Search Results (11)

This study investigates the usefulness of extemporaneous cytological examination performed during imaging-guided biopsies in dogs and cats. In veterinary diagnostics, imaging techniques such as ultrasound and computed tomography are essential for identifying lesions, but they cannot distinguish between inflammatory and neoplastic processes. Biopsies are therefore required, and this study explores whether immediate cytological evaluation of tissue cores, rolled onto slides and examined under a microscope, can help determine sample adequacy and reduce the number of biopsies needed. Seventy-nine animals with soft tissue or bone masses underwent ultrasound or CT-guided biopsies, followed by extemporaneous cytology and histopathological analysis. Cellular material representative of the lesion was identified in 81.1% of cases, allowing clinicians to conclude the procedure without further sampling. The diagnostic accuracy of cytology compared to histology was 68.3%, with particularly high accuracy for lipomas, melanomas, and mast cell tumors. When excluding non-diagnostic samples due to poor preparation or lesion characteristics, the accuracy reaches 92.1%. These findings suggest that extemporaneous cytology is a useful tool for verifying sample adequacy in real time, potentially reducing procedural risks and improving diagnostic efficiency. While histology remains the gold standard, this method offers immediate feedback and may enhance clinical decision-making in veterinary interventional diagnostics. Full article

Lipoma arborescens (LA) is a rare, non-neoplastic, intra-articular, mass-like lesion with villous lipomatous proliferation that replaces and distends the synovium, particularly in the knee joint. A few cases have been sporadically reported to affect the shoulder, elbow, wrist, hip, and ankle. The authors would like to present a rare and unique case of LA in the elbow joint with significant osteoarthritis in a 24-year-old young man, which suggests that a longstanding pre-existing LA can give rise to severe degenerative arthritis even in young patients unless diagnosed early and adequately treated. Full article

Background and Clinical Significance: Lipomas, benign tumors composed of adipose tissue, are recognized as one of the two most common fat-containing soft tissue tumors, underscoring their relative prevalence among benign tumors in children. Despite their prominence, lipomas rarely occur before 20 years of age, highlighting a discrepancy between their commonality and the age at which they typically manifest. This case report focuses on a 11-year-old patient who noticed the presence of an intraoral mass, which prompted further investigation, ultimately leading to the diagnosis of a lipoma located on the palate. Following our diagnosis, we searched for similar cases; however, the relevant literature was rather limited. There was a case report of a 4-year-old patient who presented with a lipoma on her tongue and a case report of a 6-year-old patient who presented with a lipoma on the buccal mucosa. Case Presentation: The young patient came with his parents to the Department of Oral Medicine and Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, and reported the presence of a growth in the middle of the upper jaw. A tumor, of approximately 1 cm diameter, was observed in the middle of the palate, on the border between the hard and soft palate. The surrounding mucosa appeared normal, which is critical in differentiating the tumor from more aggressive pathological entities. It was characterized by a soft and slippery consistency. The patient was referred to a cone beam computed tomography (CBCT) examination to investigate if there was any bone involvement. Based on clinical and radiographical findings, a biopsy was carried out. The tumor was initially excised in its entirety and the base was electrocauterized to avoid placing sutures. The histopathological examination that followed suggested the presence of an intraoral lipoma since lobules of mature adipose tissue in lamina propria and fatty tissue in close proximity to mucinous salivary glands were noticed. Conclusions: The development of lipomas in young patients can be attributed to a multitude of factors that interplay with one another, emphasizing the need for a comprehensive understanding of these growths. Additionally, underlying conditions such as diabetes mellitus, hypercholesterolemia, and obesity also play a crucial role, highlighting the interconnected nature of metabolic disorders and lipoma formation. The surgical approaches for the removal of oral lipomas primarily revolve around complete surgical excision, which is considered the mainstay treatment for these benign tumors. Full article

The rarity of foot and ankle tumours, together with the numerous histological entities, presents a challenge in accumulating sufficient patients to draw reliable conclusions. Therefore, we decided to present an update of a retrospective analysis of their distribution patterns, comprising 536 cases of foot and ankle tumours presented to our tumour board between June 1997 and June 2023. Our aim was to provide a comprehensive overview of the prevalence and distribution patterns of benign and malignant bone and soft tissue tumours of the foot and ankle. A total of 277 tumours involved bone (51.7%). Of these, 242 (87.4%) were benign and 35 (12.6%) were malignant. In addition, 259 soft tissue tumours (48.3%) were found, of which 191 (73.7%) were benign and 68 (26.3%) were malignant. The most common benign bone tumours were simple bone cysts, enchondromas, osteochondromas, aneurysmal bone cysts, and lipomas of bone. Common benign soft tissue tumours included a tenosynovial giant cell tumour, haemangioma, plantar fibromatosis, schwannoma, and lipoma. The most common malignant soft tissue tumours were synovial sarcoma, malignant melanoma, and myxofibrosarcoma. In terms of anatomical location, the hindfoot was the most common site (28.7%), followed by the midfoot (25.9%), ankle (25.4%), and forefoot (20.0%). The distribution of benign entities often follows typical patterns, which may facilitate an early diagnosis even without biopsy (e.g., simple bone cyst, plantar fibromatosis). On the other hand, the distribution patterns of many rare or malignant entities are inconsistent. Individual soft tissue malignancies occur very sporadically, even over long periods of time and in specialized tumour centres. It is therefore important to recognise that any suspicious mass in the foot and ankle must be considered a possible malignancy until proven otherwise. Full article

