RESUMO
Fundamento: Los angiolipomas son tumores benignos que se presentan en adultos con una localización, preferentemente, en el espacio epidural posterior torácico. Objetivo: Presentar un caso que debutó con un traumatismo axial lumbosacro donde se evidenció una localización poco común de la lesión y sin relación con las estructuras del canal raquídeo. Presentación del caso: Hombre de 25 años que se cayó y debido a ello se le hizo un traumatismo directo en la región sacrococcígea con dolor y aumento de volumen regional, asociado a parestesias glúteas. Los estudios radiológicos evidenciaron una fractura del cóccix y la presencia de una lesión ubicada en las partes blandas, de aspecto redondeado, homogéneo, sólido, de poco más de 50 mm de diámetro. Se le realizó tratamiento quirúrgico que consistió en coccigectomía subperióstica y exéresis macroscópica de la masa. El estudio histológico concluyó el diagnóstico de un angiolipoma. Conclusiones: Los angiolipomas son tumores raros que tienen características radiológicas peculiares, requieren de alta sospecha clínico-imagenológica para indicar los estudios y el tratamiento. La exéresis total es recomendada para evitar la recurrencia y mejorar el pronóstico.
Background: Angiolipomas are benign tumors that appear in adults with special location in the posterior thoracic epidural position. Objective: To present a case that appeared with a lumbosacral axial trauma where a non-common lesion location was evidenced with no relation among the structures of the spinal canal. Case presentation: 25-year-old man who fell down, consequently suffered a painful direct trauma to the sacrococcygeal region and increased regional volume, associated with gluteal paresthesias. Radiological studies showed a fracture of the coccyx and presence of a lesion located in the soft tissues, with a rounded, homogeneous, solid aspect, a little more than 50 mm in diameter. Surgical treatment consisted of subperiosteal coccygectomy and macroscopic excision of the mass. Histological study concluded the diagnosis of an angiolipoma. Conclusions: Angiolipomas are rare tumors with peculiar radiological features, they require high clinical-imaging suspicion for studies and treatment. Total excision is recommended to avoid recurrence and improve prognosis.
Assuntos
Região Sacrococcígea/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem , Cóccix/cirurgia , Cóccix/lesões , Angiolipoma/cirurgiaRESUMO
Background: Angiolipoma is a benign tumor composed of endothelial cells and mature adipocytes. Tumors reported indomestic species include two variants; infiltrative or non-infiltrative. Bitches and intact males seem predisposed. Thismesenchyme tumor is commonly mistaken with lipoma due to its soft texture and subcutaneous site and often requireshistopathology to confirm its diagnosis. Microscopic examination also enables the evaluation of surgical margins and ruleout possible infiltrative sites. Complete surgical excision is usually curative. This study reports a case of non-infiltratingangiolipoma in a dog.Case: A 14-year-old mixed-breed dog was presented to a veterinary clinic in the city of Rio de Janeiro, RJ, Brazil. Onpalpation, a painless mass was noted, with high mobility and covered by intact hirsute skin in the right subcutaneousventrolateral region. Computed tomography of the chest showed an expansive mass of uptake only from the edges of thesoft tissues of the right subcutaneous ventrolateral region. The mass was homogeneous and well delimited, suggesting aneoplastic process. Subsequently, the mass was surgically removed, fixed in 10% buffered formalin, and sent for histopathological analysis. On macroscopic examination, the mass was well delimited, without skin coverage, and measured2.3×1.9×0.6 cm. The consistency was smooth and unctuous in appearance with a compact cream-colored surface withblackish multifocal spots. Under microscopy, the histological sections showed neoplasm of mature adipocytes and of endothelial cells of blood vessels benign were filled with a marked amount of red blood cells...(AU)
Assuntos
Animais , Feminino , Cães , Angiolipoma/veterinária , Cães/cirurgia , Angiolipoma/diagnóstico , Tomografia Computadorizada de Emissão/veterináriaRESUMO
Background: Angiolipoma is a benign tumor composed of endothelial cells and mature adipocytes. Tumors reported indomestic species include two variants; infiltrative or non-infiltrative. Bitches and intact males seem predisposed. Thismesenchyme tumor is commonly mistaken with lipoma due to its soft texture and subcutaneous site and often requireshistopathology to confirm its diagnosis. Microscopic examination also enables the evaluation of surgical margins and ruleout possible infiltrative sites. Complete surgical excision is usually curative. This study reports a case of non-infiltratingangiolipoma in a dog.Case: A 14-year-old mixed-breed dog was presented to a veterinary clinic in the city of Rio de Janeiro, RJ, Brazil. Onpalpation, a painless mass was noted, with high mobility and covered by intact hirsute skin in the right subcutaneousventrolateral region. Computed tomography of the chest showed an expansive mass of uptake only from the edges of thesoft tissues of the right subcutaneous ventrolateral region. The mass was homogeneous and well delimited, suggesting aneoplastic process. Subsequently, the mass was surgically removed, fixed in 10% buffered formalin, and sent for histopathological analysis. On macroscopic examination, the mass was well delimited, without skin coverage, and measured2.3×1.9×0.6 cm. The consistency was smooth and unctuous in appearance with a compact cream-colored surface withblackish multifocal spots. Under microscopy, the histological sections showed neoplasm of mature adipocytes and of endothelial cells of blood vessels benign were filled with a marked amount of red blood cells...
