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Introduction: Head and neck lipomas have seldom drawn attention in the literature, except in isolated case reports. Aims: This study aimed to assess the presentation variability of head and neck lipomas as well as the relative importance and efficiency of pre-operative diagnostic methods used. Materials and methods: A retrospective review was undertaken of medical records and imaging studies of 24 patients with histopathologically proven head and neck lipomas, over a three-year period. Results: The 24 patients had 26 lipomas. Men predominated (62.5 per cent). The posterior subcutaneous neck was the most common site. Three patients had deep lipomas affecting the hypopharynx, larynx and parotid gland; all were correctly diagnosed pre-operatively. Computed tomography (CT) scan with specific radiodensity recording was the preferred pre-operative investigation. Conclusions: Lipomas should be considered in the differential diagnosis of soft-tissue head and neck masses even in rare locations. A CT or magnetic resonance imaging scan can correctly diagnose a lipoma pre-operatively, thereby allowing better treatment planning.

This study evaluated the diagnostic accuracy of clinical, radiological, and histopathological examinations for differential diagnosis between atypical lipomatous tumor (ALT)/well-differentiated liposarcoma (WDLS) and lipoma, and aimed to develop a new combined scoring system for the preoperative diagnosis of ALT/WDLS. Eighty-nine lipomas and 56 ALT/WDLS were included and their clinical characteristics, magnetic resonance imaging (MRI) findings, histological findings by hematoxylin and eosin (HE) staining were investigated. Then, univariate and multivariate logistic regression analyses were performed for the findings, and a combined scoring system consisted of predictive factors of ALT/WDLS was developed. The univariate and multivariate logistic regression analyses revealed that tumor location (lower extremity), deep site, size (> 11 cm), thick septa (> 2 mm), enhancement of septa or nodular lesions, and lipoblasts were significantly different for the diagnosis of ALT/WDLS. We developed a combined scoring system based on the six predictive factors (total 0–16 points, the cutoff was 9 points). The area under the curve was 0.945, and sensitivity was 87.6% and specificity was 91.1% by the receiver operating characteristics curve. This combined scoring system does not require special equipment and reagents such as fluorescence in situ hybridization (FISH), and anyone can use it easily in many medical institutions with high diagnostic accuracy.

Cardiac lipoma is an uncommon primary cardiac tumor. With the advancement of diagnostic methods and treatment techniques, more cases of cardiac lipomas have been reported and suggest that the entity previously widely thought to display classic features may also show atypical findings. A systemic review of the rare cardiac tumor was done by searching the literature of cardiac lipoma. We endeavor to summarize the clinical features of the rare disease from pathogenesis to treatment. Literature of cardiac lipoma was retrospectively searched through PubMed and 255 cases of cardiac lipoma were included into this analysis. Cardiac lipomas can occur anywhere within the heart, 53.1% were located within the cardiac chambers, 32.5% in the pericardium, 10,7% within the myocardium and 3.7% involved multiple structures. More than half of the reported cardiac lipomas (66%) may be clinically symptomatic, presenting with symptoms ranging from chest discomfort to syncope depending on their size and location as well as extent of myocardial involvement. Noninvasive cardiac imaging has replaced the role of autopsy and cardiothoracic surgery in detection and diagnosis of cardiac lipomas. Most symptomatic patients (83.7%) were treated by resection of cardiac lipomas and 68.3% of asymptomatic patients also underwentprophylactic resection. Overgrowth and myocardial infiltration of lipomas may result in unsuccessful resection. Recurrence of cardiac lipomas was rare but reported in a few cases. The early detection and accurate diagnosis of cardiac lipoma is of great significance in clinical management, to avoid an unfavourable outcome due to overgrowth.

Background Lipomatous tumors represent the most common type of soft tissue neoplasms. Mouse double minute 2 homolog (MDM2)/cyclin-dependent kinase 4 (CDK4) immunostaining is considered effective in differentiating between benign lipomas and intermediate malignant atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLPSs). However, these tumors have traditionally been diagnosed histopathologically using hematoxylin and eosin-stained specimens, which is referred to here as morphological diagnosis. In this study, the accuracy of morphological diagnoses that had been made before MDM2/CDK4 immunostaining became available for distinguishing between lipoma and ALT/WDLPS was examined. Methods The study participants were 109 patients with a morphological diagnosis of lipoma (68 patients) or ALT/WDLPS (41 patients) who had undergone surgical resection of the tumor in our hospital between 2009 and 2012. Tissue samples from all patients were used for MDM2/CDK4 immunostaining and the confirmation of MDM2/CDK4 amplification by fluorescence in situ hybridization (FISH). Results Of the 41 patients with a morphological diagnosis of ALT/WDLPS, only 17 were positive for MDM2 FISH. In addition, one of the 68 patients with a morphological diagnosis of lipoma showed MDM2 amplification by FISH. When the definitive diagnosis of ALT/WDLPS was made by the positive results of MDM2 FISH, the sensitivity and specificity of morphological diagnosis were 41.5% and 98.5%, respectively. The sensitivity of MDM2 and CDK4 immunostaining was 55.6% and 40.0%, respectively, and their specificity was 87.0% and 84.6%, respectively. This indicates that the diagnostic accuracy of these immunostaining assays was not particularly high. The clinical features suggesting ALT/WDLPS were: patient age (older), maximum tumor diameter (large, cut-off value of 125 mm), tumor location (lower limb), and tumor depth (deep-seated). Conclusions Morphological diagnosis alone can accurately diagnose lipomas. However, it has a propensity to overdiagnose ALT/WDLPS. Thus, MDM2 FISH should be used more proactively, not only for lesions with obvious morphological abnormalities, but also for lipomatous tumors that are clinically suggestive of ALT/WDLPS.