Infiltrative lipomas, which are locally invasive tumors composed of well-differentiated adipocytes, are histologically identical to lipomas but have a tendency to infiltrate adjacent muscle and fibrous tissue without metastasis, such as muscle; connective tissue; bone; and, in rare cases, peripheral nerves and the spinal cord. They differ from liposarcomas yet also exhibit neoplastic cell infiltration and often recur despite surgical removal. A 10-year-old spayed Maltese female dog presented with hindlimb paresis and back pain for two months. Computed tomography and magnetic resonance imaging revealed an extensive fatty mass impinging on the vertebral canal, compressing the spinal cord, and extending into the surrounding muscle layers and thoracic cavity. The mass was surgically removed, and subsequent postoperative computed tomography confirmed complete removal of the mass using Vitrea^® advanced visualization fat measurement. Histopathological analysis confirmed that the mass was an infiltrative lipoma. The patient’s symptoms completely resolved after surgery, with no recurrence reported at the 2-year follow-up. This case highlights the benefits of using postoperative computed tomography combined with the automated fat measurement technique to determine whether reoperation is necessary or to predict patient prognosis by identifying potential residual lipoma post-surgery. Full article

Simple bone cysts (SBCs) and intraosseous lipoma (IOL) of the calcaneus are rare tumor entities that are primarily diagnosed due to unspecific heel pain, incidental findings, or rarely due to pathological fractures. Compared to traditional open tumor resections, endoscopic resection of these benign tumors aims to minimize surgical morbidity and maximize surgical efficiency without compromising safety. Grafting is regularly performed to reduce the risk of recurrence and stimulate osseous consolidation of the lytic lesion. As the incidence is low and treatment strategies are heterogeneous, there is no clear consensus for the treatment of simple cysts or intraosseous lipomas of the calcaneus. The objectives of this study are (a) to present medium to long-term results after endoscopic resection and grafting with allogenic cancellous bone or bioresorbable hydroxyapatite and calcium sulfate cement, and (b) to add further evidence to the discussion of whether calcaneal SBC and IOL are the same entity at different developmental stages. Between 2012 and 2019, a total of 25 benign bone tumors consisting of 17 SBCs and 8 IOLs were treated by A.T. with endoscopic resection and grafting, comprising the largest cohort to date. For grafting, 12 patients received allogenic cancellous bone (group A) and 13 patients received injectable bone substitute (group B). Pre- and postoperative imaging using plain X-rays and MRI was retrospectively analyzed with a mean follow-up time of 24.5 months to assess tumor size, osseous consolidation (modified Neer classification), and tumor recurrence. A retrospective chart analysis focusing on adverse intra- and perioperative events and other complications associated with the surgical procedure was performed using the modified Clavien–Dindo classification (CD1-3). A total of 12/13 cases with allogenic bone grafting showed a Neer Type 1 osseous healing of the tumorous lesion after endoscopic resection, whereas only 5/11 cases with injectable bone substitute showed sufficient healing (types 1 and 2). There were three recurrent cysts (Neer 4) and two persistent cysts (Neer 3) after using injectable bone substitute. Two CD1 complications were observed in group A (prolonged wound drainage, sural neuritis) and eight complications were observed in group B (6× CD1, 2× CD3). At least two IOLs diagnosed preoperatively using MRI were ultimately identified as SBCs upon histopathologic examination. Allogenic cancellous bone grafting after endoscopic resection of calcaneal SBC or IOL showed a very low rate of complications and no tumor recurrence in our series. On the other hand, depending on the material used, injectable bone substitute showed a high rate of “white-out” (excessive drainage), resulting in multiple complications such as prolonged wound healing, insufficient permanent defect filling, recurrence, and revision surgery. Over time, calcaneal SBC may transform into IOL, exhibiting distinct features of both entities simultaneously during ossoscopy and histopathological analysis. Full article

Thyroglossal duct (TGD) remnants in the form of cysts or fistulas usually present as midline neck masses and they are removed along with the central body of the hyoid bone (Sistrunk’s procedure). For other pathologies associated with the TGD tract, the latter operation might be not necessary. In the present report, a case of a TGD lipoma is presented and a systematic review of the pertinent literature was performed. We present the case of a 57-year-old woman with a pathologically confirmed TGD lipoma who underwent transcervical excision without resecting the hyoid bone. Recurrence was not observed after six months of follow-up. The literature search revealed only one other case of TGD lipoma and controversies are addressed. TGD lipoma is an exceedingly rare entity whose management might avoid hyoid bone excision. Full article

