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      • Record: found
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      A rare case of chest wall lipoma growing into the pleural cavity: a case report

      case-report

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          Abstract

          Background

          Several cases of lipoma in unusual locations in the thorax have been reported. Appropriate surgical treatment depending on the location and shape is often required.

          Case presentation

          We herein report an extremely rare case of a chest wall lipoma growing into the pleural cavity. The tumor was successfully removed without damaging the capsule by a combination of direct and thoracoscopic approaches.

          Conclusions

          Chest wall lipomas growing into pleural cavity can be successfully treated by a combination of direct and thoracoscopic approaches.

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          Most cited references18

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          Lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas): results of MRI evaluations of 126 consecutive fatty masses.

          C. Helms, M Gaskin (2004)
          Our objectives were to evaluate the reliability of MRI in distinguishing simple lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas) and to identify various imaging mimics of well-differentiated liposarcoma. One hundred twenty-six consecutively imaged grossly fatty masses were retrospectively reviewed. MRI examinations, their prospective interpretations, and their corresponding pathology reports were compared to determine the reliability of MRI in distinguishing simple lipomas, lipoma variants, and well-differentiated liposarcomas. The success of MRI in identifying well-differentiated liposarcomas among other fatty masses was as follows: sensitivity, 100%; specificity, 83%; accuracy, 84%; positive predictive value, 38%; and negative predictive value, 100%. MRI was 100% specific in the diagnosis of simple lipoma. Sixty-three percent of lesions considered suspicious for well-differentiated liposarcoma were actually simple lipomas (13%) and benign lipoma variants (50%), including chondroid lipoma (13%), osteolipoma (6%), hibernoma (6%), lipoleiomyoma (6%), angiolipoma (6%), and infarcted lipoma (13%). Because of differences in treatment, prognosis, and long-term follow-up, it is important to preoperatively distinguish simple lipomas from well-differentiated liposarcomas. MRI is highly sensitive in the detection of well-differentiated liposarcomas and highly specific in the diagnosis of simple lipomas. However, when an extremity or body wall lesion is considered suspicious for well-differentiated liposarcoma, it is more likely (64%) to represent one of many benign lipoma variants.
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            Can Experienced Observers Differentiate between Lipoma and Well-Differentiated Liposarcoma Using Only MRI?

            Patrick W. O'Donnell, Anthony M. Griffin, William C. Eward … (2013)
            Well-differentiated liposarcoma represents a radiographic diagnostic dilemma. To determine the accuracy, interrater reliability, and relationship of stranding, nodularity, and size in the MRI differentiation of lipoma and well-differentiated liposarcoma, MRI scans of 60 patients with large (>5 cm), deep, pathologically proven lipomas or well-differentiated liposarcomas were examined by 10 observers with subspecialty training blinded to diagnosis. Observers indicated whether the amount of stranding, nodularity, and size of each tumor suggested a benign or malignant diagnosis and rendered a diagnosis of lipoma or well-differentiated liposarcoma. The accuracy, reliability, and relationship of stranding, nodularity, and size to diagnosis were calculated for all samples. 69% of reader MRI diagnoses agreed with final pathology diagnosis (95% CI 65–73%). Readers tended to err choosing a diagnosis of liposarcoma, correctly identifying lipomas in 63% of cases (95% CI 58–69%) and liposarcomas in 75% of cases (95% CI 69–80%). Assessment of the relationship of stranding, nodularity, and size to correct diagnosis showed that the presence of each was associated with a decreased likelihood of a lipoma pathological diagnosis (P < 0.01). While the radiographic diagnosis of lipoma or well-differentiated liposarcoma cannot be made with 100% certainty, experienced observers have a 69% chance of rendering a correct diagnosis.
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              Atypical lipomatous tumor/well-differentiated liposarcoma of the extremity and trunk wall: importance of histological subtype with treatment recommendations.

              Murray F. Brennan, David Kooby, Samuel Singer … (2003)
              This study defines the behavior and classification of atypical lipomatous tumors (ALT) and well-differentiated liposarcomas (WDLS) of the extremity and trunk. A total of 91 well-differentiated lipomatous tumors of the extremity and trunk were identified from a soft tissue tumor database between July 1982 and June 2001. A soft tissue pathologist, blinded to prior diagnosis and clinical outcome, reviewed histology. Those composed predominantly of mature adipose tissue with scattered atypical stromal cells and scant lipoblasts or fibrosis were ALTs. Tumors with lipoblasts but /=25% fibrosis were identified as sclerosing WDLS. Clinical factors were analyzed to assess effects on local recurrence-free survival (LRFS). Histological review identified 34 ALTs and 57 WDLSs. Of the WDLSs, 29 were lipoma-like and 28 were sclerosing. Five-year and 10-year LRFS were 100% +/- 0% and 78% +/- 9%, respectively. Factors evaluated were age, sex, tumor site, tumor size, histology, presentation status, margin status, and adjuvant radiotherapy. Positive resection margins and sclerosing histology were associated with reduced LRFS. Dedifferentiation was observed in three tumors (3%). Lipoma-like WDLSs and ALTs share similar histological features and favorable behavior. Margin-positive sclerosing WDLSs have a 10-year LRFS of only 17% and should undergo function-preserving re-excision when possible, or adjuvant radiotherapy.
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                Author and article information

                Contributors
                Seong Oh. Park:
                ORCID: http://orcid.org/0000-0001-8990-0635
                psopark950@gmail.com
                Journal
                Journal ID (nlm-ta): J Cardiothorac Surg
                Journal ID (iso-abbrev): J Cardiothorac Surg
                Title: Journal of Cardiothoracic Surgery
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1749-8090
                Publication date (Electronic): 12 July 2021
                Publication date PMC-release: 12 July 2021
                Publication date Collection: 2021
                Volume: 16
                Electronic Location Identifier: 197
                Affiliations
                [1 ]GRID grid.49606.3d, ISNI 0000 0001 1364 9317, Department of Thoracic and Cardiovascular Surgery, , Hanyang University College of Medicine, ; Seoul, South Korea
                [2 ]GRID grid.49606.3d, ISNI 0000 0001 1364 9317, Department of Plastic and Reconstructive Surgery, , Hanyang University College of Medicine, ; Seoul, South Korea
                Author information
                http://orcid.org/0000-0001-8990-0635
                Article
                Publisher ID: 1576
                DOI: 10.1186/s13019-021-01576-x
                PMC ID: 8274025
                PubMed ID: 34247638
                SO-VID: a63f0803-37aa-4cfd-b7f5-0a5cfbed103d
                Copyright © © The Author(s) 2021
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 3 September 2020
                Date accepted : 3 July 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002380, Hanyang University;
                Award ID: 2020
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                ScienceOpen disciplines: Surgery
                Keywords: lipoma,chest wall lipoma,deep-seated lipoma,dumbbell shape
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: lipoma, chest wall lipoma, deep-seated lipoma, dumbbell shape

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