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PubMed2002

Cauda equina syndrome caused by idiopathic sacral epidural lipomatosis.

The patient, who was a non-obese woman with no predisposing conditions of lipomatosis, slowly developed cauda equina syndrome. Spinal magnetic resonance imaging (MRI) presented mass lesion of high intensity on T1-weighted image (WI) and an intermediate signal intensity in T2 WI in the epidural space of S1 to coccyges. It has been reported that most idiopathic epidural lipomatosis (IEDL) is observed in obese men, and all cases have involved the thoracic or lumbar region. This is the first report of a patient with cauda equina syndrome caused by idiopathic sacral epidural lipomatosis (EDL).

Aged↗

PubMed1978

Replacement lipomatosis of the kidney.

Replacement lipomatosis and renal sinus lipomatosis are parts of a spectrum of fatty replacement of destroyed or atrophic renal tissue. When long-standing inflammation exists in a kidney, especially with calculus disease, replacement lipomatosis may be the end result. Awareness of this process along with the specific radiologic findings will allow a correct preoperative diagnosis.

Aged↗

PubMed1996

Symptomatic epidural lipomatosis secondary to obesity. Case report.

The authors present a case of thoracic spinal cord compression secondary to epidural lipomatosis in an obese patient. This patient represents the 10th case of epidural lipomatosis secondary to simple obesity reported in the literature. The diagnosis is based on three criteria: 1) medical history and physical examination consistent with segmental spinal cord compression; 2) epidural fat thickness greater than 7 mm in the region of compression, based on magnetic resonance imaging (preferred) or computerized tomographic imaging; and 3) a height-to-weight ratio greater than 27.5 kg/m2. This specific correlation between epidural fat thickness measurement and calculation of height-to-weight ratio has not previously been reported. Surgical decompression through a posterior laminectomy and excision of excess epidural fat resulted in immediate reversal of the patient's symptoms. Knowledge of the association of epidural lipomatosis with obesity in the absence of glucocorticoid imbalance is important in discerning what may be an underrecognized syndrome.

Aged↗

PubMed1988

Sonography and computed tomography in deep cervical lipomas and lipomatosis of the neck.

Nineteen deep cervical lipomas and five patients with cervical lipomatosis were examined with computed tomography (CT) and Sonography. By means of CT, which is the imaging method of choice for both diseases, it is possible to differentiate between circumscribed lipomas and infiltrating intramuscular lipomas. In addition, an exact localization in parenchymatous organs is possible. Cervical lipomatosis is also clearly delineated. Sonography is the first imaging method in cervical swelling or lesions; therefore, knowledge of the sonomorphology of fatty tumors is mandatory. Cervical lipomas have a fairly typical sonomorphology, but it is not as pathognomonic as the density values are by means of CT. In cervical lipomatosis, an adequate pretherapeutic assessment of the depth of infiltration is not possible sonographically. Only the cervical vessels can be clearly differentiated in this condition.

Head and Neck Neoplasms↗

PubMed2001

[Pelvic lipomatosis: contribution of a new case to the literature].

OBJECTIVE: To describe an additional case of pelvic lipomatosis, a rare condition that can be encountered by the urologist. METHODS/RESULTS: A 66-year-old patient consulted for irritative voiding syndrome and fever. Patient evaluation by IVP and CT demonstrated pelvic lipomatosis. CONCLUSIONS: Pelvic lipomatosis is a disease with variable clinical and radiological features. Careful follow-up is warranted for prevention and treatment of possible complications.

Aged↗

PubMed2002

Spinal epidural lipomatosis.

Epidural lipomatosis is an uncommon disorder defined as a pathologic overgrowth of normal epidural fat. It is most often associated with administration of exogenous steroids of variable duration and dose. However, it can occur in the absence of exposure to steroids. We report two cases of spinal epidural lipomatosis following more than 20 years of steroid use due to asthma. Pathologic compression fracture due to osteoporosis and acute cord compression syndrome were found in these 2 cases. After emergent decompressive laminectomy and fusion surgery, neurological function recovered. From a review of literature, most patients received decompressive laminectomy surgery. But in our additional cases, we performed decompressive laminectomy and fusion surgery which might prevent further spinal deformity and improve the spinal stability, then patients' symptoms subsided completely. Therefore, decompression surgery and fusion surgery may be necessary in patients with symptomatic spinal epidural lipomatosis with compression fracture.

Adrenal Cortex Hormones↗

PubMed2002

Congenital infiltrating lipomatosis of the face: case report and literature review.