Soft-tissue lesions in the oral cavity, one of the most common sites for tumors and tumor-like lesions, can be challenging to diagnose and treat due to the wide spectrum from benign indolent to invasive malignant lesions. We report an abnormally large, rapidly growing hyperplastic lesion originating from the buccal mucosa in a 28-year-old male patient. Clinical examination revealed a well-circumscribed, smooth-surfaced, pinkish nodular lesion measuring 2.3 × 2 cm, which suggested the differential diagnosis of irritation fibroma, pyogenic granuloma, oral lipoma, and other benign or malignant neoplasms such as hemangioma, non-Hodgkin’s lymphoma, or metastases to the oral cavity. Dental MRI using a 15-channel mandibular coil was performed to improve perioperative radiological and surgical management, avoiding adverse intraoperative events and misdiagnosis of vascular malformations, especially hemangiomas. Black bone MRI protocols such as STIR (short-tau inversion recovery) and DESS (double-echo steady-state) were used for high-resolution radiation-free imaging. Radiologic findings supported the suspected diagnosis of an irritation fibroma and ruled out any further head and neck lesions, therefore complete surgical resection was performed. Histology confirmed the tentative diagnosis. This article evaluates the use of this novel technique for MR diagnosis in the perioperative management of soft-tissue tumors in oral and maxillofacial surgery. Full article

Intraosseous lipomas are rare bone lesions that can affect any part of the skeleton. In the calcaneum, they are, generally, asymptomatic, but in some cases, patients may complain of pain, swelling or tenderness. Well-conducted radiography and MRI examinations can lead to an accurate diagnosis. In most cases, patients could benefit from conservative means of treatment, but in long-lasting symptomatic cases, surgical treatment may be a good option. The purpose of this article is to increase clinicians’ awareness of this lesion as a possible cause of heel pain and to describe a case of a symptomatic intraosseous lipoma of the calcaneum who underwent curettage and bone cement filling after failure of conservative treatment. Full article

Breed predispositions to canine digital neoplasms are well known. However, there is currently no statistical analysis identifying the least affected breeds. To this end, 2912 canine amputated digits submitted from 2014–2019 to the Laboklin GmbH & Co. KG for routine diagnostics were statistically analyzed. The study population consisted of 155 different breeds (most common: 634 Mongrels, 411 Schnauzers, 197 Labrador Retrievers, 93 Golden Retrievers). Non-neoplastic processes were present in 1246 (43%), tumor-like lesions in 138 (5%), and neoplasms in 1528 cases (52%). Benign tumors (n = 335) were characterized by 217 subungual keratoacanthomas, 36 histiocytomas, 35 plasmacytomas, 16 papillomas, 12 melanocytomas, 9 sebaceous gland tumors, 6 lipomas, and 4 bone tumors. Malignant neoplasms (n = 1193) included 758 squamous cell carcinomas (SCC), 196 malignant melanomas (MM), 76 soft tissue sarcomas, 52 mast cell tumors, 37 non-specified sarcomas, 29 anaplastic neoplasms, 24 carcinomas, 20 bone tumors, and 1 histiocytic sarcoma. Predisposed breeds for SCC included the Schnauzer (log OR = 2.61), Briard (log OR = 1.78), Rottweiler (log OR = 1.54), Poodle (log OR = 1.40), and Dachshund (log OR = 1.30). Jack Russell Terriers (log OR = −2.95) were significantly less affected by SCC than Mongrels. Acral MM were significantly more frequent in Rottweilers (log OR = 1.88) and Labrador Retrievers (log OR = 1.09). In contrast, Dachshunds (log OR = −2.17), Jack Russell Terriers (log OR = −1.88), and Rhodesian Ridgebacks (log OR = −1.88) were rarely affected. This contrasted with the well-known predisposition of Dachshunds and Rhodesian Ridgebacks to oral and cutaneous melanocytic neoplasms. Further studies are needed to explain the underlying reasons for breed predisposition or “resistance” to the development of specific acral tumors and/or other sites. Full article

Subcutaneous swelling as first clinical presentation of small cell lung carcinoma is uncommon and rarely reported in literature. This case highlights a rare presentation in which subcutaneous swelling was the first clinical manifestation of a small cell carcinoma of lung which also had metastasis to rib bone, muscle and pleural involvement as pleural effusion. We describe the case of a 64-year-old male patient who presented with dyspnea, pleuritic pain, loss of weight and nodule on his anterior chest, back and left arm suspicious of lipoma. Biopsies revealed small cell carcinoma of lung. This case demonstrates the meticulous work up of subcutaneous swelling in the clinical scenario of breathlessness, chest pain and loss of weight. Full article