lipomas

脂肪瘤
  • 文章类型: Journal Article
    脂肪瘤症是脂肪组织的良性增生。脂肪瘤(良性脂肪瘤)是脂肪瘤病的最常见成分。它们可能是独一无二的,也可能是多重的,封装或不封装,皮下或有时内脏。在某些情况下,它们形成大面积的非包裹脂肪肥大,纤维化程度不同。尽管没有肥胖,它们仍然可以发展。它们可能是家族性的,也可能是后天获得的。与脂肪营养不良综合征不同,它们与脂肪萎缩区域无关,除了一些罕见的病例,如2型家族性部分脂肪营养不良综合征(FPLD2)。它们的代谢影响是可变的,部分取决于相关的肥胖。它们可能具有功能或美学后果。脂肪瘤病可能是孤立的,是综合症的一部分,或者可能是内脏的。孤立性脂肪瘤病包括多发性对称性脂肪瘤病(Madelung病或Launois-Bensaude综合征),家族性多发性脂肪瘤病,痛苦的皮肤病也被称为肥胖Dolorosa或Ander综合征,间质脂肪瘤病也称为Roch-Leri脂肪瘤病,家族性血管脂肪瘤病,lipedema和hibernomas.综合征性脂肪瘤病包括PIK3CA相关疾病,Cowden/PTEN错构瘤-肿瘤综合征,一些脂肪营养不良综合征,和线粒体疾病,尤其是MERRF,多发性内分泌瘤1型,神经纤维瘤病1型,威尔逊病,Pai或Haberland综合征。最后,内脏脂肪瘤在许多器官和部位都有报道:胰腺,肾上腺,腹部,硬膜外,纵隔,本综述的目的是介绍脂肪瘤病的主要类型及其病理生理成分。当它是已知的。
    Lipomatoses are benign proliferation of adipose tissue. Lipomas (benign fat tumors) are the most common component of lipomatosis. They may be unique or multiple, encapsulated or not, subcutaneous or sometimes visceral. In some cases, they form large areas of non-encapsulated fat hypertrophy, with a variable degree of fibrosis. They can develop despite the absence of obesity. They may be familial or acquired. At difference with lipodystrophy syndromes, they are not associated with lipoatrophy areas, except in some rare cases such as type 2 familial partial lipodystrophy syndromes (FPLD2). Their metabolic impact is variable in part depending on associated obesity. They may have functional or aesthetic consequences. Lipomatosis may be isolated, be part of a syndrome, or may be visceral. Isolated lipomatoses include multiple symmetrical lipomatosis (Madelung disease or Launois-Bensaude syndrome), familial multiple lipomatosis, the painful Dercum\'s disease also called Adiposis Dolorosa or Ander syndrome, mesosomatic lipomatosis also called Roch-Leri lipomatosis, familial angiolipomatosis, lipedema and hibernomas. Syndromic lipomatoses include PIK3CA-related disorders, Cowden/PTEN hamartomas-tumor syndrome, some lipodystrophy syndromes, and mitochondrial diseases, especially MERRF, multiple endocrine neoplasia type 1, neurofibromatosis type 1, Wilson disease, Pai or Haberland syndromes. Finally, visceral lipomatoses have been reported in numerous organs and sites: pancreatic, adrenal, abdominal, epidural, mediastinal, epicardial… The aim of this review is to present the main types of lipomatosis and their physiopathological component, when it is known.
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  • 文章类型: Case Reports
    脂肪瘤是常见的良性软组织肿瘤,主要由成熟的脂肪组织组成。由于其特征性的缓慢生长,临床上经常遇到它们,通常是柔软的,无痛,皮下结节。虽然脂肪瘤通常无症状,当患者导致不适时,他们会寻求手术干预,化妆品问题,或功能损害。在这个案例报告中,我们介绍了一名43岁男性的双侧上肢和右大腿的25个脂肪瘤的成功手术切除。术前评估,精确的手术技术,和术后护理被强调为重要的管理组成部分。案例强调了个体化治疗的重要性,确保有症状的脂肪瘤诊断和有效管理。本报告为照顾脂肪瘤性病变患者的医疗保健专业人员提供了宝贵的参考,有助于理解软组织肿瘤的治疗。
    Lipomas are common benign soft tissue tumors composed primarily of mature adipose tissue. They are often encountered clinically due to their characteristic slow growth, typically as soft, painless, subcutaneous nodules. While lipomas are generally asymptomatic, surgical intervention is sought by patients when they lead to discomfort, cosmetic concerns, or functional impairment. In this case report, we present the successful surgical excision of 25 lipomas in the bilateral upper limbs and right thigh of a 43-year-old male. Pre-operative assessment, precise surgical technique, and post-operative care are highlighted as essential management components. The case emphasizes the importance of individualized treatment, ensuring symptomatic lipomas\' diagnosis and effective management. This report serves as a valuable reference for healthcare professionals caring for patients with lipomatous lesions, contributing to understanding soft tissue tumor management.
