RESUMO
Colonic lipomas are infrequent, benign, non-epithelial, fatty neoplasms. Most of the colonic lipomas are asymptomatic, but around 25% of patients may develop symptoms. Nowadays, surgical resection of the involved segment is the treatment of choice. We report three cases of colonic intussusceptions caused by colonic lipomas in adult patients. The patients underwent surgical resection, and the diagnosis was confirmed by histopathological examination of the specimens.
Los lipomas colónicos son neoplasias benignas, adiposas, no epiteliales poco frecuentes. La mayoría de los lipomas de colon son asintomáticos, pero alrededor del 25% de los pacientes pueden desarrollar síntomas. En la actualidad, la resección quirúrgica del segmento afectado es el tratamiento de elección. Presentamos tres casos de intususcepción intestinal secundaria a lipomas colónicos en pacientes adultos. Los pacientes fueron sometidos a resección quirúrgica y el diagnóstico se confirmó mediante examen histopatológico.
Assuntos
Neoplasias do Colo , Intussuscepção , Lipoma , Adulto , Neoplasias do Colo/complicações , Humanos , Intussuscepção/diagnóstico por imagem , Intussuscepção/etiologia , Intussuscepção/cirurgia , Lipoma/complicações , Lipoma/diagnóstico por imagem , Lipoma/cirurgiaRESUMO
BACKGROUND: Thymic tumors are unusual neoplasms, representing 0.2 to 1.5% of tumors in humans, but correspond to 20% of mediastinal tumors and 50% of those that occur in the anterior mediastinum. They tend to appear around the fourth and fifth decades of life without gender predilection. Up to 30% of patients are asymptomatic, therefore many are incidentally diagnosed. Radical thymectomy is the treatment of choice with high survival rates when detected in the early stages. METHODS: This was a retrospective descriptive study, including 18 adult patients' diagnosis of thymic neoplasm, who were managed with surgical resection from 2011 to 2019. Information about demographics, clinical characteristics, imaging findings, surgical and medical management, plus histological findings was obtained and reported. RESULTS: 18 patients with thymic tumors were included, of which specific histologic studies reveled thymomas, carcinomas, neuroendocrine tumors, thymolipoma and thymic cyst. Mean age was 52.7 years, with a predominance of male population. The main symptom was dyspnea, followed by cough and chest pain. Paraneoplastic syndromes such as myasthenia gravis, aplastic anemia and Cushing syndrome were reported. 89% of cases were treated by radical thymectomy alone, while only 2 cases required chemotherapy and radiotherapy. There were no surgical complications. Mean hospital stay length was 11. 9 days, with only 1 mortality during hospital admission. 5-year survival rate was 81%. CONCLUSIONS: The treatment of choice is radical thymectomy, which has been shown to positively impact patient mortality. Early detection is key to improve patient outcomes.
Assuntos
Síndromes Paraneoplásicas/epidemiologia , Timectomia , Timo/patologia , Neoplasias do Timo/cirurgia , Idoso , Carcinoma/complicações , Carcinoma/diagnóstico , Carcinoma/mortalidade , Carcinoma/cirurgia , Colômbia/epidemiologia , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Lipoma/complicações , Lipoma/diagnóstico , Lipoma/mortalidade , Lipoma/cirurgia , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/mortalidade , Tumores Neuroendócrinos/cirurgia , Síndromes Paraneoplásicas/etiologia , Estudos Retrospectivos , Taxa de Sobrevida , Timoma/complicações , Timoma/diagnóstico , Timoma/mortalidade , Timoma/cirurgia , Timo/diagnóstico por imagem , Timo/cirurgia , Neoplasias do Timo/complicações , Neoplasias do Timo/diagnóstico , Neoplasias do Timo/mortalidadeRESUMO
Retroperitoneal lipomas are extremely rare with few cases reported so far in the literature. They can reach different sizes and present with a variety of symptoms. The differential diagnosis is mainly with well-differentiated liposarcoma (WDLPS). We present a 34-year-old woman with a retroperitoneal lipoma herniating through the inguinal canal into the proximal thigh. The patient underwent complete oncological resection using a Karakousis's abdominoinguinal incision. Retroperitoneal lipomas are a very rare condition and sometimes require resections technically challenging. MDM2 amplification is critical for its differential diagnosis with WDLPS.
