Colonic lipomas an uncommon cause of intussusception in adult patients: report of three cases and literature review.

Colonic lipomas are infrequent, benign, non-epithelial, fatty neoplasms. Most of the colonic lipomas are asymptomatic, but around 25% of patients may develop symptoms. Nowadays, surgical resection of the involved segment is the treatment of choice. We report three cases of colonic intussusceptions caused by colonic lipomas in adult patients. The patients underwent surgical resection, and the diagnosis was confirmed by histopathological examination of the specimens.

Los lipomas colónicos son neoplasias benignas, adiposas, no epiteliales poco frecuentes. La mayoría de los lipomas de colon son asintomáticos, pero alrededor del 25% de los pacientes pueden desarrollar síntomas. En la actualidad, la resección quirúrgica del segmento afectado es el tratamiento de elección. Presentamos tres casos de intususcepción intestinal secundaria a lipomas colónicos en pacientes adultos. Los pacientes fueron sometidos a resección quirúrgica y el diagnóstico se confirmó mediante examen histopatológico.

Primary thymus tumors: retrospective case analysis at a reference center in Latin America, 2011-2019.

BACKGROUND: Thymic tumors are unusual neoplasms, representing 0.2 to 1.5% of tumors in humans, but correspond to 20% of mediastinal tumors and 50% of those that occur in the anterior mediastinum. They tend to appear around the fourth and fifth decades of life without gender predilection. Up to 30% of patients are asymptomatic, therefore many are incidentally diagnosed. Radical thymectomy is the treatment of choice with high survival rates when detected in the early stages. METHODS: This was a retrospective descriptive study, including 18 adult patients' diagnosis of thymic neoplasm, who were managed with surgical resection from 2011 to 2019. Information about demographics, clinical characteristics, imaging findings, surgical and medical management, plus histological findings was obtained and reported. RESULTS: 18 patients with thymic tumors were included, of which specific histologic studies reveled thymomas, carcinomas, neuroendocrine tumors, thymolipoma and thymic cyst. Mean age was 52.7 years, with a predominance of male population. The main symptom was dyspnea, followed by cough and chest pain. Paraneoplastic syndromes such as myasthenia gravis, aplastic anemia and Cushing syndrome were reported. 89% of cases were treated by radical thymectomy alone, while only 2 cases required chemotherapy and radiotherapy. There were no surgical complications. Mean hospital stay length was 11. 9 days, with only 1 mortality during hospital admission. 5-year survival rate was 81%. CONCLUSIONS: The treatment of choice is radical thymectomy, which has been shown to positively impact patient mortality. Early detection is key to improve patient outcomes.

Resection of a giant retroperitoneal lipoma herniating through the inguinal canal.

Retroperitoneal lipomas are extremely rare with few cases reported so far in the literature. They can reach different sizes and present with a variety of symptoms. The differential diagnosis is mainly with well-differentiated liposarcoma (WDLPS). We present a 34-year-old woman with a retroperitoneal lipoma herniating through the inguinal canal into the proximal thigh. The patient underwent complete oncological resection using a Karakousis's abdominoinguinal incision. Retroperitoneal lipomas are a very rare condition and sometimes require resections technically challenging. MDM2 amplification is critical for its differential diagnosis with WDLPS.

Surgical Resection of a Symptomatic Superior Vena Cava Lipoma: A Case Report and Literature Review.

BACKGROUND: Lipomas are the most common form of benign soft tissue neoplasms and most frequently occur in the subcutaneous tissue. Rarely does a lipoma primarily arise from the arteries or veins. The most common location for an intravascular lipoma is the inferior vena cava, and rarely lipomas originate in the superior vena cava (SVC). Large lipomas of the SVC may be associated with central venous occlusive symptoms. There are only 7 cases of SVC lipomas reported in the literature. Here, we present only the second case of a large symptomatic lipoma located in the SVC, right internal jugular vein, and innominate veins. METHODS: We present a case of a 5-cm lipoma located in the SVC, discovered incidentally and surgically resected via median sternotomy. RESULTS: The patient underwent a successful open surgical resection of a symptomatic lipoma located in his SVC. CONCLUSIONS: Lipomas of the SVC are exceptionally rare, with only 7 cases described in the literature. This case demonstrates that lipomas can be safely excised from the SVC leading to resolution of central venous occlusive symptoms. A comprehensive literature review reveals that surgical resection is generally without complication, leads to resolution of symptoms, and does not require long-term follow-up.

