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Duodenal angiolipoma is a rare adipocytic tumor, with non-specific symptoms precluding an early diagnosis. We present a case of a 67-year-old female admitted due to upper gastrointestinal bleeding. The upper endoscopy and endoscopic ultrasound evaluation showed a subepithelial lesion in the third portion of the duodenum. Endoscopic excision was performed using a standard polypectomy technique after endoloop placement. Histopathology was compatible with duodenal angiolipoma. The authors highlight duodenal angiolipoma as a rare adipocytic tumor potentially causing gastrointestinal bleeding, which can be safely treated with endoscopic excision.

A 83-year-old woman with previous history of gallstone was hospitalized with intermittent melena of 1-week duration. Gastroscopy showed a protuberant mass with thick pedicle and superficial ulcer measuring 3.0 × 4.0-cm in the lower gastric body (Fig. 1. A). Biopsy of the ulcer indicated chronic inflammation without evidence of malignancy. Abdominal contrast-enhanced computed tomography demonstrated a well-defined and mixed density mass with heterogeneous enhancement in the gastric body. The final diagnosis was gastric angiolipoma.

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Purpose: Spinal angiolipomas are benign spinal epidural tumors consisting of mature fat cells with angiomatous components. These tumors are rare in children and there are no definite management guidelines., Method: To the best of our knowledge, only five cases of spinal angiolipomas have been reported in children below 12 years. This article discusses the presentation, diagnostics, and surgical tips for the management of a case of spinal angiolipoma., Result: In this paper, we present a one and half-year-old child presenting with a spontaneous spinal epidural hematoma from a spinal angiolipoma and underscore the importance of early surgery in a benign disease for a good outcome., Conclusion: Overall neurological recovery and prognosis following timely intervention for spinal angiolipomas are good.

A 63-year-old woman presented to the emergency unit with a huge (40 × 35 × 10 cm) oval-shaped pedunculated growth in the back with superficial ulceration in its lower aspect, associated with signs of sepsis. After adequate resuscitation, the patient was transferred to the operation theatre where the tumour was completely excised and the resultant wound was closed in primary manner using polypropylene sutures with suction drains inserted in the wound bed. The patient was discharged home after two days and was followed-up for two months. No wound complications were recorded on follow-up. Angiolipoma is a benign variant of lipoma that, despite what has been reported in the literature, may affect any age and any region of the body. Complications of angiolipoma may include ulceration, sepsis, gangrene and possible systemic inflammatory response syndrome which may pose a threat to the patient's life, hence should be managed promptly after adequate patient preparation.

