Giant Lipomas of the Hand. Our Experience

Abstract Objective Giant lipomas are benign tumors larger than 5 cm in size that are very uncommun in the hand, with the extant literature limited to case reports and small case series. The aim of the present study is to describe our experience with giant lipomas at the level of the hand, reviewing the most important aspects in relation to their diagnosis and treatment. Material and Methods We present 6 patients treated in our service with giant lipomas of the hand between 2007 and 2015. Four cases only presented difficulty in grasping and mobilizing the hand due to the large size of the lipoma. Two cases were accompanied by a clinical feature of compression of the median nerve in relation to its location within the carpal tunnel. Results All patients underwent surgery, and a complete excision of the lipoma was performed. The functional results have been satisfactory in all cases. Conclusions Giant lipomas of the hand are infrequent tumors of slow growth, generally asymptomatic, although they can cause a compressive pathology due to the great size that they reach. Magnetic resonance imaging is an especially useful test to locate and accurately determine the size of the lesion in view of its surgical excision. After surgery, it is important to make a differential diagnosis with low-grade liposarcomas through an anatomopathological study, since both, macroscopically, have similar characteristics.

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Juvenile Nasopharyngeal Angiofibroma - Excision Through Lateral Rhinotomy and Sublabial Approach - A Case Report

Journal of Dhaka Medical College ◽

10.3329/jdmc.v20i1.8587 ◽

1970 ◽

Vol 20 (1) ◽

pp. 78-81

Author(s):

NK Sinha ◽

MH Rashid ◽

MM Shaheen ◽

DC Talukder ◽

MAY Fakir ◽

...

Keyword(s):

Surgical Excision ◽

Complete Removal ◽

Definitive Treatment ◽

Surgical Approaches ◽

Complete Excision ◽

Nasopharyngeal Angiofibroma ◽

Male Adolescents ◽

Large Size ◽

Complete Surgical Excision ◽

Sublabial Approach

Juvenile angiofibroma is a rare hypervascular, locally aggressive benign tumour which is exclusively found in the nose and paranasal sinuses of male adolescents. The definitive treatment for this tumour is complete surgical excision. Different surgical approaches are used for complete excision. Most recent development is excision of the tumour using endoscopes. But in certain cases with large size and different extensions, open transfacial approaches are the choice for complete removal and for less operative bleeding, which are the main challenges for surgical excision of this tumour. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8587 J Dhaka Med Coll. 2011; 20(1) :78-81

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diode laser for excisional biopsy of pyogenic granuloma: a case series

International Journal of Dental Research ◽

10.14419/ijdr.v5i2.7837 ◽

2017 ◽

Vol 5 (2) ◽

pp. 112

Author(s):

Gaurav Mahajan ◽

Aditi Gautam

Keyword(s):

Diode Laser ◽

Traumatic Injury ◽

Case Series ◽

Surgical Excision ◽

Excisional Biopsy ◽

Pyogenic Granuloma ◽

Low Grade ◽

Giant Cell Granuloma ◽

Hormonal Factors ◽

Peripheral Giant Cell Granuloma

Pyogenic granuloma is one of the inflammatory hyperplasias seen in the oral cavity. This term is a misnomer because the lesion is unrelated to infection and in reality arises in response to various stimuli such as low- grade local irritation, traumatic injury or hormonal factors. The clinical diagnosis of such lesion can be quite challenging because of its close resemblance to certain malignancies like peripheral giant cell granuloma, kaposi’s sarcoma, non hodgkin’s lymphoma etc. for excisional biopsy, options available are conventional surgical excision, electrocautery or lasers. In this report, we seek to highlight the therapeutic advantages achieved with a soft tissue diode laser in the treatment of pyogenic granuloma.