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  • 文章类型: Case Reports
    脂肪瘤是常见的良性间质瘤,而脂肪瘤病并不常见。家族性多发性脂肪瘤病(FML)是一种罕见的综合征,其特征是多发性通常无痛性脂肪瘤,可能与其他疾病有关。FML被认为是遗传的,提出了各种继承模式。在这个案例报告中,我们描述了一例多发性家族性脂肪瘤病,误诊为皮肤病。
    Lipomas are common benign mesenchymal tumours, whereas lipomatoses are uncommon. Familial multiple lipomatosis (FML) is a rare syndrome characterized by multiple usually painless lipomas which may be associated with other conditions. FML is considered to be genetic, with various patterns of inheritance suggested. In this case report, we described a case of multiple familial lipomatosis that was misdiagnosed as dercum\'s disease.
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  • 文章类型: Journal Article
    扩大继发性头痛的鉴别诊断范围,包括在脑成像中偶然发现的罕见颅内肿瘤。颅内脂肪瘤是罕见的先天性畸形,通常是腹周无症状的中线病变。然而,有些病例出现头痛和癫痫发作。症状性颅内脂肪瘤非常罕见,经常在大脑成像上偶然发现。
    我们介绍了一名52岁的女性,她转诊到我们的三级中心,有甲状腺功能减退病史,并伴有头痛两年。她全身疼痛六个月,并在需要时服用镇痛药。尽管正在服药,她的头痛仍然持续。她的生命体征在正常范围内,身体和神经系统检查不明显。她的视力和眼底检查正常。
    她的大脑成像显示在call体和半球间裂隙上有病变,脂肪抑制序列上的信号衰减,特征提示曲线周脂肪瘤。镇痛药对症治疗,抗炎药稍有效果.是否需要切除肿瘤仍有争议,因为手术干预的风险远远超过潜在的好处。
    鳞茎脂肪瘤是继发性头痛的一种罕见原因。对于没有乳头水肿且对镇痛药无反应的非典型头痛患者应怀疑。这可能是颅内脂肪瘤的唯一表现特征,使其更加难以怀疑和诊断,从而强调评估继发性头痛的重要性。诊断很重要,因为如果患者出现新的局灶性缺陷,可能需要长期随访。这可能需要手术干预。
    UNASSIGNED: Expand the differential diagnosis of secondary headache to include rare intracranial tumours, detected incidentally on brain imaging. Intracranial lipomas are rare congenital malformations, and are usually pericallosal asymptomatic midline lesions. However, some cases present with headache and seizures. Symptomatic intracranial lipomas are very rare and often detected incidentally on brain imaging.
    UNASSIGNED: We present a 52-year-old woman referred to our tertiary centre with a history of hypothyroidism presented with headache for 2 years. She had generalised body pains for six months. Her headache was persistent despite being on medications. Physical and neurological examination was unremarkable. Her visual acuity and fundus examination were normal.
    UNASSIGNED: Her brain imaging revealed a lesion over the corpus callosum and in the interhemispheric fissure with signal attenuation on the fat suppression sequence, features suggestive of curvilinear pericallosal lipoma. Symptomatic treatment with analgesics and anti-inflammatory agents were slightly effective. It is debatable whether tumour removal is required, as the risks of surgical intervention far outweigh the potential benefits.
    UNASSIGNED: Corpus callosal lipoma is a rare and unrecognised cause of secondary headache. It should be suspected in patients with an atypical headache without papilledema and who are unresponsive to analgesics. This may be the only presenting feature of intracranial lipomas rendering it even more difficult to suspect and diagnose, thus emphasising the importance of evaluating secondary headaches. Diagnosis is important because long-term follow-up may be required if patients develop new focal deficits, which may necessitate surgical intervention.