Background: The aim of our study was to report our experience in the classification and therapeutic management strategies for spontaneous perirenal hemorrhage (SPH)., Methods: From September 2005 to April 2015, 20 patients with SPH were newly diagnosed in our hospital. Their clinical features, image findings, identification of underlying causes, and therapeutic management were retrospectively analyzed, and relevant literature was reviewed. In this study, patients were classified according to the degree of severity of the disease or emergency imaging diagnosis of underlying causes. On the basis of the former, patients were classified as critical and noncritical, and on the basis of the latter, patients were classified as renal cell carcinoma (RCC), undefined solid neoplasm, angioleiomyolipoma (AML), and unknown cause., Results: In the acute stage, contrast-enhanced computed tomography (CT) was superior to ultrasonography for both diagnostic accuracy of SPH (p = 0.02) and etiology discovery power (p = 0.004). The results of contrast-enhanced magnetic resonance imaging (MRI) were identical to those of contrast-enhanced CT. We summarized a flowchart in the whole classification and therapeutic strategies of SPH. According to the imaging diagnosis of underlying causes, all the patients with undefined solid neoplasm or RCC underwent emergency operation. Patients with AML or unknown cause underwent selective arterial embolization (SAE) or conservative management according to the critical degree. Acute hemorrhage was controlled in 19 cases, of which 14 were cured by the operation and only one critical patient with severe shock died shortly despite rescue efforts., Conclusions: Contrast-enhanced CT or MRI is the first choice of imaging examination, which could not only accurately diagnose SPH but also detect the underlying causes. Choice of therapeutic strategies for SPH should vary according to the identification of critical patients and imaging diagnosis of underlying cause., (Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: Spinal angiolipomas are rare epidural tumours that are usually revealed by chronic symptoms of medullar irritation. We report a case of acute paraplegia caused by spontaneous bleeding revealing a thoracic angiolipoma., Case Description: A 17-year-old male patient with no previous medical history was admitted for acute onset of paraplegia with bladder retention and loss of sensation in the lower limbs, preceded by dorsal pain during the three previous days. MRI showed an enhanced T1-weighted image of a T7-T12 epidural lesion. The T1-weighted isosignal and the T2-weighted hyposignal suggested haemorrhagic complications. Due to a mass effect on the spinal cord, an emergency laminectomy was performed. Histopathological examination of the lesion revealed an angiolipoma with spontaneous bleeding. Clinical outcome was favourable after two months., Conclusion: This case is one of the first to be reported, although the clinical presentation is similar to that of other rare reported cases of paraplegia due to spinal compression by tumoural bleeding., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Colonic intussusception is an uncommon phenomenon in adults. Advanced imaging has facilitated the increase in awareness of this rare disease. When present, the lead point is most often secondary to a malignancy with primary adenocarcinoma being the most frequent cause. Current surgical management involves oncologic resections for this reason. This is a report of the third ever-reported case of colonic intussusception secondary to an angiolipoma and the first in the western hemisphere. We also demonstrate that these masses are amenable to minimally invasive resection for definitive management., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

The Klippel-Feil syndrome is a congenital malformation of the skull flap involving complex cervical vertebrae and organs, characterized by a classic triad: short neck, limitation of movement of the head due to cervical spine fusion and low hairline in occipital region. It results from an error in the axial skeleton segmentation of the embryo; its incidence is estimated at 1/40,000-42,000 births and predominates in females. The aim of this paper is to describe the clinical picture of a patient with Klippel-Feil syndrome and multiple malformations, including tracheoesophageal fistula, bifid thumb and intracranial lipomas/angiolipomas,that have not been previously described in the syndrome, so it is considered an exceptional finding., (Sociedad Argentina de Pediatría.)

Spinal angiolipomas are fairly infrequent benign tumours that are usually located in the epidural space of the thoracic column and represent 0.14% to 1.3% of all spinal tumours. Lumbar angiolipomas are extremely rare, representing only 9.6% of all spinal extradural angiolipomas. We report the case of a woman who complained of a lumbar pain of several months duration with no neurological focality and that had intensified in the last three days without her having had any injury or made a physical effort. The MR revealed an extradural mass L1-L2, on the posterior face of the medulla, decreasing the anteroposterior diameter of the canal. The patient symptoms improved after surgery. Total extirpation of the lesion is possible in most cases, and the prognosis is excellent even if the lesion is infiltrative. For this reason, excessively aggressive surgery is not necessary to obtain complete resection., (Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.)

Epidural angiolipomas are uncommon benign tumors of the spine. Their clinical presentation is usually a progressive spinal cord compression. We report the case of a 22-year-old patient who presented with an acute paraparesis and a spontaneous epidural hematoma, which revealed a epidural angiolipoma which extended from C7 to T3. The patient underwent a C7-T3 laminectomy, in emergency, with evacuation of the hematoma and extradural complete resection of a fibrous epidural tumor bleeding. The postoperative course was favorable with regression of neurological symptoms. Epidural angiolipomas can be revealed by spontaneous intratumoral hemorrhage without traumatism. The standard treatment is total removal by surgery., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

A woman in her mid-50s presented with a 3-month history of upper abdominal pain. Initial examination using ultrasound was unremarkable and the patient was sent home. The patient returned 8 days later and CT imaging revealed intussusception as the cause of her symptoms. The involved bowel was surgically reduced and transected with the lead point found to contain a 3 cm mass. Histological examination revealed the mass to be an angiolipoma. To the best of our knowledge, this is the first reported case of adult jejunojejunal intussusception secondary to angiolipoma., (2015 BMJ Publishing Group Ltd.)

