámenes realizados por otras razones suele ser la forma de su diagnóstico. Sin embargo, algunos lipomas pueden ser sintomáticos. Presentamos el caso de paciente femenino de 36 años quien posterior a presentar dolor del tobillo derecho se diagnostica una lesión en el calcáneo, que posterior a su análisis anatomopatológico resultó ser un angiolipoma intraóseo. Presentamos su tratamiento con médula ósea autóloga y su evolución(AU)
Intraosseous lipomas are considered the rarest and a very infrequently benign primary bone tumors. Its incidence is less than 1 per 1,000 between primary tumors and by 2002 had published fewer than 100 cases worldwide. The angiolipoma, is a histological variant of lipoma even rarer, representing only 5 to 17% of all intraosseous lipomas. This is usually an asymptomatic lesion, radiological finding in tests performed for other reasons is usually the way to diagnosis. However, some may be symptomatic lipomas. We report the case of a female patient aged 36 who after presenting pain in the right calcaneus, which after pathologic analysis proved diagnosed intraosseous angiolipoma. We present treatment with autologous bone marrow and evolution(AU)
Subject(s)
Humans , Female , Adult , Angiolipoma/diagnosis , Lipoma , Ankle , Neoplasms , Pain , Radiography , DiagnosisABSTRACT
OBJECTIVE: Intraosseous lipomas may be less rare lesions than previously suggested in the literature. They have frequently been misdiagnosed as other benign bone lesions. A combination of computed tomography, magnetic resonance imaging and radiography is essential for decreasing misdiagnosis rates. MATERIALS AND METHODS: This retrospective study presents ten cases of intraosseous lipoma. The patients' ages ranged from 25 to 80 years, and six of them were female. Six patients presented with bone pain, whereas four patients were asymptomatic with incidentally discovered lesions. The involved bones were: femur (four patients), tibia (two patients), calcaneus (one patient), sacrum (one patient), iliac bone (one patient), navicular bone (one patient). All of the patients were assessed by means of conventional radiography, computed tomography and magnetic resonance imaging of the affected region. RESULTS: In all of the cases, plain films revealed well-defined lytic lesions. Both computed tomography and magnetic resonance imaging were quite useful in demonstrating fat within the femur. The histologic pattern of all tumors was that of mature adipose tissue. CONCLUSION: Intraosseous lipoma is a well-defined entity that may develop with varying presentations. Plain radiographs alone cannot establish the diagnosis of this lesion. However, both computed tomography and magnetic resonance imaging are quite useful methods in these cases.
OBJETIVO: Lipomas intra-ósseos podem ser lesões menos raras do que anteriormente sugerido na literatura. Freqüentemente têm sido erroneamente diagnosticados como outras lesões ósseas benignas. A combinação de tomografia computadorizada, ressonância magnética e radiografia é essencial para reduzir as taxas de erro diagnóstico. MATERIAIS E MÉTODOS: Este estudo retrospectivo apresenta dez casos de lipoma intra-ósseo. As idades dos pacientes variavam entre 25 e 80 anos, e seis deles eram do sexo feminino. Seis pacientes apresentavam dor óssea, enquanto quatro eram assintomáticos com lesões descobertas casualmente. Os ossos afetados foram: fêmur (quatro pacientes), tíbia (dois pacientes), calcâneo (um paciente), sacro (um paciente), osso ilíaco (um paciente), osso navicular (um paciente). Todos os pacientes foram avaliados por meio de radiografia convencional, tomografia computadorizada e ressonância magnética das regiões afetadas. RESULTADOS: Em todos os casos, as radiografias revelaram lesões líticas bem delimitadas. Tanto a tomografia computadorizada como a ressonância magnética foram bastante úteis para demonstrar gordura dentro do tumor. O padrão histológico de todos os tumores caracterizou-se por tecido adiposo maduro. CONCLUSÃO: Lipoma intra-ósseo é uma entidade bem definida que pode se desenvolver com variadas apresentações. Radiografias convencionais, isoladamente, não podem diagnosticar essas lesões. Entretanto, a tomografia computadorizada e a ressonância magnética são métodos bastante úteis nesses casos.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Calcaneus/pathology , Femur/pathology , Lipoma/diagnosis , Bone Neoplasms/diagnosis , Tibia , Brazil , Diagnosis, Differential , Lipoma/pathology , Magnetic Resonance Imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Intraosseous lipoma is one of the rarest benign primary tumors of the bone, especially of the spine, but has been reported at increasing frequency. Only a few cases of intraosseous lipoma originating primarily in the spine were reported. Twenty one-year old male with intraosseous lipoma located in lamina and spinous process of the 4th lumbar vertebra, who presented with lower back pain is reported. And the clinical features, natural courses and treatments of this rare tumor are discussed with literature review.