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  • 文章类型: Case Reports
    胃脂肪瘤(GI)是一种罕见的胃良性肿瘤,起源于脂肪组织。它通常是无症状的,并且在内窥镜检查或影像学检查中被偶然诊断出。
    一名66岁男性,表现为上腹痛和酸反流。上消化道内窥镜检查显示幽门窦粘膜下3厘米。患者接受了胃大部切除术。将标本送到病理科。根据微观发现,诊断为粘膜下胃肠道。
    GI的诊断通常是在影像学检查中偶然做出的。治疗选择包括内窥镜或手术切除;然而,对无症状患者可考虑保守治疗.建议定期进行放射学监测以监测生长并评估任何恶性转化。
    GI是一种罕见的肿瘤,通常无症状,但可表现为非特异性胃肠道症状。通过组织学检查确诊,和成像技术,如计算机断层扫描或MRI可用于术前评估。手术切除仍然是主要的治疗方法,而在某些情况下可以考虑内镜切除。
    UNASSIGNED: Gastric lipoma (GI) is a rare benign tumor of the stomach that arises from adipose tissue. It is often asymptomatic and is incidentally diagnosed on endoscopy or imaging studies.
    UNASSIGNED: A 66-year-old male presented with epigastric pain and acid reflux. Upper gastrointestinal endoscopy revealed a 3-cm submucosal lesion in the pyloric antrum. The patient underwent a subtotal gastrectomy. The specimen was sent to the pathology department. Based on the microscopic findings, the diagnosis was a submucosal GI.
    UNASSIGNED: The diagnosis of GIs is usually made incidentally during imaging studies. Treatment options include endoscopic or surgical resection; however, conservative management can be considered in asymptomatic patients. Periodic radiological surveillance is recommended to monitor growth and assess for any malignant transformation.
    UNASSIGNED: GI is a rare tumor that is usually asymptomatic but can present with nonspecific gastrointestinal symptoms. The diagnosis is confirmed through histological examination, and imaging techniques such as computed tomography or MRI can be useful in preoperative evaluation. Surgical resection remains the primary treatment, while endoscopic resection may be considered in certain cases.
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  • 文章类型: Case Reports
    大多数颅内脂肪瘤无症状,但头痛是最常见的症状。重击得分有时很高。因此,有必要在治疗偏头痛的同时监测影像学表现。
    Most intracranial lipomas are asymptomatic, but headache is the most common symptom. The pounding score is sometimes high. Therefore, it is necessary to monitor imaging findings in parallel with the treatment of migraine.
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  • 文章类型: Case Reports
    背景:与发育不良无关的脊髓脂肪瘤很少见,自然史未知。在这份报告中,我们描述了两个病例;它们在长期随访中显示复发,这让我们怀疑良性畸形的病因。
    方法:两名患者,一名19岁的南美妇女和一名14岁的患有脊髓脂肪瘤的男孩,接受了手术切除。脂肪瘤与发育不良无关,位于颈胸和颅颈交界处。在这两种情况下,由于临床进展,我们决定手术;前者有一个渐进的自然过程,而后者在先前手术复发后出现临床恶化。手术在神经生理监测和术中超声的辅助下进行;进行部分切除和髓减压,根据最近的建议。
    结论:由于这些病变的稀有性和先前报道病例的长期随访中的异质性,目前这些病变的自然史未知。尽管以前的报告描述了手术切除后的良好结果,长期随访,尤其是在年轻的科目中,这些结局可能与进展和复发有差异.我们通过描述另外两个进展和复发病例,为最后一个证据做出了贡献。
    结论:应该对患有脊髓脂肪瘤的年轻受试者进行长期密切随访,因为他们更容易受到侵略性的影响。代谢和荷尔蒙的变化可能是这一进展的背后。如果发现神经衰退,必须考虑再次手术。
    BACKGROUND: Spinal lipomas not associated with dysraphism are rare and have an unknown natural history. In this report, we describe two cases; they showed recurrence during long-term follow-up, which makes us doubt a benign malformative etiology.
    METHODS: Two patients, a 19-year-old South American woman and a 14-year-old boy with spinal lipomas, underwent surgical resection. The lipomas were not associated with dysraphism and were located in the cervicothoracic and craniocervical junctions. In both cases, we decided to operate due to clinical progression; the former had a progressive natural course, and the latter experienced clinical worsening after recurrence from previous surgeries. The surgery took place with the assistance of neurophysiological monitoring and intraoperative ultrasound; a partial resection and medullary decompression were done, following the more recent recommendations.
    CONCLUSIONS: The natural history of these lesions is currently unknown due to their rarity and the heterogeneity in the long-term follow-up of previously reported cases. Although previous reports describe good outcomes after surgical resection, long follow-ups, especially in young subjects, may show differences in these outcomes with progression and recurrence. We contribute to this last piece of evidence by describing two more cases of progression and recurrence.
    CONCLUSIONS: Long-term close follow-up should be done in young subjects with spinal lipomas, as they are more prone to an aggressive course. Metabolism and hormonal changes may be behind this progression. Reoperation must be considered if neurological decline is detected.