We report a 58-year-old man presenting with acute paraplegia. MRI showed a haematoma within a well-defined epidural lesion at C7-D1. Intraoperatively, organised epidural haematoma surrounded by tumour tissue was found. The final histopathology report was angiolipoma. The patient had dramatic recovery. Angiolipomas should be considered in the differential diagnosis of acute paraplegia when imaging shows well-circumscribed haematoma., (2014 BMJ Publishing Group Ltd.)

Intussusception in adults is rare and more common in the paediatric population. Clinically, most adult patients have chronic non-specific symptoms due to partial obstruction. In contrast, most paediatric patients present with the classic triad of abdominal pain, vomiting and blood in stool. Adult intussusception is commonly associated with an organic aetiology, most likely a benign or malignant neoplasm as a lead point of intussusception. We describe a case of a 29-year-old woman with subacute presentation due to ileoileal intussusception secondary to a polypoid submucosal angiolipoma. Angiolipoma is a benign lesion composed of mature adipose tissue and thin-walled capillaries. The presence of thin-walled vessels differentiates it from a lipoma. Angiolipomas of the small intestine are extremely rare with very few reported cases. This case not only demonstrates an unusual benign lesion as a cause of intussusception, but also illustrates an atypical clinical presentation in adults with intussusception.

Angiolipomas are frequently observed benign tumors. They have a typical vascular component and are often located in subcutaneous tissues, and more rarely, in the gastrointestinal tract. We present the case of a 58-year-old man who complained of abdominal discomfort in the left lower quadrant and two to three bloody stools a day without any obvious etiology. These symptom became more severe in the next three days, due to a large angiolipoma located in the descending colon, which was diagnosed intraoperatively. In a literature review, we found only 22 cases of angiolipomas involving the gastrointestinal tract which are reported in the literature from 1960 to 2012 in PubMed; the key words used in the search are gastrointestinal tract angiolipoma, esophagus, stomach, duodenum, intestine, ileocecal junction, colon, rectum angiolipomas. Colon angiolipoma with intussusception, as seen in this case, is rare and may require emergent surgical intervention.

Angiolipoma is a rare, benign variant of lipoma; its distinctive feature is its prominent vascularity. It presents as a subcutaneous nodule of white adipose tissue; pain, which may be exacerbated by pressure, is the chief symptom. The anatomic distribution predominantly involves the trunk and extremities. Because of the rarity of this condition in otorhinolaryngology, our understanding of its diagnosis, treatment, and follow-up is limited. Microscopically, two different histopathologic forms of angiolipomas exist: circumscribed and infiltrating. The diagnosis of angiolipoma can be aided by ultrasound, computed tomography, or magnetic resonance imaging. Surgical excision remains the treatment of choice. Sites of previously reported otolaryngologic cases include the cheek, palate, mandible, nasal septum, and cervical area. We describe what we believe to be the second case of a nasal tip angiolipoma in a 78-year-old woman complaining of progressive aesthetic deformity.

A 26-year-old woman in week 31 of pregnancy presented to the emergency room with acute onset of paraplegia. Her medical history was unremarkable. Neurological examination revealed complete paraplegia, total sensory loss below the T7 dermatome, and significant vesicorectal dysfunction. MRI revealed an intraspinal mass from T3 to T4, which was hyperintense on both T1-weighted and T2-weighted images. Blood examination found no abnormality. She underwent emergent hemilaminectomy and removal of the hematoma. Intraoperatively, unusually ectatic venous vessels were found adhered to the lower surface of the epidural clot. No concurrent vascular malformations were identified and the dura mater was intact. The histological diagnosis was angiolipoma. Postoperatively her neurological deficits showed remarkable improvement, and she gave birth to a healthy baby. Spinal angiolipoma in a pregnant woman may be complicated with acute epidural hemorrhage. Emergent surgical evacuation can be performed safely with a good functional prognosis., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Spinal angiolipoma is a rare benign tumour. It usually presents as a slowly progressive compressive lesion. Bleeding in this tumour is extremely rare and is spontaneous and acute. This is the first reported case of post-traumatic bleeding from a spinal angiolipoma, who developed subacute progressive paraparesis. The pathological definition of this rare entity is not well established. Histologically it is distinct from cutaneous angiolipoma.

