Adult ; Female ; Hemangioma ; complications ; Humans ; Kidney Neoplasms ; complications ; Lipoma ; complications ; Lung Diseases ; complications ; diagnosis ; Tuberous Sclerosis ; complications ; diagnosis

Here, we describe a popliteal mass that was initially misdiagnosed as a simple popliteal cyst, which finally turned out to be osteochondrolipoma. A 63-year-old housewife presented with sustained knee pain in association with a palpable mass on the popliteal fossa. The mass was in the posteromedial area and soft, non-tender, non-movable in the posteromedial area. Using plain radiography, the mass appeared as a round, soft tissue density lesion containing bony fragments. We performed an ultrasound-guided needle biopsy in conjunction with magnetic resonance imaging, followed by an open excisional biopsy. Microscopically, histological sections showed a lipoma with cartilaginous and osseous differentiation, finally diagnosed as osteochondrolipoma. In conclusion, popliteal masses are not always simple cysts, and the evaluation of masses in the popliteal fossa is always necessary.
Female ; Humans ; Lipoma/complications/*diagnosis ; Middle Aged ; Osteochondroma/complications/*diagnosis ; Popliteal Cyst/etiology ; Soft Tissue Neoplasms/complications/*diagnosis

No abstract available.
Aged ; Colonic Diseases/*diagnosis/etiology/surgery ; Colonoscopy ; Female ; Humans ; Intussusception/*diagnosis/etiology/surgery ; Lipoma/complications/*diagnosis/surgery ; Tomography, X-Ray Computed

No abstract available.
Adult ; Colonic Diseases/*diagnosis/etiology/surgery ; Colonoscopy ; Humans ; Intussusception/*diagnosis/etiology/surgery ; Lipoma/complications/*diagnosis/pathology ; Male ; Tomography, X-Ray Computed

PURPOSE: For exact diagnosis and treatment, exploratory laparotomy is usually needed. The aim of this study was to verify the usefulness of single incision laparoscopic surgery for small bowel resection. METHODS: Five patients who underwent single incision laparoscopic surgery for small bowel tumor at our hospital from April 2010 to September 2011 were analyzed retrospectively. RESULTS: There were three m ale and two female patients. The mean age of patients was 55 years. The mean body mass index was 23.6 kg/m2. The largest diameter of the tumor ranged from 1.2 to 7.7 cm. The length of incision ranged from 3 to 6.5 cm (mean, 4.3 cm). The Octoport (Dalim, Seoul, Korea) was used in three cases, and a glove-port or SILS port was used in the other cases. After the whole abdominal exploration and localization of the tumor, the small bowel, including the tumor, was resected and end to end anastomosis was made extracorporeally. The mean operation time was 111.8 minutes. The mean length of hospital stay was 7.2 days. There was no occurrence of postoperative complication. Histologically, two tumors were diagnosed as gastrointestinal stromal tumors, and the other three patients were diagnosed as heterotopic pancreas, lipoma, and diffuse large B cell lymphoma, respectively. CONCLUSION: Single incision laparoscopic surgery is very useful for localization and resection of small bowel tumors. Compared to conventional laparoscopic surgery, it can reduce the number of trocars without increased difficulty. Small bowel tumor can be a suitable indication for single-incision laparoscopic surgery.
Body Mass Index ; Diagnosis ; Female ; Gastrointestinal Stromal Tumors ; Humans ; Laparoscopy* ; Laparotomy ; Length of Stay ; Lipoma ; Lymphoma, B-Cell ; Pancreas ; Postoperative Complications ; Retrospective Studies ; Seoul ; Surgical Instruments