Congenital infiltrating lipomatosis of the face comprises a subgroup of lipomatous tumors. While rare, it remains a definite clinical entity. Its etiology is unknown. The tumor is congenital in origin and occurs in infancy or early childhood. It is poorly enveloped and characterized by diffuse infiltration of mature adipose tissue over normal muscle fibers, rapid growth, associated osseous hyperplasia, and a high recurrence rate after surgical intervention. Due to its diffuse infiltration and involvement of important facial structures, complete surgical excision is often impossible. A total of 14 cases of congenital infiltrating lipomatosis of the face was found in a literature review. Herein we present an additional case who had both diffuse infiltrating lipomatosis and a well-encapsulated lipoma on her left cheek.

Face↗

PubMed2003

Co-existent massive renal replacement lipomatosis and xanthogranulomatous pyelonephritis--a case report.

Renal replacement lipomatosis is a benign condition that may assume major clinical significance by producing pyelocalyceal deformities that may be mistaken for true renal masses. While the number of reported cases of renal replacement lipomatosis has been relatively small, this entity's prevalence is probably underestimated. We report a case of co-existent massive renal replacement lipomatosis and xanthogranulomatous pyelonephritis.

Humans↗

PubMed2004

Benign symmetric lipomatosis in a 73-year-old man: a case report with a brief review of the literature.

Benign symmetric lipomatosis (BSL) is a rare disease which is characterized by symmetric diffuse deposition of mature fat tissue and considered to originate in brown fat. A case of benign symmetric lipomatosis in a 73-year old man is presented. He has been treated for alcoholic abuse in mental hospitals several times and referred to our hospital for evaluation and treatment of the subcutaneous tumor in the neck, bilateral supraclavicular areas, bilateral upper arms, anterior chest wall, back, and the abdomen. Resected tumors had ill-defined margin and smooth surface. Histologically, the tumor was composed of diffuse proliferation of mature fat tissues, focal myxoid change and spindle cell proliferation. A histopathological diagnosis of lipomatosis with focal spindle cell proliferation was made. Although several hypotheses of this disease have been postulated, the present case suggested that the etiology of BSL is closely related with alcoholic abuse-induced metabolic disorder and deteriorated function of adipocytes due to specific location of tumor.

Adipocytes↗

PubMed1992

[Lumbo-radicular pain caused by epidural lipomatosis in an obese patient: recovery after hypocaloric diet].

The case reported concerns an obese patient suffering from lumbo-radicular intermittent claudication due to lumbar epidural lipomatosis. Compression was revealed by magnetic resonance imaging which showed the existence of a hypersignal in weighted sequences in T1 situated in the epidural space and narrowing the dural sheath. Three cases of lumbar epidural lipomatosis related to obesity have already been described. Treatment in all three was surgical with the result assessed as good in one case and poor in two. The interest of the present case is demonstration of the cause and effect relationship between epidural lipomatosis and obesity as shown by complete restoration of the epidural space after a calorie-controlled diet, and the possibility of successful treatment by this technique.

Diet, Reducing↗

PubMed1991

[Epidural angiolipoma and multiple familial lipomatosis].

In a 35-year old woman presenting familial multiple lipomatosis, spastic paraparesis developed and became worse under tetracosactide therapy. Signs of spinal cord compression at T3 were present. CT and MRI revealed a fat-containing epidural tumour (angiolipoma). The association of angiolipoma with familial multiple lipomatosis has not yet been reported. This association supports the theory that angiolipomas are hamartomatous lesions. The deterioration observed under tetracosactide suggests that iatrogenic epidural lipomatosis is due to the development of a pre-existing lipoma.

Adult↗

PubMed1991

[A case of epidural lipomatosis presenting spinal ataxia].

A 41-year-old man was doing well until July 1989, when he noted numbness over soles, followed 4 months later by difficulty in walking. These symptoms were progressively getting worse, and he was admitted to our department on June 12, 1990. General physical examination was unremarkable. Neurologically cranial nerves were intact except old right, traumatic strabismus. Muscle tone and deep tendon reflexes were normal throughout, but bilateral Babinski and Chaddock reflexes were present. Mild weakness of lower extremities were found on muscle testing (4/5). In sensory system, superficial sensory disturbance below T10 was seen, and markedly diminished vibration and position senses of lower extremities were noted. Cerebellar test was intact, although unsteadiness was found on heel-shin test. Romberg sign was definitely positive. His gait was wide-based and ataxic. Laboratory data showed no abnormalities in CBC, chemistry, urinalysis, serological tests and endocrinological examinations. Spinal MRI (Siemens 1.5 Tesla) showed abnormal deposition of epidural fatty tissues compressing spinal cord with flattening of cord from T4 to T8. Spinal ataxia as compressive myelopathy due to epidural lipomatosis was considered and he underwent laminectomy from T4 to T8 with improvement in walking. Epidural lipomatosis is an unusual cause of spinal cord compression, presenting compressive myelopathy, radiculopathy, cauda equina syndrome, intermittent claudication, or back pain. Most of cases were associated with long-term administration of adrenocortical steroid hormone, or underlying diseases, except only 3 cases including ours. This is the first case of spinal epidural lipomatosis presenting progressive gait disturbance due to spinal ataxia.