Objective: Tumor-induced osteomalacia (TIO) is a rare condition due to phosphate wasting secondary to the release of a phosphatonin, fibroblast growth factor-23. Attempts to identify the tumor by physical examination and/or conventional imaging are sometimes unrewarding. In such cases, somatostatin receptor scintigraphy with octreotide has been successfully proposed., Methods: Two case reports and a review of the literature allow to demonstrate the diagnostic usefulness of octreotide and the therapeutic value of somatostatin., Results: Octreotide studies were positive in 79% of 24 reported TIO, including our 2 cases. In one of our patients with incomplete removal of the tumor, octreotide therapy was unable to improve hypophosphatemia, despite a decrease in fibroblast growth factor-23 levels by 30%. Similar results were achieved in most of the reported cases. Surgical procedures were effective in these cases and resulted in complete clinical and biochemical recovery., Conclusion: We highlight the impact of somatostatin receptor evaluation in the management of TIO.

Infiltrating angiolipomas are rarely encountered in the spine. We present a case involving a 71-year-old man with a dorsal epidural angiolipoma at the T5-T7 level. The tumor involved the T5-T6 vertebral bodies and left pedicle. The patient presented with acute paraparesis and MRI showed a homogeneously hyphointense lesion on T1-weighted images. The epidural component of the tumor was removed via laminectomy to achieve adequate cord decompression. The patient was symptom-free at a 2-year follow-up. This report emphasizes the unusual clinical presentation and MRI features of an infiltrating spinal angiolipoma and discusses therapeutic management options.

Spinal epidural angiolipoma is a rare benign tumor containing vascular and mature adipose elements. A slow progressive clinical course was mostly presented and rarely a fluctuating course during pregnancy. The authors report the original case of spontaneous spinal epidural bleeding resulting from thoracic epidural angiolipoma who presented with hyperacute onset of paraplegia, simulating an extradural hematoma. The patient was admitted with sudden non-traumatic hyperacute paraplegia during a prolonged walk. Neurologic examination showed sensory loss below T6 and bladder disturbances. Spinal MRI revealed a non-enhanced heterogeneous thoracic epidural lesion, extending from T2 to T3. A bilateral T2-T4 laminectomy was performed to achieve resection of a lipomatous tumor containing area of spontaneous hemorrhage. The postoperative course was uneventful with complete neurologic recovery. Histologic examination revealed the tumor as an angiolipoma. Because the prognosis after rapid surgical management of this lesion is favorable, the diagnosis of spinal angiolipoma with bleeding should be considered in the differential diagnosis of hyperacute spinal cord compression.

Angiolipoma is a rare tumor of the spine commonly presenting with compressive myelopathy. We report a spinal angiolipoma in a 14-year-old patient with acute spinal subarachnoid hemorrhage (SAH). To our knowledge this is the first reported case of a spinal angiolipoma presenting with SAH, associated with post-subclavian coarctation with diffuse hypoplasia of the descending aorta. This association of coarctation of aorta, aortic hypoplasia and spinal angiolipoma has also not been reported previously.