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Asymptomatic nodule on face: Dermoscopic and histopathological clue for diagnosis

Nepal Journal of Neuroscience ◽

10.3126/njn.v17i1.28369 ◽

2020 ◽

Vol 17 (1) ◽

pp. 63-65

Author(s):

Anisha Joshi ◽

Deeptara Pathak Thapa

Keyword(s):

Head And Neck ◽

Peripheral Nerves ◽

Neck Region ◽

Surgical Excision ◽

Benign Tumors ◽

Complete Excision ◽

Head And Neck Region ◽

The Common ◽

Slow Growing ◽

Rare Diagnosis

Schwannomas/ neurilemmomas are benign tumors of nerve sheath arising from Schwann cells that form myelin sheath around peripheral nerves. They are usually solitary, slow growing and encapsulated lesions. Head and neck are the common sites. We report a case of a 38 years old Nepalese female who had presented with a solitary asymptomatic, slow growing nodule on the left side of the chin for the last three years. Dermoscopy of the lesion revealed arborizing vessels with brownish pigmentation overlying a whitish to pinkish background. Complete excision of the lesion was performed. Histopathological evaluation of the lesion revealed schwannoma. Though schwannomas are a rare diagnosis, they should be considered as a differential diagnosis of any unilateral, asymptomatic, slow growing nodule in the head and neck region. Dermoscopy is a useful tool which helps to differentiate schwannoma from other lesions. Histopathology is the gold standard for diagnosis and the treatment of choice is surgical excision.

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Gliomas of the optic nerve or chiasm

Journal of Neurosurgery ◽

10.3171/jns.1988.68.1.0085 ◽

1988 ◽

Vol 68 (1) ◽

pp. 85-98 ◽

Cited By ~ 220

Author(s):

Ellsworth C. Alvord ◽

Steven Lofton

Keyword(s):

Optic Nerve ◽

Growth Rates ◽

Surgical Excision ◽

Sufficient Information ◽

Low Grade ◽

Complete Excision ◽

Content Type ◽

Complete Surgical Excision ◽

Table Analysis ◽

Fine Print

✓ A review of the literature revealed 623 cases of optic gliomas with sufficient information to permit actuarial (life-table) analysis concerning the prognosis of this disease by the patients' age, tumor site, treatment, and presence of concomitant neurofibromatosis or extension into the hypothalamus or ventricle. All of these factors are important. The development of mathematical models led to the conclusion that these tumors, generally regarded histologically as low-grade astrocytomas, actually have a very wide but continuous range of growth rates. Some grow rapidly enough to be explained by simple exponential doubling at a constant rate, but most behave as though their growth decelerates. Decelerating growth rates make comparisons of various groups of patients difficult. No support is found for the classical hypothesis that some may be hamartomas. Inadequately treated gliomas of the optic nerve or chiasm bear about the same poor prognosis. However, tumors of the optic nerve (intracranial as well as intraorbital) have an excellent prognosis following complete surgical excision and only a slightly poorer prognosis following irradiation. About 5% of optic nerve gliomas recur in the chiasm following “complete” intraorbital excision. Patients with neurofibromatosis have about twice the recurrence rate following complete excision of an intraorbital glioma. Optic chiasmal gliomas appear to respond to irradiation with doses above 4500 rads. Patients with neurofibromatosis have about the same prognosis as patients without neurofibromatosis following irradiation of a chiasmal glioma.

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An Initial Overview of Management and Treatment Outcomes for Head and Neck Hemangiomas

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v32i2.73 ◽

2018 ◽

Vol 32 (2) ◽

pp. 30-33

Author(s):

Rodolfo U. Fernandez

Keyword(s):

Radiofrequency Ablation ◽

Head And Neck ◽

Surgical Management ◽

Vascular Tissue ◽

Case Series ◽

Surgical Excision ◽

Capillary Hemangioma ◽

University Hospital ◽

Treatment Modalities ◽

Complete Excision

Objective: To provide an initial overview of the outcomes of different treatment modalities used for hemangiomas. Methods: Design: Case Series Setting: Tertiary National University Hospital Participants: Records of 21 patients diagnosed with head and neck hemangiomas in the Philippine General Hospital Department of Otorhinolaryngology from 2009 to 2014 were reviewed. Results: Majority of the patients were female (61.9%) and in the pediatric age group (57.1%). Of the 21 patients, 6 underwent medical management, 13 had surgical management, 1 had both medical and surgical management, and 1 opted to observe the lesion. All patients treated with propranolol observed a decrease in the size of the lesion. Seven out of the 13 patients had radiofrequency ablation; all had gross residual lesion. Six of the 13 underwent excision, with complete excision being achieved in 5 of 6 cases. Conclusion: Treatment response of patients in this series with hemangiomas of the head and neck to propranolol at a dose of 1 to 2 mg/kg/day may reflect international data. Outcomes analysis for radiofrequency ablation and surgical excision requires a longer duration of follow-up. Keywords: propranolol hydrochloride, prednisone, pulsed radiofrequency treatment, capillary hemangioma, vascular tissue neoplasms