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  • 文章类型: Journal Article
    脂肪瘤是良性软组织肿瘤;最常见的是分布在全身的皮下平面。然而,很少有地方是罕见的脂肪瘤。这里,我们讨论了4例异常亚部位的头颈部脂肪瘤的表现。尽管它在体内的患病率很高,脂肪瘤很少见于上消化道,这些病变除了美容畸形外,还会引起严重的吞咽和呼吸窘迫问题。在头部和颈部,脂肪瘤最常见的部位是脸颊,接着是舌头。扁桃体脂肪瘤非常罕见。脂肪瘤的主要治疗方法是完全手术切除,很少知道完全切除后的复发。我们在这里讨论一系列4例脂肪瘤,出现在头颈部不常见的亚部位。这些包括颈部病变,舌头,腭和扁桃体窝。脂肪瘤是良性间质瘤,最初并不麻烦。然而,随着尺寸的增加,它们会引起严重的消化问题,并伴有功能受损,需要完全的手术切除。
    Lipomas are benign soft tissue tumors; the most common ones present in subcutaneous planes distributed throughout the body. However, there are few sites which are unusual location for lipomas. Here, we discuss the presentation of 4 cases of head and neck lipomas at unusual subsites. Though its prevalence is high in the body, lipomas are rarely seen in upper aerodigestive tract and these lesions can cause severe deglutition and respiratory distress problems in addition to cosmetic deformities. In the head and neck, most common location of lipoma is the cheek, followed by the tongue. Tonsillar lipomas are very rare. The mainstay treatment for lipomas is complete surgical excision and recurrence following complete removal is rarely known. We are here discussing a series of 4 cases of lipomas, presenting at uncommon subsites in head and neck region. These include lesions over neck, tongue, palate and tonsillar fossa. Lipomas are benign mesenchymal tumors, that are initially non bothersome. However, with increasing size they can cause severe aerodigestive problems with functional compromise and need complete surgical excision.
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  • 文章类型: Journal Article
    MEN1(多发性内分泌瘤)综合征患者的非内分泌检查结果也包括皮肤病变,尤其是肿瘤类型的病变。这是对英语医学文献的叙述性回顾,包括有关MEN1和皮肤病学问题的原始研究(除了每种内分泌肿瘤/神经内分泌瘤的皮肤病学特征),通过基于PubMed的搜索识别(基于临床相关性,没有时间表限制或对统计显著性水平的关注)。我们确定了27项涉及MEN1和皮肤肿瘤患者临床表现的原始研究;其他8项原始研究也包括遗传背景;以及另外4项原始研究也包括在内。最大的队列来自意大利的研究(N=145个人),西班牙(N=90),美国(N=48和N=32),日本(N=28)。患者的年龄从18岁到76岁不等,大多数人都在四十多岁。最常见的皮肤肿瘤是血管纤维瘤(AF),胶原瘤(CG),和脂肪瘤(L)。其他病变为不典型痣,基底细胞癌,鳞状细胞癌,acrochordons,融合和网状乳头状瘤病,牙龈丘疹,和眼睑的皮肤T细胞淋巴瘤.非肿瘤方面是五彩纸屑样色素减退,Café-au-lait斑斑,牙龈丘疹.MEN1基因,在黑素瘤中也发现了各自的menin参与,但与MEN1的关联仍有争议。通常,皮肤肿瘤(AF,CG,和L)是良性的,仅出于美容原因进行手术治疗。其中一些报告为第一次介绍。即使皮肤损伤不是病因性的,识别它们在MEN1患者的早期识别中起着重要作用。MEN1受试者的亚组是否易于发展这些类型的皮肤病变以及它们如何影响MEN1进化仍然是一个悬而未决的问题。
    Non-endocrine findings in patients with MEN1 (multiple endocrine neoplasia) syndrome also include skin lesions, especially tumor-type lesions. This is a narrative review of the English-language medical literature including original studies concerning MEN1 and dermatological issues (apart from dermatologic features of each endocrine tumor/neuroendocrine neoplasia), identified through a PubMed-based search (based on clinical relevance, with no timeline restriction or concern regarding the level of statistical significance). We identified 27 original studies involving clinical presentation of patients with MEN1 and cutaneous tumors; eight other original studies that also included the genetic background; and four additional original studies were included. The largest cohorts were from studies in Italy (N = 145 individuals), Spain (N = 90), the United States (N = 48 and N = 32), and Japan (N = 28). The age of patients varied from 18 to 76 years, with the majority of individuals in their forties. The most common cutaneous tumors are angiofibromas (AF), collagenomas (CG), and lipomas (L). Other lesions are atypical nevi, basocellular carcinoma, squamous cell carcinoma, acrochordons, papillomatosis confluens et reticularis, gingival papules, and cutaneous T-cell lymphoma of the eyelid. Non-tumor aspects are confetti-like hypopigmentation, café-au-lait macules, and gingival papules. MEN1 gene, respective menin involvement has also been found in melanomas, but the association with MEN1 remains debatable. Typically, cutaneous tumors (AF, CG, and L) are benign and are surgically treated only for cosmetic reasons. Some of them are reported as first presentation. Even though skin lesions are not pathognomonic, recognizing them plays an important role in early identification of MEN1 patients. Whether a subgroup of MEN1 subjects is prone to developing these types of cutaneous lesions and how they influence MEN1 evolution is still an open issue.