Spinal angiolipomas are extremely rare benign tumors composed of mature lipomatous and angiomatous elements. Most are symptomatic due to progressive spinal cord or root compression. This article describes the case of a 60-year-old woman who presented with a 6-month history of low back pain radiating to her right leg. The pain was multisegmental. The condition had worsened with time. Lumbar magnetic resonance imaging revealed a dorsal epidural mass at L5 and erosion of the lamina of the L5 vertebra. Laminectomy was performed, and an extradural tumor was totally excised. Neuropathologic examination identified it as a lumbar spinal angiolipoma. There was no evidence of recurrence in follow-up 12 months later. This rare clinical entity must be considered in the differential diagnosis for any spinal epidural lesion.

This 16-year-old boy with Proteus syndrome suffered acute spinal cord compression secondary to hemorrhage into an extradural paraspinal angiolipomatous hamartoma. A magnetic resonance (MR) imaging study performed 12 years earlier had revealed the presence of this tumor at the apex of a mild thoracic scoliosis, which had been stable during the intervening decade. Spinal cord neurological deficit in Proteus syndrome is rare. It can arise either from vertebral abnormalities and kyphoscoliotic deformities or from tumor encroachment. The authors describe the temporal evolution of scoliosis and acute spinal cord compression caused by a paraspinal angiolipomatous hamartoma over a period of 12 years. A review of the literature suggests that regular follow up, including serial MR imaging, is indicated in children with Proteus syndrome and scoliosis. Earlier resection of extradural tumor mass encroaching on the cord is warranted in the treatment of these children.

Spinal angiolipomas are rare, benign lesions representing 0.14 to 1.2% of all spinal axis tumors. They most commonly involve the midthoracic spine and are located in the posterior epidural space. Up to now, six pediatric cases have been reported in the literature; two of them involved an acute clinical onset that was related to a venous infarction of a tumor. The authors report the case of a 16-year-old boy with a midthoracic epidural angiolipoma who was admitted with a clinical history of an acute paraparesis. In contrast to previous descriptions, the acute onset in this case was related to a spontaneous intratumoral abscess within the tumor.

We report a case of an angiolipoma involving the thyroid gland of a 74-year-old woman. The patient presented with a multinodular goiter that was surgically removed. Gross examination of the specimen revealed an intrathyroidal well-circumscribed nodule that microscopically showed the typical features of an angiolipoma. There was no evidence of extrathyroidal extension, necrosis, or atypia. To our knowledge, this is the first reported case of a primary angiolipoma of the thyroid gland.

A 33-year-old female with a longstanding history of seizures was admitted to our hospital with subarachnoid haemorrhage (SAH). Computed tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) depicted a vascular fat-containing lesion overlying a right frontal cortical polymicrogyria. The diagnosis of angiolipoma was established. Conservatory management was undertaken with full recovery. She has been followed for 5 years since, with neither re-bleeding nor morphologic change of the lesion. This is a rare intracranial lesion, with only 11 intracranial angiolipomas published in the literature, and is the first case reported which is associated with SAH caused by this lesion.

Obstructive sleep apnoea syndrome (OSAS) is the cessation of airflow with the continuance of respiratory effort during sleep. OSAS associated with a neck mass is extremely rare. Angiolipoma is a rare, benign, fatty tumour composed of mature lipocytes and multiple areas containing angiomatous elements. The treatment for an angiolipoma is surgical excision. We report the case of a 47-year-old male who presented with a history of loud snoring associated with sleep apnoea. A polysomnographic study demonstrated an apnoea-hypopnoea index of 72/h. CT showed a 3.5 x 3 x 8 cm3 hypoattenuated mass of fat density in the left parapharyngeal space causing an impression on the nasopharynx and oropharynx with a peripheral hyperintense area. A cervical transparotid surgical approach was used. A histological study led to the definitive diagnosis of angiolipomal without evidence of malignancy. After surgery, the snoring disappeared and the patient remained tumour-free after 54 months of follow-up. This is the first case in the literature of a patient with nocturnal polysomnographic-documented OSAS caused by a left parapharyngeal angiolipoma.