Assuntos
Feminino , Animais , Cães , Angiolipoma/diagnóstico , Angiolipoma/veterinária , Cães/cirurgia , Tomografia Computadorizada de Emissão/veterináriaRESUMO
Laryngeal angiolipoma is a benign and rare tumor at this level. It is a type of unique lipoma, which is located in aritenoepiglottic retraction, epiglottis, and postcricoid region, and it is usually diagnosed after surgical exeresis. It is usually silent until it reaches a large size, causing dysphagia as the most common symptom; so it should be part of the differential diagnosis of odynophagia. We present a case in a male patient of supraglottic angiolipoma as an unusual cause of odynophagia
El angiolipoma laríngeo es un tumor benigno e infrecuente a este nivel. Es un tipo de lipoma único, que se localiza en el repliegue aritenoepiglótico, la epiglotis y la región poscricoidea, y suele diagnosticarse tras su exéresis quirúrgica. Suele ser silente hasta que alcanza gran tamaño, ocasionado odinofagia como síntoma más frecuente; de ahí que deba formar parte del diagnóstico diferencial de la odinofagia. Presentamos un caso en un paciente varón de angiolipoma supraglótico, como causa inusual de odinofagia
Assuntos
Angiolipoma , Laringe , LipomaRESUMO
El angiomiolipoma de cavidad nasal es un tumor hamartomatoso extremadamente infrecuente compuesto por adipocitos maduros, espacios vasculares con escaso tejido elástico y la presencia de haces de células musculares lisas maduras. Se manifiesta principalmente por obstrucción nasal unilateral y epistaxis recurrente. Se presenta el caso de una paciente de 73 años con historia crónica de obstrucción nasal y epistaxis recurrente izquierda asociada a rinorrea y descarga posterior intermitente. La tomografía computarizada (TC) y resonancia nuclear magnética (RNM) demuestran una lesión vascular circunscrita en fosa nasal izquierda. La angiografía demostró irrigación exclusiva de la arteria esfenopalatina izquierda. Se realizó extirpación de la lesión por abordaje endonasal endoscópico previa embolización arterial. La revisión de la literatura mundial muestra que es el duodécimo caso de angiomiolipoma de cavidad nasal reportado.
Angiomyolipoma of nasal cavity is an extremely rare hamartoma tumor composed of mature adipocytes, vascular spaces with lack of elastic tissue, and the presence of bundles of mature smooth muscle cells. It manifests itself mainly by unilateral nasal obstruction and recurrent epistaxis. We present the case of a 73-years-old woman with chronic history of left-sided nasal obstruction and recurrent epistaxis associated with rhinorrhea and intermittent post nasal drip. Computed tomography and magnetic resonance imaging demonstrate a vascular lesion inside the left nasal cavity. Angiography showed irrigation exclusively by the left sphenopalatine artery Surgical excision was performed by endoscopic endonasal approach after arterial embolization. World literature review showed that this is the twelfth reported case of angiomyolipoma of the nasal cavity.
Assuntos
Humanos , Feminino , Idoso , Neoplasias Nasais/cirurgia , Neoplasias Nasais/diagnóstico , Angiolipoma/cirurgia , Angiolipoma/diagnóstico , Endoscopia/métodos , Imageamento por Ressonância Magnética , Angiografia Cerebral , Tomografia Computadorizada por Raios X , Epistaxe/etiologia , Cavidade NasalRESUMO
El síndrome de Klippel-Feil es una malformación congénita de la charnela cráneo-cervical compleja que involucra vértebras y visceras, caracterizada por la tríada clásica de cuello corto, limitación de movimientos de la cabeza por la fusión de vértebras cervicales e implantación baja del cabello en la región occipital. Se presenta por falla de segmentación en el esqueleto axial del embrión. Su incidencia se estima en 1/40 000-42 000nacimientos y predomina en el sexo femenino. El objetivo del presente trabajo es describir el cuadro clínico de un paciente con síndrome de Klippel-Feil y múltiples malformaciones asociadas, entre ellas, fístula traqueoesofágica, pulgar bífido y lipomas/angiolipomas intracraneales, las cuales, hasta ahora, no han sido descritas en el síndrome, por lo que se considera un hallazgo excepcional.
