A rare intramuscular osteolipoma: A case report.

INTRODUCTION: Lipomas are frequently presented in adults and account for almost 50% of all soft-tissue tumors. Osteolipomas are rare and usually located in the intraosseous region or adjacent to bone. It is very unusual for osteolipomas with no connection to bony structures. We report a rare intramuscular osteolipoma independent of bone tissue. PRESENTATION OF CASE: We report a case of a 58-year-old man with painful and progressively enlarging mass in the right lower leg. A plain X-ray and computed tomography (CT) scans revealed a large homogeneous, low-fat density mass containing an oval shape calcification without bone connection. MRI showed a circumscribed mass in the peroneus muscle with a large calcified component. The patient underwent surgical excision of the mass. Histologically, benign osteolipoma was the final diagnosis. No recurrence was observed at six months follow-up. DISCUSSION: Lipoma is a common benign soft tissue neoplasm but osteolipoma is rare. Most cases osteolipomas are connected with bone. independent of bone tissue has been reported in very few cases. Most of them occurred in the head and neck area. The pathogenesis of osteolipoma is still not clear. Although CT and MRI are useful for differential diagnosis, care should be taken because sometimes they are indistinguishable from well-differentiated liposarcomas. Excisional biopsy is useful for definitive diagnosis. CONCLUSION: Although ossifying lipomas are very rare, it is important to keep them in mind when a lesion with adipose tissue in combination with ossification is encountered.

Crossbar Technique for the Failed Clavicular Hook Plate Fixation in an Acute Acromioclavicular Joint Dislocation: Salvage for Acromial Fracture after Clavicular Hook Plate.

We experienced acromial erosion and subsequent fracture after the treatment of Rockwood type V acromioclavicular dislocation with hook plate and coracoclavicular ligament augmentation. It was treated by using a surgical technique to address an acromial fracture and subsequent losses of reduction in acromioclavicular joint with two trans-acromial cortical screws (crossbar technique). The reduction state of acromioclavicular joint could be maintained by these two screws. Our crossbar technique could be considered as a good salvage procedure for the reduction loss caused by cutout or significant erosion of acromion after insertion of clavicular hook plate.

Region- and neuronal phenotype-specific expression of NELL2 in the adult rat brain.

NELL2, a neural tissue-enriched protein, is produced in the embryo, and postembryonically in the mammalian brain, with a broad distribution. Although its synthesis is required for neuronal differentiation in chicks, not much is known about its function in the adult mammalian brain. We investigated the distribution of NELL2 in various regions of the adult rat brain to study its potential functions in brain physiology. Consistent with previous reports, NELL2-immunoreactivity (ir) was found in the cytoplasm of neurons, but not in glial fibrillary acidic protein (GFAP)-positive glial cells. The highest levels of NELL2 were detected in the hippocampus and the cerebellum. Interestingly, in the cerebellar cortex NELL2 was observed only in the GABAergic Purkinje cells not in the excitatory granular cells. In contrast, it was found mainly in the hippocampal dentate gyrus and pyramidal cell layer that contains mainly glutamatergic neurons. In the dentate gyrus, NELL2 was not detected in the GFAP-positive neural precursor cells, but was generally present in mature neurons of the subgranular zone, suggesting a role in this region restricted to mature neurons.