BACKGROUND: Lipomas are common benign soft tissue tumors composed of mature white adipocytes, with histological features including a well-circumscribed and lobular mass covered with a thin fibrous capsule. However, lipomas that are poorly demarcated from the surrounding fat are often encountered during surgery despite a postoperative histological diagnosis. We investigated the complications associated with different types of lipomas. METHODS: This retrospective study included 119 patients who underwent lipoma excision and computed tomography (CT) imaging at our clinic between January 2011 and August 2018. We classified the lipomas as encapsulated or nonencapsulated according to the histology, CT findings, and clinical criteria. Nonencapsulated lipomas were defined as relatively heterogeneous without a distinct capsule, whereas encapsulated lipomas were homogeneous with a distinct capsule. The analyzed complications included delayed wound healing, which can cause prominent scarring, hematoma or seroma, and recurrence. RESULTS: Encapsulated and nonencapsulated lipomas were diagnosed in 89 (74.8%) and 30 (25.2%) patients, respectively. Encapsulated lipomas occurred most commonly on the head, whereas nonencapsulated lipomas occurred most commonly on the neck and trunk (P=0.000, P=0.002, and P=0.031, respectively). The Fisher exact test showed a significantly higher incidence of delayed wound healing for nonencapsulated than encapsulated lipomas (P=0.014). CONCLUSIONS: Preoperative classification of lipomas using CT imaging is important for predicting the incidence of postoperative complications. Direct excision is adequate for removing encapsulated lipomas. However, nonencapsulated lipomas might require alternative methods, such as ultrasonic liposuction, to prevent postoperative complications. Our results will help reduce the incidence of scarring by providing guidance on surgical methods.
Adipocytes, White ; Cicatrix ; Classification ; Diagnosis ; Head ; Hematoma ; Humans ; Incidence ; Lipectomy ; Lipoma ; Neck ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Seroma ; Ultrasonics ; Wound Healing

We report a rare case of giant mesenteric lipoma presenting with colicky abdominal pain. A 29-yr-old woman underwent laparoscopic resection for a giant mesenteric lipoma causing compression of the ileal loop. The resected ileal segment was encased by a giant fatty tissue, and normal mucosal fold patterns of the resected ileum were effaced by the mass. Microscopically, the mass was characterized by homogenous mature adipose tissue without cellular atypia, which was compatible with the diagnosis of a mesenteric lipoma. Despite the benign nature of this tumor, total excision with or without the affected intestinal loop should be considered if intestinal symptoms such as abdominal pain are present.
Abdominal Pain/*etiology ; Adipose Tissue/pathology ; Adult ; Diagnosis, Differential ; Female ; Humans ; Ileal Diseases/etiology ; Laparoscopy ; Lipoma/complications/*diagnosis/surgery ; *Mesentery/pathology ; Peritoneal Neoplasms/complications/*diagnosis/surgery ; Tomography, X-Ray Computed

PURPOSE: Laparoscopic surgery of the abdomen has grown rapidly in popularity due to the benefits, including a low level of post operative pain, early recovery, short hospitalization and excellent cosmetic results. Concerning tumor resection, most benign gastric tumors are ideal for the use of the non invasive method of a laparoscopic procedure. To evaluate the feasibility of laparoscopic surgery for benign gastric tumors, we analysed the clinicopathological findings, post operative course and prognosis. METHODS: Between January 1995 and August 2001, laparoscopic surgery was performed on 18 patients with benign gastric tumors at the Department of Surgery at Yonsei University Hospital. To evaluate the feasibility of laparoscopic surgery for these lesions, the sex, age, pathologic diagnosis, operative methods, tumor location, tumor size, operative time, recurrence, gas passing time and diet recovery time were analyzed. RESULTS: The patients group consisted of 3 men (16.7%) and 15 women (83.3%), with a mean age of 51.9+/-15.0 years (range, 23~80). The histopathological examinations showed 12 mesenchymal tumors (5 leiomyomas, 4 stromal tumors, 3 Schwannomas), 2 mucosa origin tumors (1 retention polyp, 1 villous adenoma), 2 ectopic pancreata, 1 carcinoid tumor and 1 lipoma. The operation methods were 14 laparoscopic wedge resections of stomach, 1 laparoscopic assisted partial gastrectomy and 1 gastrotomy and polypectomy. In 2 patients, a laparotomy was required following the laparoscopy due to difficulties in detecting the tumors. In one of the 2 converted cases, preoperative endoscopic marking of the tumor site was performed, but the dye was spread very widely from the mid body to the prepylorus. The other tumor was located on the lesser curvature of the upper third, around the esophagogastric junction, but it was not exactly identified. The tumors were located in the upper, middle, and lower third of the stomach in 7, 9 and 2 cases, respectively. As a circumferential location, 7 tumors were mainly situated on the anterior wall, 6 on the posterior wall, 3 on the greater curvature and 2 on the lesser curvature. All tumors, even those on the lesser curvature and posterior wall, were able to be resected with laparoscopy. The size of the resected tumors averaged 2.2+/-0.9 cm (range, 0.8~4.3). The resection margins were all negative. The operation time averaged 145.8+/-57.0 min (range 70~280). The time to passing gas averaged 2.2+/-0.9 days (range 1~4). The recovery time to a soft diet averaged 5.9+/-1.9 days (range, 2~9). The postoperative course of all the patients was uneventful, and there were no postoperative complications with the exception of one case of diet intolerance. During the follow up there have been no recurrences to date. CONCLUSION: With its proper application in benign gastric tumors, laparoscopic surgery needs to identify the exact site of a tumor, can contribute significantly to an improved patient outcome because it is less complicated and safer compared to conventional gastrectomy methods.
Abdomen ; Carcinoid Tumor ; Diagnosis ; Diet ; Esophagogastric Junction ; Female ; Follow-Up Studies ; Gastrectomy ; Hospitalization ; Humans ; Laparoscopy* ; Laparotomy ; Leiomyoma ; Lipoma ; Male ; Mucous Membrane ; Operative Time ; Polyps ; Postoperative Complications ; Prognosis ; Recurrence ; Stomach