Laparoscopic sleeve gastrectomy for giant gastric lipoma in morbid obese patient.

ANTECEDENTES: Los lipomas gástricos corresponden al 5% de los lipomas gastrointestinales. Muchos de ellos son solitarios, pequeños y asintomáticos, pero también pueden ocasionar síntomas obstructivos y sangrados. El tratamiento estándar es quirúrgico. CASO CLÍNICO: Mujer de 50 años con antecedente de obesidad mórbida, índice de masa corporal de 47.4 kg/m2, que se presenta con síntomas de epigastralgia y anemia. Se diagnostica un lipoma gástrico de 6.3 cm mediante tomografía y se confirma por biopsia endoscópica. DISCUSIÓN: La paciente fue exitosamente tratada a través de gastrectomía laparoscópica en manga. CONCLUSIÓN: La gastrectomía laparoscópica en manga es el procedimiento de elección para el tratamiento de los lipomas gástricos gigantes en los pacientes con obesidad mórbida cuando la anatomía lo permite. BACKGROUND: Gastric lipomas account for 5% of all gastrointestinal lipomas. Most of them are solitary, small and asymptomatic, however, they can cause severe symptoms such as obstruction, bleeding and intussusception. The standard treatment is surgical resection. CASE REPORT: 50 years old female with history of morbid obesity with a body mass index (BMI) of 47.4 Kg/m2, who presented with symptoms of epigastric pain and anemia. CT scan of the abdomen revealed a 6.3 cm gastric lipoma, confirmed by endoscopic biopsy. DISCUSSION: Laparoscopic sleeve gastrectomy is the procedure of choice for the excision of giant gastric lipomas in the morbidly obese, when anatomically feasible.

Invaginación de colon causado por lipoma / Colon invagination caused by lipoma

Los lipomas del colon ocupan el tercer lugar en frecuencia de aparición de tumores benignos. Estos tumores están formados por tejido adiposo bien diferenciado con un estroma fibroso. La gran mayoría de estos lipomas es asintomática, algunos en raras ocasiones presentan complicaciones de urgencia. El fin de esta publicación es presentar un caso de obstrucción de colon por lipoma. (AU)

Benign colonic lesions are infrequent and account for a low percentage of all colonic tumors. Among the benign tumors, lipomas are third in frequency. They are composed of mature adipose tissue with fibrous stroma. Most of them are asymptomatic but in rare instances, they may present as surgical emergencies. We present one case of colonic obstruction caused by lipomas. (AU)

Infiltrative lipoma causing lumbar nerve root compression in a dog

Background: Lipomas are benign soft tissue mesenchymal neoplasms composed of adipose cells and are usually foundin the subcutaneous tissue. Occasionally, lipomas may invade muscles or grow between them, in which case they arecharacterized as infiltrative lipomas. Clinical signs resulting from an intermuscular lipoma compressing peripheral nervesare rarely encountered in dogs. This case report aims to describe the neurological signs, diagnosis, and clinical evaluationof a dog diagnosed with infiltrative lipoma compressing a lumbar spinal nerve root.Case: A 12-year-old neutered male Fox Paulistinha, weighing 10.5 kg, was presented with difficulties in walking for thepast 15 days with no previous history of trauma. On physical examination, the presence of three cutaneous nodules wasnoted in the ventral thoracic region, with onset of one year and slow and progressive growth. A cytological evaluation ofthe nodules was performed, and lipoma was diagnosed. At the neurological examination, the patient presented ambulatoryparaparesis with marked motor deficit and atrophy of the quadriceps muscles of the left pelvic limb. Conscious proprioceptive deficit, the absence of patellar reflex, and diminished withdrawal reflex were observed in the left hind limb, in additionto diffuse pain on epaxial palpation of the lumbar region. Electroneuromyography showed increased insertion activity inthe left gastrocnemius muscle and moderate spontaneous activity (fibrillation). Persistence of 10% was observed in theF-wave study of the left tibial nerve. These findings indicate partial involvement of the roots of the left sciatic-tibial nerve.Magnetic resonance imaging (MRI) showed the presence of a mass measuring 3.18 × 1.04 × 1.4 cm, interspersed withthe paravertebral muscles, and located adjacent to the L2 and L3 spinous processes...(AU)

Experience of the hernia and wall department in the management of abdominal wall endometriosis for 9 years.

