Lipomas are common benign soft tissue tumors, typically presenting as painless, slow-growing masses of mature adipose tissue. However, their occurrence as pedunculated lesions in the perianal region is rare. We present a case of a 70-year-old male with a 20-year history of a painless, cosmetically concerning mass in the perianal region. Clinical examination and ultrasonographic findings were consistent with a pedunculated lipoma. Surgical excision was performed successfully, and histopathological examination confirmed the diagnosis of lipofibroma. This case highlights the importance of considering unusual presentations of lipomas in the differential diagnosis of perianal masses. It emphasizes the role of surgical excision for symptomatic or cosmetically concerning lesions. Long-term follow-up is essential to monitor for recurrence and ensure optimal patient outcomes.

BACKGROUND: Focal nodular hyperplasia is a common nonmalignant liver mass. This nonvascular lesion is an uncommon mass in children, especially those with no predisposing factors, namely radiation, chemotherapy, and hematopoietic stem cell therapy. Exophytic growth of the lesion further than the liver margins is not common and can complicate the diagnosis of the lesion. This report observes a focal nodular hyperplasia as a pedunculated lesion in a healthy child.
METHODS: We describe a 9-year-old healthy Persian child who was born following in vitro fertilization complaining of abdominal pain lasting for months and palpitation. Employing ultrasound and computed tomography, a mass was detected in the right upper quadrant compatible with focal nodular hyperplasia imaging features. The child underwent surgery and the mass was resected.
CONCLUSIONS: Diagnosing focal nodular hyperplasia, especially pedunculated form can be challenging, although magnetic resonance imaging with scintigraphy is nearly 100% sensitive and specific. Thus, a biopsy may be needed to rule out malignancies in some cases. Deterministic treatment in patients with suspicious mass, remarkable growth of lesion in serial examination, and persistent symptoms, such as pain, is resection, which can be done open or laparoscopic.

There is a debate regarding the prediction of lymph node metastasis (LNM) in pedunculated T1 colorectal cancer (CRC). In this study with four cases of pedunculated T1 CRCs, we aimed to investigate gene expression variations based on the distance from the Haggitt line (HL) and identify potential molecular risk factors for LNM. By leveraging the Cancer Transcriptome Atlas and digital spatial profiling technology, we meticulously analyzed discrete regions, including the head, HL, proximal stalk region (300-1000 μm from HL), and distal stalk region (1500-2000 μm from HL) to identify spatially sequential molecular changes. Our findings showed significant overall gene expression variations among the head, proximal stalk, and distal stalk regions of pedunculated T1 CRCs compared to the control adenoma. Compared to LNM-negative T1 CRCs, LNM-positive T1 CRC showed that the expression of genes involved in immune-related pathways such as B2M, HLA-B, and HLA-E were significantly downregulated in the distal stalk region compared to the proximal stalk region. In summary, our results may tentatively suggest considering endoscopic resection of the stalk with a minimum 2000 μm margin from the HL, taking into account the gene expression alterations related to immune-related pathways. However, we acknowledge the limitations of this pilot study, notably the small case series, which may restrict the depth of interpretation. Further validation is imperative to substantiate these findings.

Bronchogenic cyst results from abnormal bronchial budding. Thin-stalked mobile bronchogenic cysts are rare and sometimes radiologically mimic mass lesion, making preoperative diagnosis difficult. We present a 12-year-old boy with a preoperative diagnosis of intraparenchymal cystic lung lesion misled by radiology. We performed a mini-thoracotomy revealing a thin stalked mobile elongated cyst that arose from the right inferior pulmonary ligament, confirmed as a bronchogenic cyst in histopathology.

This is a case of a large pedunculated lipofibroma on the left axilla in a 36-year-old woman. The lesion was excised completely with no recurrence after one year of follow-up. A new name for this rare entity is proposed to be more inclusive of all lesions of pedunculated lipofibroma and to differentiate it from another entity called fibrolipoma.