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Recurrent abdominal liposarcoma presenting with intestinal obstruction

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz188 ◽

2019 ◽

Vol 2019 (6) ◽

Author(s):

Belal S Abufkhaida ◽

Barah K Alsalameh

Keyword(s):

Intestinal Obstruction ◽

Local Recurrence Rate ◽

Slow Growth ◽

Abdominal Mass ◽

Rare Entity ◽

Complete Excision ◽

Retroperitoneal Liposarcoma ◽

Large Size ◽

High Local Recurrence Rate ◽

Mechanical Intestinal Obstruction

Abstract Liposarcoma is the most common retroperitoneal sarcoma and mesenchymal tumor in the abdomen. Usually, it presents with vague symptoms due to its large size and slow growth at the time of diagnosis. Liposarcoma is associated with a high local recurrence rate according to its histology, size and growth rate. Up till now, surgical resection is the only effective treatment for primary and recurrent abdominal liposarcoma. Secondary mesenteric liposarcoma is an extremely rare entity and so far a small number of cases have been reported in the literature. In this article, we present a rare case of a 63-year-old female patient who was diagnosed with mesenteric liposarcoma after 3 years of complete excision of retroperitoneal liposarcoma, presenting primarily as abdominal mass causing mechanical intestinal obstruction.

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Therapeutic Options for the Treatment of Darier’s Disease: A Comprehensive Review of the Literature

Journal of Cutaneous Medicine and Surgery ◽

10.1177/12034754211058405 ◽

2021 ◽

pp. 120347542110584

Author(s):

N. Hanna ◽

M. Lam ◽

P. Fleming ◽

C. Lynde

Keyword(s):

English Language ◽

Case Reports ◽

Case Series ◽

Surgical Excision ◽

Therapeutic Options ◽

Keratosis Follicularis ◽

Darier’S Disease ◽

Dyskeratosis Follicularis ◽

Darier's Disease ◽

Oral Isotretinoin

Darier’s disease (also known as keratosis follicularis or dyskeratosis follicularis) is an autosomal dominant inherited disorder which manifests as hyperkeratotic greasy papules in the first or second decade of life. Aside from symptom management and behavioral modifications to avoid triggers, there are currently no validated treatments for Darier’s disease (DD). However, a variety of treatments have been proposed in the literature including retinoids, steroids, vitamin D analogs, photodynamic therapy, and surgical excision. The purpose of this review article is to identify therapeutic options for treating DD and to outline the evidence underlying these interventions. A search was conducted in Medline for English language articles from inception to July 4, 2020. Our search identified a total of 474 nonduplicate studies, which were screened by title and abstract. Of these, 155 full text articles were screened against inclusion/exclusion criteria, and 113 studies were included in our review. We identified Grade B evidence for the following treatments of DD: oral acitretin, oral isotretinoin, systemic Vitamin A, topical tretinoin, topical isotretinoin, topical adapalene gel, topical 5-flououracil, topical calciptriol and tacalcitol (with sunscreen), grenz ray radiation, and x-ray radiation. All other evidence for treatments of DD consisted of case reports or case series, which is considered grade C evidence. Considering the quality and quantity of evidence, clinicians may consider initiating a trial of select topical or oral retinoids first in patients with localized or generalized DD, respectively.

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Alveolar Soft Part Sarcoma: A Single-Center 26-Patient Case Series and Review of the Literature

Sarcoma ◽

10.1155/2012/907179 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 40

Author(s):

Koichi Ogura ◽

Yasuo Beppu ◽

Hirokazu Chuman ◽

Akihiko Yoshida ◽

Noboru Yamamoto ◽

...