BACKGROUND: Abdominal wall endometriosis is a rare pathological entity. It presents as a tumor with pain, erythema, which worsens with Valsalva maneuvers. OBJECTIVE: To show the experience and results in the management of the department of hernias and abdominal wall in a hospital of second level and to present review of the literature. METHOD: The files of patients treated in the department of hernias and abdominal wall, surgically treated with preoperative clinical and postoperative histopathological diagnosis of abdominal wall endometriosis were taken. The data was described using measures of central tendency and percentages. RESULTS: Twenty-nine patients were identified, with an average age of 32.75 years, 68.9% reported cyclic catamenial pain associated with a tumor in the abdominal wall; a preoperative clinical diagnosis of abdominal wall endometriosis was made in 89.75%. Only one patient was reported with histopathological diagnosis of fibrolipoma. The totality of the patients referred cesarean section as previous surgery. No recurrences were reported. CONCLUSIONS: Abdominal wall endometriosis is the presence of ectopic endometrial tissue in any layer of the abdominal wall. Patients with this diagnosis are referred to the general surgeon presenting a tumor, however, the preoperative diagnosis rate is erroneous in most cases. Abdominal wall ultrasound is useful in diagnosis; tomography and magnetic resonance determine the extent of the disease. The treatment must be related to the extension of the disease and its recurrence is associated with the presence of positive margins.

ANTECEDENTES: La endometriosis de pared abdominal es una enfermedad rara, se presenta como una tumoración con dolor, eritema, y que empeora a las maniobras de Valsalva. OBJETIVO: Mostrar la experiencia y los resultados en el manejo del departamento de hernias y pared abdominal en un hospital de segundo nivel y presentar una revisión de la literatura. MÉTODO: Se tomaron los expedientes de pacientes tratadas en el departamento de hernias y pared abdominal, intervenidas quirúrgicamente con diagnóstico clínico preoperatorio e histopatológico posoperatorio de endometriosis de pared abdominal. Los datos se describieron usando medidas de tendencia central y porcentajes. RESULTADOS: Se identificaron 29 pacientes, con una edad promedio de 32.75 años. El 68.9% reportó dolor cíclico catamenial asociado a tumoración de pared abdominal; se hizo diagnóstico clínico preoperatorio de endometriosis de pared abdominal en el 89.75%. Solo una paciente se reportó con diagnóstico histopatológico de fibrolipoma. La totalidad de las pacientes refirió operación cesárea como cirugía previa. No se reportaron recurrencias. CONCLUSIONES: La endometriosis de pared abdominal es la presencia de tejido endometrial ectópico en la pared abdominal. Las pacientes con este diagnóstico son referidas al cirujano general por presentar tumoración, sin embargo, la tasa de diagnóstico preoperatorio es baja en la mayoría de los casos. El ultrasonido es de utilidad en el diagnóstico; la tomografía y la resonancia magnética determinan la extensión de la enfermedad. El tratamiento debe relacionarse con la extensión de la enfermedad y su recurrencia se asocia con la presencia de márgenes positivos.

