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This case report presents a rare instance of intrabronchial lipoma in a patient with active pulmonary tuberculosis. A tumor located in the right lower bronchus was unexpectedly discovered during a bronchoscopy. Following a biopsy, the histopathological analysis confirmed it to be a lipoma. After six months of regular anti-tuberculosis treatment, most of the patient’s tuberculosis lesions were absorbed. The lipoma in the right lower bronchus was completely removed using bronchoscopic High-frequency electric snare. After 339 days, a follow-up bronchoscopy revealed that only a few white scars remained in the wall of the right lower bronchus. The size of the lumen was unaffected, and there was no deterioration in the patient’s pulmonary tuberculosis. However, it remains unclear whether the removal of the right lower bronchial lipoma contributed to the recovery from pulmonary tuberculosis. Narrow Band Imaging (NBI) technology proved useful in safely guiding the High-frequency electric snare procedure.

Terminal myelocystocele (TMC) is a rare form of spinal dysraphism which arises due to aberration in the secondary neurulation process involving the caudal cell mass. Terminal myelocystocele has been defined by Pang et al. based on essential and non-essential features. One of the non-essential features includes non dysraphic lipomas which do not tether to the neural placode. We are presenting two cases which meets all the essential criteria outlined by Pang et al. for TMC but also show the presence of a lipomatous component tethering to the neural placode, similar to a dysraphic lipoma. Through this article, we want to showcase a subset which represents “true” terminal lipomyelocystocele (TLMC), bridging the spectrum of spinal dysraphism between TMC and lipomyelomeningocele (LMM).

Introduction Lipoma is one of the most common mesenchymal tumours. It is mostly benign in character. Those whose size is > 10 centimetres are called giant lipomas. Although its incidence is low in the extrathoracic axillary region, brachial plexus, and pectoral region, it also causes thoracic outlet syndrome (TOS), especially if it compresses the neurovascular bundle at the thoracic outlet. Case presentation A 51-year-old male patient was admitted to the hospital with pain, numbness, and tingling in his left arm that started three months ago. A mass measuring approximately 10 × 10 cm was found in the left lateral thoracic wall, in the region just inferior to the axilla and along the lateral border of the scapula. When the patient was in the supine position, the mass was observed to migrate to the axillary region. When the patient leaned forward, it was observed that the mass shifted towards the upper part of the pectoral muscle. There was paraesthesia and tingling in the fingertips of the left hand, however, muscle strength was normal. Adson’s and Wright’s tests were positive. Considering the symptoms in the left upper extremity, we decided to excise the lesion. On postoperative day one, the patient stated that the pain and tingling in the left extremity had significantly decreased. We observed that neurological complaints significantly decreased, and oedema regressed in the first postoperative month. In the third postoperative month, the patient stated that he had no complications. Conclusion There is no study in the literature reporting that lipoma seen outside the extrathoracic regions mentioned causes TOS. Particularly mobile and large-sized lipomas might cause compression of the neurovascular bundle in the thoracic outlet areas by pushing the tissues. We aimed to report the first case of TOS caused by a giant lipoma located on the lateral thoracic wall, just inferior to the axilla and outside the thoracic cavity.

Background Lipomyelomeningoceles (LMMs) are subcutaneous lipomas with dural penetration that often present with spinal cord tethering and may lead to neurological deterioration if untreated. This report describes a rare case of an LMM associated with immature nephroblastic tissue, representing a nephrogenic rest (NR) or, less likely, an immature teratoma. Clinical presentation An 8-day-old infant girl presented to the clinic with a sacral dimple. Imaging demonstrated a tethered spinal cord with low-lying conus medullaris and an LMM. A firm mass was noted in the subcutaneous lipoma. Detethering surgery and removal of the lipoma and mass were performed at the age of 6 months. Pathological examination identified the mass as cartilage, fat, and immature nephroblastic tissue consistent with NR tissue or, less likely, a teratoma with renal differentiation. Conclusion This presentation of an LMM associated with an immature teratoma or NR poses a risk of malignant transformation in patients. As a result, careful surgical dissection, resection, and close clinical follow-up are recommended for these patients.

Background Wilson’s disease (WD) is an inherited disorder of copper metabolism. Agenesis of the corpus callosum is the complete or partial absence of the major united fiber bundles connecting the cerebral hemispheres. Intracranial lipoma is an adipose tissue tumor resulting from an abnormal embryonic development of the central nervous system. The simultaneous occurrence of these three disorders is rare and has not been reported. This report focuses on the pathogenesis and association between the three disorders and highlights the importance of recognizing and effectively managing their coexistence. Case presentation The purpose of this study was to present a patient with coexisting WD, intracranial lipoma, and corpus callosum dysplasia. We reviewed a female patient hospitalized in 2023 with clinical manifestations of elevated aminotransferases and decreased ceruloplasmin, as well as genetic testing for an initial diagnosis of Wilson’s disease. Subsequently, a cranial MRI showed corpus callosum dysplasia with short T1 signal changes in the cerebral falx, leading to a final diagnosis of Wilson’s disease combined with intracranial lipoma and corpus callosum dysplasia. The patient’s WD is currently stable after treatment with sodium dimercaptosulfonamide (DMPS) and penicillamine, and the patient’s abnormal copper metabolism may promote the growth of intracranial lipoma. Conclusion The pathogenesis of WD combined with intracranial lipoma and corpus callosum dysplasia is complex and clinically rare. The growth of intracranial lipomas may be associated with abnormal copper metabolism in WD. Abnormal copper metabolism affects lipid metabolism and triggers inflammatory responses. Therefore, early diagnosis and treatment are beneficial for improvement. Each new case of this rare co-morbidity is important as it allows for a better assessment and understanding of these cases’ more characteristic clinical manifestations, which can help estimate the course of the disease and possible therapeutic options.