UNASSIGNED: Hepatic hemangioma is among the most common benign liver lesions. However, giant pedunculated hepatic hemangiomas are exceptionally rare and associated with additional risks, such as torsion.
UNASSIGNED: We present the case of a 63-year-old female patient who presented with abdominal distension and pain. Barium meal examination and gastroscopy revealed a large, smooth-surfaced submucosal bulge located at the fundus of the stomach. Subsequent MRI examination identified a mass measuring approximately 6.4 x 7 cm in the left upper abdomen. Surgical intervention was planned for mass removal. However, intraoperative exploration revealed the origin of the mass to be the liver, and subsequent histopathological examination confirmed it as a hemangioma.
UNASSIGNED: We systematically summarized the characteristics of our case along with 31 previously reported cases. Giant pedunculated hepatic hemangiomas typically occur in the left lobe of the liver. Due to their atypical presentation, a combination of imaging methods such as ultrasound, CT, and/or MRI is essential for accurate diagnosis. Furthermore, surgical intervention is recommended due to the potential risks of bleeding, rupture, and torsion.

UNASSIGNED: Conjunctival papilloma commonly develops in infants and children. It is believed that the etiologic agent, human papillomavirus (HPV), gets implanted from the infected maternal birth canal in the conjunctival sac of the new borne while parturition. It grows as solitary or multiple pedunculated benign masses adjacent to the caruncle. It is uncommon but if growing in adults it grows on the limbal conjunctiva and could be malignant.
UNASSIGNED: An Afro-American adult male developed two distinct conjunctival growths on his left lower lid. One growth was pedunculated and the second one sessile. The initial diagnosis of \'benign conjunctival papillomas\' was made. Patient was recommended to wait and watch. After about two years the neoplasia had doubled their sizes. Surgical excisional biopsy was performed for diagnostic and therapeutic reasons. The tumor beds were treated with intra-operative cryotherapy using liquid nitrogen and applying double-freeze-thaw technique. Histopathology proved the masses to be benign and caused by HPV. Recurrence and seeding of virus during surgical excision leading to multiple new masses are dreaded complications during management of conjunctival papilloma. Though a short follow-up, yet after three months there were no signs of recurrence.
UNASSIGNED: A brief review of literature is presented to highlight the fact that rarely such conjunctival papillomas may develop at unusual sites and in adults. We believe that the uncommon demographic and anatomic presentation of this case is worth sharing with ophthalmic community.

Hepatoblastoma is the most common primary malignancy of hepatic origin in children, with an estimated incidence of 0.5-1.5 per million children. Hepatoblastoma classically has an intraparenchymal location, and pedunculated hepatoblastoma is a relatively rare entity. Accurate diagnosis can be challenging due to its extrahepatic location and possibly its thin peduncle, which is not easily identified in imaging.
Here, we report a case of asymptomatic giant palpable hepatoblastoma in the LUQ of a four-month-old male infant, initially suspected of neuroblastoma based on abdominal ultrasound findings. The final diagnosis of giant pedunculated hepatoblastoma was made based on the abdominal CT scan and the diagnosis was confirmed by percutaneous biopsy. Due to the size of the tumor, complete removal of the tumor was not initially possible. Therefore, the patient was treated with several courses of chemotherapy. The tumor was shrunk and then completely removed. The patient was treated, and no complications were found in the 6-month follow-up.
Pedunculated hepatoblastoma is rare but should be considered as a possibility in the case of a perihepatic mass in a pediatric patient that can be confused with other upper abdominal masses such as an adrenal mass. Therefore, in such cases, we must look for the vascular pedicle in the imaging and keep the AFP check in mind.

Fibrous uterine polyps are very common in women during or after menopause, and less often seen in women of child-bearing age, with a maximum of frequency between 40, and 49 years. They can have various locations in the uterus depending on the patient\'s age, mostly the body, and fundus. We report a rare case of cervical localization of a pedicled fibrous polyp issuing from the cervix, in a 44-year-old female patient with 3 living children and a history of miscarriage, who had been presenting breakthrough bleeding, and pelvic pain for 3 months. It is essential to remind young radiologists of the different presentations of fibrous polyps, how to explore them better and when to fear malignancy and thus insist in a histologic study, in order to help clinicians to choose the most adequate treatment option.

We report a rare case of a large prolapsed pedunculated uterine myoma measuring 15 cm in its greater diameter. In order to make a surgical procedure safe and feasible, appropriate clinical predictors should be taken into account and pre- and intraoperative preparations be available to the surgeon\'s armamentarium.