Subject(s)
Humans , Male , Lipoma , Low Back Pain , SpineABSTRACT
PURPOSE: We analyzed 10 cases of intraosseous lipoma to elucidate the clinical, radiographic and pathological features, and studied the correlation between of the radiographic and pathological findings. MATERIALS AND METHODS: Ten cases of 9 patients were the subjects of this study. One patient had intraosseous lipoma in bilateral calcaneus.For the analysis of clinical features, medical records were reviewed. The simple x-ray, MRI and CT images were reviewed. The MRI examinations included T1-weighted, T2-weighted and fat-suppressed (STIR) images in all cases. Histological findings were reviewed and classified with Milgram's stage classification, and the radiographic findings also in 3 stages, and correlation of radiographic and histological stage was studied. RESULTS: The mean age of the patients was 39 years (range, 34-60 years). Seven patients were men and three were women. The meansize of the lesion was 3.4 cm (range, 2.0-5.0 cm). The most common anatomical location was calcaneus as 7 cases. Only four patients complained pain as symptom and six patients were asymptomatic. We had curettage and bone graft for the treatment. There were nolocal recurrence or malignant change during the follow up. With Milgram's classification, two cases were stage I, four were stage II and the other four were stage III. In radiographic stage, two cases were stage I, three were stage II and five were stage III. The radiographicstages were very well correlated to the histological stage. CONCLUSION: Intraosseous lipomas had characteristic radiographic and histological features according to the presenting stages, and their radiographic findings were very well correlated to the histological findings.
Subject(s)
Female , Humans , Male , Calcaneus , Classification , Curettage , Follow-Up Studies , Lipoma , Magnetic Resonance Imaging , Medical Records , Recurrence , TransplantsABSTRACT
Lipoma is the most common soft tissue tumor, but among the rarest tumors of the bone. The first case, reported by Cornil and Renvier in 1868 was a lipoma in the diaphysis of the femur. In Korea, 12 cases of intraosseous lipoma have been reported. A 42-year-old woman presented with a radiolucent lesion that was well marginated, lobulated, and had a sclerotic border by radiographic findings of the proximal humerus taken after a traffic accident. Magnetic resonance imaging and biopsy were performed for diagnosis. Histologically, the lesion was compatible with intraosseous lipoma. Intralesional curettage with a bone graft was performed. No recurrence was evident at the 1 year follow-up. We report a case of intraosseous lipoma that arose in the proximal humerus and include a review of the literature.
Subject(s)
Adult , Female , Humans , Accidents, Traffic , Biopsy , Curettage , Diagnosis , Diaphyses , Femur , Follow-Up Studies , Humerus , Korea , Lipoma , Magnetic Resonance Imaging , Recurrence , TransplantsABSTRACT
Intraosseous lipoma is one of the rarest primary benign tumors of bone and it is characterised by a neoplastic overgrowth of univacuolar fat cells. The incidence is less than one per 1,000 bone tumors. Most commonly, long bones are affected, with a tendency for metaphyseal involvement. Because of its rarity and nonspecific clinicopathologic findings, biopsy is needed for accurate diagnosis. Currettage and bone-grafting is the treatment of choice if the lesion is painful or if structural stability is threatened. We report 3 cases of intraosseous lipoma in long tubular bones with review of literatures. Two cases were treated by surgical intervention and the other case by conservative management.
Subject(s)
Adipocytes , Biopsy , Diagnosis , Incidence , LipomaABSTRACT
Despite the large amount of adipose tissue in bone marrow, intraosseous lipoma is a very rare tumor. Since th first report by Cornil and Renvier in 1868 for a lipoma in the diaphysis of the femur, many cases of intraosseous lipomas of the limbs have been reported. For intraosseous lipoma, Dahlin reported an overall incidence of one per 1,000 bone tumors. Child reported the first case of intraosseous lipoma in the calcaneus. In Korea, a intraosseous lipoma in the fibula was reported only. We reported a case of intraosseous lipoma in the calcaneus.