ABSTRACT
Liposarcomas are the most common type of sarcomas arising in the retroperitoneum. Retroperitoneal lipomas are extremely rare. They should be distinguished from well-differentiated liposarcomas in order to provide the appropriate treatment. A 53-years-old male was admitted with the presence of a palpable mass in the upper abdomen. Contrast enhanced computerized tomography (CT) of the abdomen and pelvis showed a 20x12 cm mass arising in the retroperitoneum and inglobing the celiac and superior mesenteric trunks. Because of unresectability an open surgical biopsy was performed. Histological examination showed the presence of adipose tissue with diffuse liponecrosis without definitive features of neoplasia. At six-month follow-up a CT documented an increase of the tumor to 22x13 cm. The mass was stable at the CT, performed at 1-year follow-up. Given the impossibility to distinguish well-differentiated liposarcomas from lipomas and the in the present case of unresectable retroperitoneal mass, an observational follow-up was a justified.
Subject(s)
Lipoma/diagnosis , Liposarcoma/diagnosis , Retroperitoneal Neoplasms/diagnosis , Contrast Media , Diagnosis, Differential , Histological Techniques , Humans , Lipoma/diagnostic imaging , Liposarcoma/diagnostic imaging , Male , Middle Aged , Retroperitoneal Neoplasms/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
The morphological analysis of 223 cases of chronic calculous cholecystitis has drawn attention to the following outstanding facts: (a) elementary lesions are numerous (above all ulceration, mucosal erosion, antral and intestinal metaplasia) and put together a complex sight; (b) mild, moderate and severe dysplasias have a surprising high incidence (67%), even in the age-group under 40; (c) dysplasia is more common in the gallbladders bearing parallel hyperplastic and metaplastic mucosal changes, if compared with gallbladders where these changes are lacking; (d) thickness of gallbladder's wall and incidence of dysplasia are in direct relation; (e) echographic preoperative assessment of wall's thickness has predictive value for presence of dysplasia; (f) CEA and CA 19-9 have a progressively increasing expression in the various degrees of dysplasia.