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  • 文章类型: Case Reports
    成熟脂肪细胞的良性软组织肿瘤称为脂肪瘤(脂肪细胞)。脂肪瘤可以在身体的任何地方发展,虽然它在嘴里并不常见。表面定位的脂肪瘤通常呈黄色,无痛,软,并且不波动,上皮表面薄。因此,表面上经常看到微妙的血管图案。更深的病变可能不会表现出这一发现,因此,不是临床公认的。由于患者没有报告任何主观临床症状,牙医经常偶然诊断出这种脂肪瘤。深部脂肪瘤需要专门的影像学检查,比如对比增强计算机断层扫描,磁共振成像,或超声波来确定它们的范围。脂肪瘤的大小范围可以从微小到大到巨大。大型脂肪瘤通常具有“滑脱征”和结节状表面。巨大脂肪瘤的直径可达10厘米。脂肪瘤可以是单细胞或多细胞的。皮肤病,变形杆菌综合征,神经纤维瘤病,家族性腺瘤性息肉病在不同部位均表现为脂肪瘤。这些口腔脂肪瘤的优选治疗过程是手术切除。此类脂肪瘤不会再复发。脂肪瘤有许多微小的品种。传统的描述是由均匀大小和形状的成熟脂肪细胞的小叶组成的明确定义的肿瘤。术语“纤维脂肪瘤”是指含有大量纤维结缔组织的脂肪瘤,“血管脂肪瘤”是指含有许多微小血管的脂肪瘤,“粘液瘤”是指具有粘液样细胞背景的脂肪瘤,和“梭形细胞脂肪瘤”是指含有均匀梭形细胞混合物的脂肪瘤。与多形性脂肪肉瘤相比,多形性脂肪瘤表现出梭形细胞和奇怪的,超色大细胞,这让病理学家很难区分它们。肌内脂肪瘤是侵入骨骼肌束的脂肪瘤。因为它们很难完全根除,肌内脂肪瘤更容易复发。
    A benign soft tissue tumor of mature fat cells is called a lipoma (adipocytes). Lipoma can develop anywhere on the body, although it is uncommon in the mouth. Lipomas that are superficially positioned are often yellowish in color, painless, soft, and non-fluctuating with a thin epithelial surface. As a result, a delicate pattern of blood vessels is frequently seen on the surface. Deeper lesions might not exhibit this finding and, as a result, are not as clinically recognized. Since the patients do not report any subjective clinical symptoms, the dentist often diagnoses such lipomas by accident. Deep-seated lipomas require specialist imaging procedures, such as contrast-enhanced computed tomography, magnetic resonance imaging, or ultrasound to determine their extent. Lipomas can range in size from tiny to large to enormous. Large lipomas typically feature a \"slip sign\" and a nodular surface. Giant-sized lipomas can have a diameter of up to 10 cm. Lipomas can be single or multicellular. Dercum\'s disease, Proteus syndrome, neurofibromatosis, and familial adenomatosis polyposis all exhibit lipomas in various locations. The preferred course of treatment for these oral lipomas is surgical removal. Such lipomas do not recur again. Lipoma comes in a number of tiny varieties. The traditional description is of a well-defined tumor made up of lobules of uniformly sized and shaped mature fat cells. The term \"fibrolipoma\" refers to lipomas that contain a sizable amount of fibrous connective tissue, \"angiolipoma\" refers to lipomas that contain numerous tiny blood vessels, \"myxolipoma\" refers to lipomas with a background of myxoid cells, and \"spindle cell lipoma\" refers to lipomas that contain a mixture of uniform spindle cells. When compared to a pleomorphic liposarcoma, the pleomorphic lipoma exhibits spindle cells and strange, hyperchromatic large cells, making it challenging for the pathologist to tell them apart. An intramuscular lipoma is a lipoma that invades skeletal muscle bundles. Because they are harder to entirely eradicate, intramuscular lipomas are more likely to reoccur.
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