This study evaluated the diagnostic value of clinicopathological features and immunohistochemical markers for distinguishing lipomas from atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLPS). An integrated diagnostic model for ALT/WDLPS was developed to guide diagnosis, treatment planning, and prognosis. This retrospective analysis included 216 patients with lipomatous tumors diagnosed between February 2018 and December 2024, including lipomas ( n  = 149), spindle cell lipomas ( n  = 3), ALTs/WDLPs ( n  = 62), and WDLPS with a low-grade de-differentiated component ( n  = 2). Immunohistochemical data for MDM2, CDK4, and p16 were available for 131 patients. MDM2 amplification was significantly more frequent in patients ≥ 55 years and in tumors of the lower limbs (the thigh) and retroperitoneum ( p  = 0.000). Larger tumor size and multiplicity were also associated with MDM2 amplification ( p  < 0.05). Immunohistochemistry sensitivities for ALT/WDLPS vs. lipomas: 65% (MDM2), 100% (CDK4), and 80.4% (p16); combined, the specificity was 100% and sensitivity 85.6%. The diagnostic model achieved 93.3% sensitivity and 72.2% specificity. Scores < 0.219 indicated a higher likelihood of lipoma, while scores > 0.652 indicated a higher likelihood of liposarcoma. Age ≥ 55 years, lower extremity/retroperitoneal location, tumor diameter ≥ 9.9 cm, and positive markers were independent risk factors. This model provides an effective tool for ALT/WDLPS identification.

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.

Gastrointestinal (GI) lipomas are rare; however, they are frequent enough to be considered in the differential diagnosis of gut tumours. Here, we present our experience with GI lipomas managed at our institute over the last three years. This is a retrospective cohort study of patients with GI lipomas managed between January, 2020 and April, 2023 at a tertiary care centre. Clinical presentation, location, and details of surgical procedure were analysed. Ten patients were included, six of whom had lipoma in the colon, one in the stomach, and one each in the duodenum, jejunum, and ileum. The mean age at the time of presentation was 48.8 years (range, 19-77 years), and strong male preponderance (4:1) was noted. Preoperative diagnosis of lipoma on cross-sectional imaging was possible in all patients. All patients were symptomatic and were managed surgically. While GI lipomas are generally considered to be indolent and benign tumours, they can potentially lead to severe complications. The utilisation of computed tomography and magnetic resonance imaging has brought about a significant transformation in diagnosing this condition, enabling preoperative identification in most cases. The surgery offers a definitive treatment with minimal risk of postoperative complications.

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 Cardiac lipoma, a seldom-encountered benign tumor positioned beneath the endocardium, has the potential to impair electrophysiological functions. Diagnosis is principally based on imaging modalities. The uniqueness of this case lies in the tumor’s extension both internally and externally within the right atrium, rendering it of special interest. From a clinical standpoint, surgical removal is commonly advocated, wherein early intervention is pivotal in improving patients’ long-term prognoses. Case presentation A 35-year-old male was admitted to the hospital for treatment subsequent to the identification of a cardiac mass two days prior. Initial diagnostic assessments, encompassing CT scans and echocardiography, identified a space-occupying lesion within the heart. The patient underwent surgical excision of the cardiac tumor, utilizing mild hypothermic extracorporeal circulation via femoral vessel access. Intraoperative findings revealed adipose-like tissue of a “dumbbell-shaped” configuration situated both within and external to the right atrium, measuring approximately 8 cm*9 cm internally and 7 cm*6 cm externally, with the extracardiac mass being marginally larger. Postoperative pathological analysis confirmed a cardiac lipoma diagnosis. A follow-up echocardiogram conducted three months post-surgery exhibited no notable abnormalities. The patient is under continuous observation to monitor for any recurrence or potential long-term complications. Conclusion In this case report, we detail with precision a rare cardiac pathology manifested by an expansive infiltrative lipoma that pervades the endocardial and epicardial layers of the right atrium. After thorough preoperative diagnostic workup and evaluation, we contend that surgical intervention represents the optimal therapeutic approach for managing such conditions, with the goal of preemptively reducing the likelihood of cardiac compression or intracardiac obstruction.