Infiltrative lipoma causing lumbar nerve root compression in a dog

Background: Lipomas are benign soft tissue mesenchymal neoplasms composed of adipose cells and are usually foundin the subcutaneous tissue. Occasionally, lipomas may invade muscles or grow between them, in which case they arecharacterized as infiltrative lipomas. Clinical signs resulting from an intermuscular lipoma compressing peripheral nervesare rarely encountered in dogs. This case report aims to describe the neurological signs, diagnosis, and clinical evaluationof a dog diagnosed with infiltrative lipoma compressing a lumbar spinal nerve root.Case: A 12-year-old neutered male Fox Paulistinha, weighing 10.5 kg, was presented with difficulties in walking for thepast 15 days with no previous history of trauma. On physical examination, the presence of three cutaneous nodules wasnoted in the ventral thoracic region, with onset of one year and slow and progressive growth. A cytological evaluation ofthe nodules was performed, and lipoma was diagnosed. At the neurological examination, the patient presented ambulatoryparaparesis with marked motor deficit and atrophy of the quadriceps muscles of the left pelvic limb. Conscious proprioceptive deficit, the absence of patellar reflex, and diminished withdrawal reflex were observed in the left hind limb, in additionto diffuse pain on epaxial palpation of the lumbar region. Electroneuromyography showed increased insertion activity inthe left gastrocnemius muscle and moderate spontaneous activity (fibrillation). Persistence of 10% was observed in theF-wave study of the left tibial nerve. These findings indicate partial involvement of the roots of the left sciatic-tibial nerve.Magnetic resonance imaging (MRI) showed the presence of a mass measuring 3.18 × 1.04 × 1.4 cm, interspersed withthe paravertebral muscles, and located adjacent to the L2 and L3 spinous processes...

Lipoma obstructivo de laringe / Obstructive laryngeal lipoma

Los lipomas de laringe son tumores benignos de crecimiento lento, pero pueden producir síntomas graves como disnea inspiratoria, apneas del sueño y disfagia. Se describe el caso clínico de un paciente con un lipoma extenso de laringe e hipofaringe que consultó por disfagia y disnea inspiratoria intermitente, y que fue tratado con éxito mediante un abordaje transoral con microscopio asistido con cauterio y láser de CO2. (AU)

Laryngeal lipomas are benign, slow-growing tumors, but they can produce severe symptoms such as inspiratory dyspnea, sleep apnea, and dysphagia. We describe the clinical case of a patient with an extensive lipoma of the larynx and hypopharynx who consulted for dysphagia and intermittent inspiratory dyspnea, and who was successfully treated by a transoral approach with microscope and assisted with cautery and CO2 laser. (AU)

Lipoma gástrico: lesión submucosa infrecuente: reporte de dos casos tratados / Unusual gastric submucosal lipoma lesion: report of two cases

El lipoma gástrico (LG), es un tumor benigno raro que representa el 5 % de los lipomas gastrointestinales y menos del 1 % de todos los tumores gástricos. Se localizan habitualmente a nivel de la submucosa y generalmente en la región antral. La endoscopia y la tomografía computarizada son las herramientas diagnósticas más utilizadas en el proceso diagnóstico. Dada su relativa rareza, quedan a menudo fuera del diagnóstico diferencial de las masas submucosas gastrointestinales superiores. El objetivo de este manuscrito, es reportar dos casos tratados de forma consecutiva y revisar la literatura existente en esta materia. Se trata de dos pacientes de sexo masculino, de 49 y 69 años de edad, a quienes se diagnosticó una lesión submucosa gástrica por endoscopia y fueron tratados quirúrgicamente y cuyos especímenes fueron estudiados histológicamente, concluyéndose en ambos casos la existencia de un LG. Ambos pacientes evolucionaron de forma correcta y permanecen en controles clínicos y endoscópicos hasta la actualidad, sin inconvenientes. El LG es una entidad poco común, que puede simular una enfermedad maligna. Presentamos dos casos tratados quirúrgicamente con resultados satisfactorios.

Gastric lipoma (GL), is a rare benign tumor that represents 5 % of gastrointestinal lipomas and less than 1 % of all gastric tumors. They are usually located at the level of the submucosa and usually in the antral region. Endoscopy and computed tomography are the diagnostic tools most used in the diagnostic process. Given their relative rarity, they are often left out of the differential diagnosis of the upper gastrointestinal submucosal masses. The aim of this manuscript was to report two cases treated consecutively and review the existing literature on this subject. Two male patients, 49 and 69 years of age, were diagnosed with a gastric submucosal lesion by endoscopy and were treated surgically. The specimens were studied histologically; concluding the existence of a GL in both cases. The two patients evolved adequately and have remained in clinical and endoscopic controls until now, without problems. GL is a rare entity, which can simulate a malignant disease. We present two cases treated surgically with satisfactory results.