Assuntos
Hérnia Inguinal/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Neoplasias Retroperitoneais/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Feminino , Hérnia Inguinal/etiologia , Hérnia Inguinal/patologia , Hérnia Inguinal/cirurgia , Humanos , Lipoma/complicações , Lipoma/patologia , Lipoma/cirurgia , Lipossarcoma/diagnóstico , Neoplasias Retroperitoneais/complicações , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Tomografia Computadorizada por Raios X , Carga TumoralRESUMO
BACKGROUND: Lipomas are the most common form of benign soft tissue neoplasms and most frequently occur in the subcutaneous tissue. Rarely does a lipoma primarily arise from the arteries or veins. The most common location for an intravascular lipoma is the inferior vena cava, and rarely lipomas originate in the superior vena cava (SVC). Large lipomas of the SVC may be associated with central venous occlusive symptoms. There are only 7 cases of SVC lipomas reported in the literature. Here, we present only the second case of a large symptomatic lipoma located in the SVC, right internal jugular vein, and innominate veins. METHODS: We present a case of a 5-cm lipoma located in the SVC, discovered incidentally and surgically resected via median sternotomy. RESULTS: The patient underwent a successful open surgical resection of a symptomatic lipoma located in his SVC. CONCLUSIONS: Lipomas of the SVC are exceptionally rare, with only 7 cases described in the literature. This case demonstrates that lipomas can be safely excised from the SVC leading to resolution of central venous occlusive symptoms. A comprehensive literature review reveals that surgical resection is generally without complication, leads to resolution of symptoms, and does not require long-term follow-up.
Assuntos
Lipoma/cirurgia , Neoplasias Vasculares/cirurgia , Procedimentos Cirúrgicos Vasculares , Veia Cava Superior/cirurgia , Humanos , Lipoma/complicações , Lipoma/diagnóstico por imagem , Lipoma/patologia , Masculino , Pessoa de Meia-Idade , Esternotomia , Resultado do Tratamento , Carga Tumoral , Neoplasias Vasculares/complicações , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/patologia , Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/patologiaAssuntos
Humanos , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/diagnóstico por imagem , Apneia Obstrutiva do Sono/cirurgia , Apneia Obstrutiva do Sono/etiologia , Apneia Obstrutiva do Sono/diagnóstico por imagem , Lipoma/cirurgia , Lipoma/complicações , Lipoma/diagnóstico por imagemRESUMO
ANTECEDENTES: Los lipomas gástricos corresponden al 5% de los lipomas gastrointestinales. Muchos de ellos son solitarios, pequeños y asintomáticos, pero también pueden ocasionar síntomas obstructivos y sangrados. El tratamiento estándar es quirúrgico. CASO CLÍNICO: Mujer de 50 años con antecedente de obesidad mórbida, índice de masa corporal de 47.4 kg/m2, que se presenta con síntomas de epigastralgia y anemia. Se diagnostica un lipoma gástrico de 6.3 cm mediante tomografía y se confirma por biopsia endoscópica. DISCUSIÓN: La paciente fue exitosamente tratada a través de gastrectomía laparoscópica en manga. CONCLUSIÓN: La gastrectomía laparoscópica en manga es el procedimiento de elección para el tratamiento de los lipomas gástricos gigantes en los pacientes con obesidad mórbida cuando la anatomía lo permite. BACKGROUND: Gastric lipomas account for 5% of all gastrointestinal lipomas. Most of them are solitary, small and asymptomatic, however, they can cause severe symptoms such as obstruction, bleeding and intussusception. The standard treatment is surgical resection. CASE REPORT: 50 years old female with history of morbid obesity with a body mass index (BMI) of 47.4 Kg/m2, who presented with symptoms of epigastric pain and anemia. CT scan of the abdomen revealed a 6.3 cm gastric lipoma, confirmed by endoscopic biopsy. DISCUSSION: Laparoscopic sleeve gastrectomy is the procedure of choice for the excision of giant gastric lipomas in the morbidly obese, when anatomically feasible.