The Klippel-Feil syndrome is a congenital malformation of the skull flap involving complex cervical vertebrae and organs, characterized by a classic triad: short neck, limitation of movement of the head due to cervical spine fusion and low hairline in occipital region. It results from an error in the axial skeleton segmentation of the embryo; its incidence is estimated at 1/40,000-42,000 births and predominates in females. The aim of this paper is to describe the clinical picture of a patient with Klippel-Feil syndrome and multiple malformations, including tracheoesophageal fistula, bifid thumb and intracranial lipomas/angiolipomas,that have not been previously described in the syndrome, so it is considered an exceptional finding.
Assuntos
Humanos , Masculino , Criança , Anormalidades Múltiplas/diagnóstico , Neoplasias Encefálicas/complicações , Deformidades da Mão/complicações , Fístula Traqueoesofágica/complicações , Angiolipoma/complicações , Síndrome de Klippel-Feil/complicações , Polegar/anormalidades , Neoplasias Encefálicas/diagnóstico , Deformidades da Mão/diagnóstico , Fístula Traqueoesofágica/diagnóstico , Angiolipoma/diagnóstico , Síndrome de Klippel-Feil/diagnósticoRESUMO
The Klippel-Feil syndrome is a congenital malformation of the skull flap involving complex cervical vertebrae and organs, characterized by a classic triad: short neck, limitation of movement of the head due to cervical spine fusion and low hairline in occipital region. It results from an error in the axial skeleton segmentation of the embryo; its incidence is estimated at 1/40,000-42,000 births and predominates in females. The aim of this paper is to describe the clinical picture of a patient with Klippel-Feil syndrome and multiple malformations, including tracheoesophageal fistula, bifid thumb and intracranial lipomas/angiolipomas,that have not been previously described in the syndrome, so it is considered an exceptional finding.
El síndrome de Klippel-Feil es una malformación congénita de la charnela cráneo-cervical compleja que involucra vértebras y vísceras, caracterizada por la tríada clásica de cuello corto, limitación de movimientos de la cabeza por la fusión de vértebras cervicales e implantación baja del cabello en la región occipital. Se presenta por falla de segmentación en el esqueleto axial del embrión. Su incidencia se estima en 1/40 000-42 000 nacimientos y predomina en el sexo femenino. El objetivo del presente trabajo es describir el cuadro clínico de un paciente con síndrome de Klippel-Feil y múltiples malformaciones asociadas, entre ellas, fístula traqueoesofágica, pulgar bífido y lipomas/angiolipomas intracraneales, las cuales, hasta ahora, no han sido descritas en el síndrome, por lo que se considera un hallazgo excepcional.
Assuntos
Anormalidades Múltiplas , Angiolipoma/complicações , Neoplasias Encefálicas/complicações , Deformidades da Mão/complicações , Síndrome de Klippel-Feil/complicações , Polegar/anormalidades , Fístula Traqueoesofágica/complicações , Anormalidades Múltiplas/diagnóstico , Angiolipoma/diagnóstico , Neoplasias Encefálicas/diagnóstico , Criança , Deformidades da Mão/diagnóstico , Humanos , Recém-Nascido , Síndrome de Klippel-Feil/diagnóstico , Masculino , Fístula Traqueoesofágica/diagnósticoRESUMO
Los lipomas intraóseos son considerados como los tumores óseos primarios benignos más raros por su muy poca frecuencia. Su incidencia es menor del 1 por 1.000 entre los tumores primarios y para 2002 se habían publicado menos de 100 casos a nivel mundial. El angiolipoma, es una variante histológica del lipoma aún menos frecuente, representando sólo del 5 al 17% de todos los lipomas intraóseos. Generalmente se trata de una lesión asintomática, un hallazgo radiológico en exámenes realizados por otras razones suele ser la forma de su diagnóstico. Sin embargo, algunos lipomas pueden ser sintomáticos. Presentamos el caso de paciente femenino de 36 años quien posterior a presentar dolor del tobillo derecho se diagnostica una lesión en el calcáneo, que posterior a su análisis anatomopatológico resultó ser un angiolipoma intraóseo. Presentamos su tratamiento con médula ósea autóloga y su evolución(AU)
Intraosseous lipomas are considered the rarest and a very infrequently benign primary bone tumors. Its incidence is less than 1 per 1,000 between primary tumors and by 2002 had published fewer than 100 cases worldwide. The angiolipoma, is a histological variant of lipoma even rarer, representing only 5 to 17% of all intraosseous lipomas. This is usually an asymptomatic lesion, radiological finding in tests performed for other reasons is usually the way to diagnosis. However, some may be symptomatic lipomas. We report the case of a female patient aged 36 who after presenting pain in the right calcaneus, which after pathologic analysis proved diagnosed intraosseous angiolipoma. We present treatment with autologous bone marrow and evolution(AU)
Assuntos
Humanos , Feminino , Adulto , Angiolipoma/diagnóstico , Lipoma , Tornozelo , Neoplasias , Dor , Radiografia , DiagnósticoRESUMO
Angiolipomas são neoplasias benignas compostas por adipócitos maduros e proliferação vascular angiomatosa de rara ocorrência no Sistema Nervoso Central. É relatado o caso de angiolipoma em cisterna silviana adjacente a aneurisma sacular de artéria cerebral média. São discutidas as características imagenológicas do tumor e a possibilidade de uma origem comum com lesões vasculares intracranianas. Este é o primeiro caso relatado de angiolipoma intracraniano associado a aneurisma de artéria cerebral média.