Tuberous sclerosis (Bourneville-Pringle disease) is an genetic autosomal dominant disease, but in over 50% cases there are new spontaneous mutations. During this disease visceral hamartomas do tend to develop in various tissues. Earlier it was considered that in order to set a diagnosis the knowledge of Vogt's triade was required (angiofibroma, epilepsia, mental retardation). But new not typical forms occur, that do not contain all the above mentioned three elements. The phenomenon is connected with the appearance of a new mutations of the gene or with a variable gene penetrance. In these study case we present a 21-year old patient who shows the fully blown symptoms of Vogt's triad and her father who only has hypopigmented macules on his back.

We report a case of infiltrating angiolipoma who presented with a large mass on the shoulder and the signs of Kasabach-Merritt syndrome. She improved dramatically within one month and the mass completely disappeared after six months of interferon treatment.

Spinal extradural angiolipomas are rare benign tumours, accounting for only 0.14-1.2% of all spinal neoplasms. They are usually localized within the thoracic extradural space of the spinal canal and their common clinical presentation is myelopathy, mainly in the way of a slowly progressive paraparesis and sometimes in an acute form. We report the case of a 85 year old man who complained of bilateral lower limb weakness with sphincter disturbance of acute instauration. The MRI showed a posterior extradural lesion at L1-L2 level that compressed conus medularis and cauda equina. He underwent urgent surgical treatment and we achieved total resection of the lesion via a L1-L2 laminectomy. The pathological examination confirmed the tumour as an angiolipoma.

We report a case of end stage renal disease in association with bilateral renal angiomyolipomas (RAML). There were no features suggestive of tubercous sclerosis (TS). Renal angiomyolipomas were detected incidentally, patient being asymptomatic for the same. She is being evaluated for live related kidney transplant.

Background: Spinal epidural angiolipoma is a rare cause of spinal cord compression. We present a case and review the clinical presentation, radiological appearance, pathological aspects and treatment of this distinct clinico-pathological entity., Methods: A case of a 46-year-old woman with a five-month history of progressive myelopathy affecting her lower extremities is presented. CT and MRI revealed a large epidural fat-containing mass compressing the spinal cord dorsally at the T7-T8 level. A laminectomy was performed with gross total resection of the lesion., Results: The patient's neurologic symptoms improved postoperatively. A two-year follow-up period has revealed no signs of tumor recurrence and no neurological deficit., Conclusion: The diagnosis of spinal angiolipoma should be considered in the differential diagnosis of spinal cord compression. Magnetic resonance imaging is the investigation of choice. The surgical objective is complete excision but, for anterior lesions involving bone, an overly aggressive approach should be tempered by an awareness of the overall indolent natural history of so-called "infiltrating" spinal angiolipomas that are only partially excised.

Extradural spinal angiolipomas are rare benign tumors containing vascular and mature adipose elements. We report 8 cases of spinal epidural angiolipomas in 6 females and 2 males. In 7 cases, the clinical manifestation was a progressive spinal cord compression and one case had a regressive paraparesis mimicking a multiple sclerosis. In the 8 cases, the localization was thoracic with an extradural complete type of contrast block in 2 cases and partial in 5 cases. The myelo-CT achieved in 7 cases and the magnetic resonance imaging done at our last case revealed a fat-containing epidural tumor. The tumors were removed in all cases through a laminectomy with a successful outcome after an average of 9 years (range: 6 months-12 years). Sixty-seven similar cases in the international literature are reviewed. A total of 75 cases have been studied: 45 women and 30 men with a mean age of 46.3 years (range: 6-73), presenting a progressive spinal cord compression in 68 cases and in 7 cases a regressive paraparesis mimicking a multiple sclerosis. Myelography shows an extradural compression of the thecal sac. MRI is nowadays the imaging modality of choice for the diagnosis of these lesions. The surgical removal often easy of the epidural spinal angiolipomas permit a fast recovery. The etiopathogenesis of this process is still controversial between the dysembryogenetic and malformative hypothesis.