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Laparoscopic two-step abdomino-parasacral resection of a giant pelvic lipoma: a case report.

J Gastrointest Oncol

August 2024

Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Background: Pelvic lipomas, particularly when massive in size, present unique surgical challenges due to their intricate anatomical location and proximity to vital structures. Complete resection of tumor is the basic principle. In this case, we demonstrated the complete resection of a huge pelvic lipoma by laparoscopy combined with a transsacral approach, which was rarely reported in the relevant literature.

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A rare disorder called congenital infiltrating lipomatosis of the face is characterized by a diffuse fatty infiltration of the soft tissues of the face. Muscle involvement and related bony hyperplasia may coexist. This particular form of lipomatous tumor is rare and typically appears in childhood.

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CLOVES syndrome is a novel sporadic mosaic segmental overgrowth syndrome, currently categorized under the canopy of PROS (-related overgrowth spectrum) disorders. All PROS disorders harbor heterozygous postzygotic activating somatic mutations involving the gene. As an upstream regulator of the signal transduction pathway, activating mutations of gene commence in uncontrolled growth of cutaneous, vascular (capillaries, veins, and lymphatics), adipose, neural, and musculoskeletal tissues.

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Aims: Well-differentiated lipomatous neoplasms encompass a broad spectrum of benign and malignant tumours, many of which are characterised by recurrent genetic abnormalities. Although a key regulator of p53 signalling, MDM2, is characteristically amplified in well-differentiated liposarcoma, recurrent abnormalities of p53 itself have not been reported in well-differentiated adipocytic neoplasms. Here, we present a series of well-differentiated lipomatous tumours characterised by p53 alterations and histological features in keeping with atypical pleomorphic lipomatous tumour (APLT).

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Asymptomatic cardiac masses are often diagnosed incidentally. Massive lipomatous hypertrophy can be confused for other cardiac masses and need careful evaluation including multimodality imaging to manage appropriately.

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