Angiolipomas are benign neoplasms composed of mature fat cells and vascular angiomatous proliferation of rare incidence in Central Nervous System.It's related a case of angiolipoma in Sylvian fissure associated with cerebral saccular aneurysm of medial cerebral artery. Imagenologic characteristics of the tumor and a possible common origin with intracranial vascular lesions are discussed. This is the first reported case of intracranial angiolipoma involving medial cerebral artery aneurysm.
Assuntos
Humanos , Masculino , Adulto , Neoplasias Encefálicas , Angiolipoma/complicações , Artéria Cerebral Média/patologia , Aneurisma/complicações , Cefaleia/etiologiaRESUMO
Spinal angiolipoma is an uncommon form of benign tumor. There are 142 reported cases and only one of acute paraplegia. We describe a case of a 39 year old male with acute spinal paraplegia angiolipoma in T4-T5 with surgical resolution three weeks after the onset of the neurological syndrome. Postoperative neurologic recovery was complete. The angiolipoma consists of mature fat cells and abnormal blood vessels. There are 2 types: non-infiltrating and infiltrating. Its clinical course is slow and progressive, it can be accelerated by vascular phenomena, intratumoral abscess, and pregnancy. There is just one report of spontaneous intratumoral hemorrhage and acute paraplegia, coinciding with our case. There is no consensus as to treatment, and release and complete resection are suggested, as it is a disease with good prognosis. Angiolipoma spinal epidural is a rare form of benign tumor, and the treatment of this pathology continues to be release and resection of the tumor, with a favorable prognosis, despite the delay in surgery, as in the case reported. Intratumoral bleeding should be considered a cause of acute spinal compression syndrome, as ocurred in our patient.
O angiolipoma espinhal é um tumor benigno incomum. Há 142 casos notificados, com apenas um de paraplegia aguda. Descrevemos o caso de um paciente de 39 anos com paraplegia aguda decorrente de angiolipoma espinal em T4-T5 com resolução cirúrgica três semanas após o início da síndrome neurológica. A recuperação neurológica pós-operatória foi completa. O angiolipoma consiste em células adiposas maduras e vasos sanguíneos anormais. Existem dois tipos: os não infiltrantes e os infiltrantes. Seu curso clínico é lento e progressivo, e pode ser acelerado por fenômenos vasculares, abcessos intratumorais e gravidez. Há somente um relato de hemorragia intratumoral espontânea e paraplegia aguda, coincidindo com o nosso caso. Não há consenso quanto ao tratamento, sugerindo-se a liberação e ressecção completa por ser uma doença de bom prognóstico. O angiolipoma espinal epidural é um tumor benigno incomum e o tratamento dessa patologia continua a ser a liberação e ressecção do tumor, que apresenta prognóstico favorável, apesar da demora da cirurgia, como no caso relatado. A hemorragia intratumoral deve ser considerada como causa da síndrome de compressão espinal aguda, como ocorreu com nosso paciente.
El angiolipoma espinal es una neoplasia benigna infrecuente. Hay 142 casos reportados y uno sólo de paraplejía aguda. Describimos un caso de un paciente de 39 años de edad de sexo masculino con paraplejía aguda por angiolipoma espinal T4-T5 con resolución quirúrgica tres semanas posteriores al inicio del síndrome neurológico. A recuperación neurológica postoperatoria fue completa. El angiolipoma se compone de células adiposas maduras y vasos sanguíneos anormales. Hay 2 tipos: no infiltrantes e infiltrantes. De curso clínico lento y progresivo que puede acelerarse mediante fenómenos vasculares, absceso intratumoral y el embarazo. Hay un solo reporte de hemorragia intratumoral espontánea y paraplejía aguda, coincidiendo con nuestro caso. No existe consenso para el tratamiento, sugiriéndose la liberación y resección total por ser una patología de buen pronóstico. Angiolipoma espinal epidural es un tumor benigno infrecuente siendo el tratamiento de ésta patología la liberación y resección tumoral con un pronóstico favorable, a pesar de la demora del acto quirúrgico como en el caso reportado. El sangrado intratumoral debe considerarse como causal de síndrome de compresión espinal agudo como ocurrió con nuestro paciente.