Adult↗

PubMed1990

A case of infiltrating lipomatosis with diffuse, symmetrical distribution.

Infiltrating lipomatosis represents a distinct clinicopathological entity characterised by collections of non-encapsulated, mature lipocytes that infiltrate local tissues. The lesions are usually first observed during the first three decades of life, but congenital types exist. Although a predilection for the lower extremity exists in approximately 80% of patients, they can affect a multitude of anatomic sites. Infiltrating lipomatosis of the face, head and neck, upper and lower extremities, trunk and abdominal cavity and pelvis have all been reported. The patient presented here had symmetrical, diffuse infiltrating lipomatosis involving almost the whole body, sparing only the head, neck, fingers and toes.

Adipose Tissue↗

PubMed1982

[Pelvic lipomatosis and retroperitoneal fibrosis: 2 phases of the same disease? Report of 3 cases and review of the literature].

Three cases of pelvic lipomatosis and a review of the literature are presented. One patient with pelvic lipomatosis was found at radiographic exploration to have retroperitoneal fibrosis with obstruction of the inferior vena cava. The classic roentgen triad which includes 1) pelvic radiolucency, 2) elevation of an intact rectosigmoid, and 3) elevation of the urinary bladder (the radiologic features simulate, in the first case, a pelvic malignancy) is present in two patients; the case 3 suggested a theoretical possibility: the pelvic lipomatosis and retroperitoneal fibrosis may be a variant of the same disease.

Female↗

PubMed1995

[Neurologic disorders in patients with Madelung's lipomatosis].

The authors had 21 patients with a rare disease, Madelung's lipomatosis. Vegetative disorders of segmental and suprasegmental levels were revealed in all patients. The character of neuropathies in Madelung's lipomatosis is discussed in detail. According to the authors, it is a complex syndrome with peripheral, vegetative, and vascular disorders. The accompanying secondary scalenus syndrome produces a peculiar clinical picture of neuropathy. The existence of neurological disorders dictates the need for complex (surgical and medicamentous) treatment of patients with Madelung's lipomatosis.

Adult↗

PubMed1979

[Relapsing lipomatosis of the ileocolic junction after surgery (author's transl)].

A 58 year old women had massive hemorrhage from ulcers originating from lipomatosis of the ileocecal valve. The tumor and part of the intestine were removed by ample surgical resection and ileo-ascendostomy was performed. The patient relapsed 11 months later with hemorrhage and lipomatosis adjacent to the anastomosis established surgically 11 months before. This case report demonstrates that lipomatosis does not only occur at the ileocecal valve but as well at junctions established artificially between ileum and colon. The reasons for this latter event are unknown.

Female↗

PubMed1994

Spinal epidural lipomatosis: two new idiopathic cases and a review of the literature.

Thoracic spinal epidural lipomatosis, a rare cause of myelopathy, is most commonly associated with exogenous corticosteroid use. The authors present the clinical, magnetic resonance imaging, computed tomography, and surgical findings for two patients with idiopathic epidural lipomatosis, successfully treated with decompressive laminectomy accompanied by fatty debulking, followed for > 3 postoperative years. They review the literature on idiopathic spinal epidural lipomatosis as well as cases associated with exogenous steroid use.

Aged↗

PubMed1994

[Two cases of replacement lipomatosis of the kidney].

Two cases of replacement lipomatosis of the kidney are reported. One patient was a 64-year-old woman who presented with pain caused by a subcutaneous abscess in the back as the chief complaint. Replacement lipomatosis of the kidney associated with staghorn calculi was diagnosed by computerized tomography (CT) and magnetic resonance imaging (MRI), and nephrectomy was performed. The other patient was a 71-year-old woman whose chief complaint was repeated episodes of pyelonephritis. Staghorn calculi and severe renal dysfunction were diagnosed, and nephrectomy was performed. In both patients, pathological examination revealed marked hyperplasia of adipose tissue in the renal sinus which consisted of mature fat cells, and replacement lipomatosis of the kidney was diagnosed. CT is useful in the diagnosis of this disease, and MRI provides further confirmation.

Adipose Tissue↗