Keyword(s):

Primary Tumor ◽

Soft Part ◽

Objective Response ◽

Survival Rates ◽

Case Series ◽

Surgical Excision ◽

Alveolar Soft Part Sarcoma ◽

Complete Excision ◽

Ajcc Stage ◽

Average Size

Background.Alveolar soft part sarcoma (ASPS) is a rare tumor, and little information is available regarding its clinical features and appropriate treatments.Methods.A retrospective review of 26 consecutive ASPS patients (12 male, 14 female; mean age of 27 years) treated at our institution over 30 years (mean followup; 71 months) was performed.Results.The primary tumor developed in the lower extremity (12), trunk (8), and upper extremity (6), with an average size of 7.2 cm (range, 2–14 cm). The AJCC stage at presentation was IIA (7), III (3), and IV (16). Surgical excision was performed in 20 patients (R0 18, R1 plus radiotherapy 2) without local recurrence. Six patients (stage IIA 3/7, stage III 3/3) later developed metastases after an average period of 28.7 months. The median survival of the 26 patients was 90 months, with overall 5/10-year survival rates of 64%/48%. AJCC stage and tumor size were significant prognostic factors. Significant palliation and slowing of metastasis progression were achieved with gamma knife radiotherapy. Nine patients receiving chemotherapy showed no objective response.Conclusions.ASPS is indolent but has a high propensity for metastasis. Early diagnosis and complete excision of the small primary tumor are essential in the treatment of ASPS.

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Differential Diagnosis of Cartilaginous Lesions of Bone

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2019-0441-ra ◽

2020 ◽

Vol 144 (1) ◽

pp. 71-82 ◽

Cited By ~ 5

Author(s):

David Suster ◽

Yin Pun Hung ◽

G. Petur Nielsen

Keyword(s):

Differential Diagnosis ◽

Massachusetts General Hospital ◽

Surgical Excision ◽

Benign Tumors ◽

Low Grade ◽

Case Review ◽

Multiple Hereditary Exostosis ◽

Tumors Of Bone ◽

Well Differentiated ◽

Cartilaginous Tumors

Context.— Cartilaginous tumors represent one of the most common tumors of bone. Management of these tumors includes observation, curettage, and surgical excision or resection, depending on their locations and whether they are benign or malignant. They can be diagnostically challenging, particularly in small biopsies. In rare cases, benign tumors may undergo malignant transformation. Objective.— To review common cartilaginous tumors, including in patients with multiple hereditary exostosis, Ollier disease, and Maffucci syndrome, and to discuss problems in the interpretation of well-differentiated cartilaginous neoplasms of bone. Additionally, the concept of atypical cartilaginous tumor/chondrosarcoma grade 1 will be discussed and its use clarified. Data Sources.— PubMed (US National Library of Medicine, Bethesda, Maryland) literature review, case review of archival cases at the Massachusetts General Hospital, and personal experience of the authors. Conclusions.— This review has examined primary well-differentiated cartilaginous lesions of bone, including their differential diagnosis and approach to management. Because of the frequent overlap in histologic features, particularly between low-grade chondrosarcoma and enchondroma, evaluation of well-differentiated cartilaginous lesions should be undertaken in conjunction with thorough review of the imaging studies.

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Pediatric Extraspinal Sacrococcygeal Ependymoma: Report of Two Cases and Literature Review

Diagnostics ◽

10.3390/diagnostics11091680 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1680

Author(s):

Francesco Fabozzi ◽

Silvia Ceccanti ◽

Antonella Cacchione ◽

Giovanna Stefania Colafati ◽

Andrea Carai ◽

...

Keyword(s):

Literature Review ◽

Case Reports ◽

Case Series ◽

Surgical Excision ◽

Central Canal ◽

Ependymal Cells ◽

The Past ◽

First Case ◽

One Year

Primary central nervous system (CNS) tumors represent the most common solid tumors in childhood. Ependymomas arise from ependymal cells lining the wall of ventricles or central canal of spinal cord and their occurrence outside the CNS is extremely rare, published in the literature as case reports or small case series. We present two cases of extra-CNS myxopapillary ependymomas treated at our institution in the past three years; both cases originate in the sacrococcygeal region and were initially misdiagnosed as epidermoid cyst and germ cell tumor, respectively. The first case, which arose in a 9-year-old girl, was treated with a surgical excision in two stages, due to the non-radical manner of the first operation; no recurrence was observed after two years of follow-up. The other case was a 12-year-old boy who was treated with a complete resection and showed no evidence of recurrence at one-year follow-up. In this paper, we report our experience in treating an extremely rare disease that lacks a standardized approach to diagnosis, treatment and follow-up; in addition, we perform a literature review of the past 35 years.

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