Epileptic seizure is the common symptom associated with lipomas in the Sylvian fissure (Sylvian lipomas). Removal of these lipomas carries risks of hemorrhage and brain damage. We report a surgical strategy of not removing the lipoma in a case of intractable temporal lobe epilepsy associated with Sylvian lipoma. We performed anterior temporal lobectomy with preservation of the pia mater of the Sylvian fissure and achieved seizure freedom. Focal cortical dysplasia type 1 of the epileptic neocortex adjacent to the Sylvian lipoma was pathologically diagnosed. We recommend our surgical procedure in similar cases to avoid complications and achieve adequate seizure control.

Background Gastrointestinal (GI) lipomas are benign, slow-growing subepithelial tumors. Most lipomas are detected incidentally at endoscopy, but they can cause GI bleeding, abdominal pain, intestinal obstruction, and intussusception, particularly if they are larger than 2 cm in diameter. The aim of this study was to investigate the efficacy, safety, and long-term prognosis of endoscopic treatment of GI lipomas. Methods A total of 28 GI lipomas treated endoscopically from January 2005 to June 2012 were retrospectively reviewed. Endoscopic treatment was performed by four methods: the unroofing technique, endoscopic mucosal resection (EMR), EMR after precutting (EMR-P), and endoscopic submucosal dissection (ESD). Results Of 28 GI lipomas, 5 were located in the stomach, 2 in the duodenum, and 21 in the colon. Thirteen lipomas were <2 cm in diameter (small lipoma), and the other 15 were ≥2 cm (large lipoma). The unroofing technique was performed in 2 cases, EMR in 17 cases, EMR-P in 4 cases, and ESD in 5 cases. En bloc resection was performed with 21 lesions (75 %), and endoscopic complete resection was achieved with 26 lesions (93 %). Incomplete resection occurred in the 2 cases treated by the unroofing technique. On pathologic examination, complete resection was achieved with 21 lesions (75 %). Delayed bleeding was observed in one patient. There were no serious complications such as perforation or post-procedural stricture. During the mean follow-up period of 19 months (range 2–91 months), no recurrence was observed. Conclusions Endoscopic treatment appears to be a safe and effective treatment for GI lipomas, including large lipomas (≥2 cm in diameter).

We report the case of a male in his early 30s who presented with a large prolapsed anal mass, a single episode of rectal bleeding and a 1 day history of lower abdominal pain. Contrast-enhanced CT imaging of the abdomen and pelvis revealed a 4.4 cm lipomatous mass protruding through the anal canal, originating from the sigmoid colon, which had intussuscepted into the rectum and anus. The patient was successfully managed with flexible sigmoidoscopy and excision of the mass. Histopathological examination confirmed the diagnosis of a colonic lipoma.

We report the case of a 34-year-old female who was evaluated for a right lower extremity soft-tissue mass, found to be a large cystic lesion bound by fibrous tissue containing innumerable, freely mobile nodules of fat. Her presentation suggested the diagnosis of nodular cystic fat necrosis (NCFN), a rare entity that likely represents a morphological subset of fat necrosis potentially caused by vascular insufficiency secondary to local trauma. Her lesion was best visualized using MRI, which revealed characteristic imaging features of NCFN including nodular lipid-signal foci that suppress on fat-saturated sequences, intralesional fluid with high signal intensity on T2-weighted imaging, and a contrast-enhancing outer capsule with low signal intensity on T1-weighted imaging. Ultrasound imaging offered the advantage of showing mobile hyperechogenic foci within the anechoic cystic structure, and the lesion was otherwise visualized on radiography as a nonspecific soft-tissue radiopacity. She was managed with complete surgical excision with pathologic evaluation demonstrating, similar to the radiologic features, innumerable free-floating, 1–5 mm, smooth, nearly uniform spherical nodules of mature fat with widespread necrosis contained within a thick fibrous pseudocapsule. Follow-up imaging revealed no evidence of remaining or recurrent disease on postoperative follow-up MRI. The differential diagnosis includes lipoma with fat necrosis, lipoma variant, atypical lipomatous tumor, and a Morel-Lavallée lesion. There is overlap in the imaging features between fat necrosis and both benign and malignant adipocytic tumors, occasionally making this distinction based solely on imaging findings challenging. To our knowledge, this is the largest example of NCFN ever reported.