ABSTRACT
AIM: Spindle cell lipomas are rare adipose tissues tumors. Histologically, these lesions are composed of mature adipocytes and spindle cells associated with collagen bundles. Spindle cell lipomas are benign tumors that can be difficult to distinguish from malignant tumors such as spindle cell liposarcomas, myxoid liposarcomas or well-differentiated liposarcomas. RESULTS: We report herein the description of two new cases. The first case was a deeply situated and infiltrating tumor located in the retromastoidian area. The karyotype showed the presence of two chromosomal abnormalities, a partial deletion of the long arm of chromosome 13, del(13)(q12) and a balanced reciprocal translocation t(2;6)(p16~21;p21). The second case was a subcutaneous tumor of posterior cervical localization. The karyotype showed a 13q deletion associated with a complex rearrangement of chromosomes 5, 6 and 10. The presence of the 13q deletion allowed us to confirm the diagnosis of spindle cell lipoma in both cases. This deletion has been previously described in six out the eleven published karyotype reports. The 13q deletion is usually associated with partial monosomy 16. The present case confirms that it can occur independently. The 6p21 rearrangement may also play a role in the pathobiology of this tumor, as suggested by the positive HMGIY expression detected by immunohistochemistry. CONCLUSION: Our study further illustrates that spindle cell lipomas can infiltrate the surrounding muscle and emphasizes the usefulness of cytogenetic analysis in the differential diagnosis of soft tissue tumors.
Subject(s)
Chromosomes, Human, Pair 13 , Cytogenetic Analysis , Gene Deletion , Lipoma/genetics , Neoplasms, Adipose Tissue/genetics , Chromosome Aberrations , Chromosomes, Human, Pair 10 , Chromosomes, Human, Pair 2 , Chromosomes, Human, Pair 5 , Chromosomes, Human, Pair 6 , Diagnosis, Differential , Humans , Immunohistochemistry , In Situ Hybridization, Fluorescence , Karyotyping , Lipoma/diagnosis , Lipoma/pathology , Male , Middle Aged , Neoplasms, Adipose Tissue/diagnosis , Neoplasms, Adipose Tissue/pathology , Translocation, GeneticABSTRACT
The generalized use of phosphocalcic biological assays makes the discovery of sporadic primary hyperparathyroidism increasingly common. In 1989-1990, first-intention surgery was performed in 26 female patients. In all cases, an exploratory cervicotomy under cervical peridural anesthesia allowed discovering and treating a parathyroid lesion: adenoma, asymmetric or symmetric hyperplasia, cancer. We discuss: the circumstances of the clinical diagnosis and the biological criteria, the timeliness of preoperative radiological assessment, the surgical strategy advocated. In more than 90% of all cases, a cervicotomy for the exploration of all areas of parathyroid migration should allow curing primary hyperparathyroidism.
Subject(s)
Hyperparathyroidism/diagnosis , Hyperparathyroidism/surgery , Adenoma/complications , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Parathyroid Diseases/complications , Parathyroid Neoplasms/complicationsSubject(s)
Cleft Lip/surgery , Cleft Palate/surgery , Palatal Obturators , Child , Child, Preschool , Humans , InfantABSTRACT
Technical aspects are described of the reconstructive laryngectomy used between 1982 and 1986 to treat 59 patients with endolaryngeal epidermoid carcinoma. Both "conservative" techniques (Tücker's laryngectomy, total endolaryngeal functional evidement) and "non-conservative" techniques (cricohyoidopexy, cricohyoidoepiglottopexy, cricobasiglossopexy) as well as their functional outcome are described. Results of surgical review of endolaryngeal spaces (paraglottic space, hyothyroepiglottic space) are analyzed for each method, and a schema for their use proposed.