OBJECTIVETo study the clinicopathologic features of lipomatosis of nerve (NLS).

METHODSThe clinical, radiologic and pathologic features were analyzed in 15 cases of NLS.

RESULTSThere were a total of 10 males and 5 females. The age of patients ranged from 4 to 42 years (mean age = 22.4 years). Eleven cases were located in the upper limbs and 4 cases in the lower limbs. The median nerve was the most common involved nerve. The patients typically presented before 30 years of age (often at birth or in early childhood) with a soft and slowly enlarging mass in the limb, with or without accompanying motor and sensory deficits. Some cases also had macrodactyly and carpal tunnel syndrome. MRI showed the presence of fatty tissue between nerve fascicles, resembling coaxial cable in axial plane and assuming a spaghetti-like appearance in coronal plane. On gross examination, the affected nerve was markedly increased in length and diameter. It consisted of a diffusely enlarged greyish-yellow lobulated fusiform beaded mass within the epineural sheath. Histologically, the epineurium was infiltrated by fibrofatty tissue which separated, surrounded and compressed the usually normal-appearing nerve fascicles, resulting in perineural septation of nerve fascicles and microfascicle formation. The infiltration sometimes resulted in concentric arrangement of perineural cells and pseudo-onion bulb-like hypertrophic changes. The perineurial cells might proliferate, with thickening of collagen fibers, degeneration and atrophic changes of nerve bundles. Immunohistochemical study showed that the nerve fibers expressed S-100 protein, neurofilament and CD56 (weak). The endothelial cells and dendritic fibers were highlighted by CD34. The intravascular smooth muscle cells were positive for muscle-specific actin.

CONCLUSIONSNLS is a rare benign soft tissue tumor of peripheral nerve. The MRI findings are characteristic. A definitive diagnosis can be made with histologic examination of tissue biopsy.

Adolescent ; Adult ; Antigens, CD34 ; metabolism ; CD56 Antigen ; metabolism ; Carpal Tunnel Syndrome ; complications ; pathology ; Child ; Child, Preschool ; Diagnosis, Differential ; Extremities ; innervation ; Female ; Hand Deformities, Congenital ; complications ; pathology ; Humans ; Lipoma ; pathology ; Lipomatosis ; complications ; diagnosis ; metabolism ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Median Nerve ; metabolism ; pathology ; Nerve Sheath Neoplasms ; pathology ; Neurofibroma ; pathology ; Neurofilament Proteins ; metabolism ; Neuroma ; pathology ; Peripheral Nervous System Diseases ; complications ; diagnosis ; metabolism ; pathology ; surgery ; Peripheral Nervous System Neoplasms ; pathology ; Retrospective Studies ; S100 Proteins ; metabolism ; Vimentin ; metabolism ; Young Adult