Advertisement

La radiologia medica

, Volume 113, Issue 5, pp 758–770 | Cite as

Lipomatous lesions of the head and neck region: imaging findings in comparison with histological type

  • S. CappabiancaEmail author
  • G. Colella
  • M. G. Pezzullo
  • A. Russo
  • F. Iaselli
  • L. Brunese
  • A. Rotondo
Head and Neck Radiology Radiologia Del Capo e Del Collo

Abstract

Purpose

Aim of the study is to demonstrate the main role of magnetic resonance imaging in the identification and characterization of lipomatous lesions of the head and neck.

Materials and methods

CT and MRI findings of 78 patients (43 male, 35 female) aged 12–80 (mean 47.5) years surgically treated for lipomatous lesions of the head and neck region between January 1995 and June 2005 were retrospectively analysed and correlated with the histological results.

Results

On CT images, lipomas and fibrolipomas appeared as smooth (38/50 cases) or lobulated (12/50 cases) well-defined masses associated with moderate displacement of surrounding tissues; tumours had high signal intensity on MR T1-weighted images, with relative decreasing signal on T2-weighted images. Infiltrating lipomas appeared as expansile ill-defined masses with heterogeneous signal. Angiolipomas showed a characteristic contrast enhancement on both CT and MRI. In one case of sialolipoma, the lesion appeared markedly heterogeneous in signal. MR and CT images of Madelung’s disease showed multiple symmetrical lipomatous masses involving the neck region. Intraosseous fatty lesions appeared as well-defined hypodense masses sometimes associated with cortical expansion and disruption.

Conclusions

Both CT and MRI exams are useful for detecting lipomatous lesions. MRI, however, is more accurate in the evaluation of their extent and in the characterisation of uncommon lipomatous lesions of the head and neck, and intravenous administration of gadolinium better depicts the margins of the tumour and its vascularisation.

Keywords

Lipomas Head and neck region CT MRI 

Lesioni lipomatose della regione testa-collo: reperti di diagnostica per immagini e confronto con i dati anatomo-patologici

Riassunto

Obiettivo

Lo scopo del lavoro è dimostrare il ruolo primario della risonanza magnetica nell’identificazione e nella caratterizzazione dei lipomi della regione testa-collo.

Materiali e metodi

Gli esami di tomografia computerizzata e risonanza magnetica di 78 pazienti (43 M, 35 F) di età compresa tra i 12 e gli 80 anni (media: 47,5), sottoposti ad intervento chirurgico per l’asportazione di lipomi del distretto testa-collo tra gennaio 1995 e giugno del 2005, sono stati valutati retrospettivamente e correlati successivamente ai risultati dellesame istologico.

Risultati

Nelle immagini di tomografia computerizzata i lipomi ed i fibrolipomi appaiono come masse ben definite con margini lisci (38/50 casi) o lobulati (12/50 casi) associate, con modesta dislocazione dei tessuti circostanti; le lesioni appaiono iperintense nelle immagini di risonanza magnetica ottenute con sequenze T1-pesate con riduzione proporzionale del segnale nelle immagini T2-pesate. I lipomi infiltranti appaiono come masse espansive scarsamente definite e dotate di segnale eterogeneo. Le immagini di tomografia computerizzata e di risonanza magnetica della malattia di Madelung mostrano lesioni multiple e simmetriche nel distretto testa-collo. Le lesioni intraossee appaiono come aree ipodense ben definite talora associate ad espansione e distruzione della corticale.

Conclusioni

La tomografia computerizzata e la risonanza magnetica sono entrambe utili per la diagnosi dei lipomi; la risonanza magnetica, tuttavia, costituisce la tecnica più leaccurata nella valutazione della loro estensione e nella caratterizzazione delle lesioni rare del distretto testa-collo. La somministrazione intravenosa di mezzo di contrasto definisce con maggiore dettaglio i margini del tumore ed il suo pattern di vascolarizzazione.

Parole chiave

Lipomi distretto testa-collo TC RM 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References/Bibliografia

  1. 1.
    Kransdorf FM (1995) Benign softtissue in a large referral population: distribution of specific diagnoses by age, sex, and localisation. Am J Roentgenol 164:395–402Google Scholar
  2. 2.
    Som PM, Scherl MP, Rao VM, Biller HF (1986) Presentation of ordinary lipomas of the head and neck: a review. Am J Neuroradiol 7:657–664PubMedGoogle Scholar
  3. 3.
    Abdullah BJJ, Liam CK, Kaur H, Mathew KM (1997) Parapharyngeal space lipoma causing sleep apnoea. BJR 70:1063–1065PubMedGoogle Scholar
  4. 4.
    Ghandour K, Issa M (1992) Lipoma of the floor of the mouth. Oral Surg Oral Med Oral Pathol 73:59–60PubMedCrossRefGoogle Scholar
  5. 5.
    Yoskovitch A, Cambronero E, Said S et al (1999) Giant lipoma of the larynx: a case report and literature review. Ear Nose Throat J 78:122–125PubMedGoogle Scholar
  6. 6.
    Canchois R, Laccourreye O, Rotenberg M et al (1995) Intrinsic infiltrating intramuscular laryngeal lipoma. Otolaryngol Head Neck Surg 112:777–779CrossRefGoogle Scholar
  7. 7.
    Benson-Mitchell R, Tolley N, Croft CB, Roberts D (1994) Lipoma of the left tonsillar fossa. J Laryngol Otol 108:507–508PubMedGoogle Scholar
  8. 8.
    Fasig JH, Robinson RA, McMulloch TM et al (2001) Spindle cell lipoma of the parotid. Fine-needle aspiration and histologic findings. Arch Pathol Lab Med 125:820–821PubMedGoogle Scholar
  9. 9.
    Eckel HE, Jungehulsing O (1994) Lipoma of the hypopharynx. Preoperative diagnosis and transoral resection. J Laryngol Otol 108:174–177PubMedCrossRefGoogle Scholar
  10. 10.
    Chaudhhry S, Sirpal YM (1997) Lipoma, a rare tumour of nasopharynx. Indian J Cancer 34:177–178Google Scholar
  11. 11.
    Yoshihara T, Kawano K, Mita N (1998) Retropharyngeal lipoma causing severe dysphagia and dyspnea. J Otolaryngol 27:363–366PubMedGoogle Scholar
  12. 12.
    Chikui T, Yonetsu K, Yoshiura K et al. (1997) Imaging findings of lipomas in the orofacial region with CY, US and MRI. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 84:88–95PubMedCrossRefGoogle Scholar
  13. 13.
    Gopinath SP (1992) Intraosseous lipoma of the skull. J Neurosurg 77:976PubMedGoogle Scholar
  14. 14.
    Arslan G, Karaali K, Cubuk M et al (2000) Intraosseous lipoma of the frontal bone. Acta Radiologica 41:320–321PubMedCrossRefGoogle Scholar
  15. 15.
    Sakashita H, Miyata M, Okabe K (1998) Intraosseous lipoma of the maxilla. A case report. Int J Oral Maxillofac Surg 27:63–64PubMedCrossRefGoogle Scholar
  16. 16.
    Buriç N, Krasiç D, Vi‰njiç M, Katiç V (2001) Intraosseous mandibolar lipoma: a case report and review of the literature. J Oral Maxillofac Surg 59:1367–1371PubMedCrossRefGoogle Scholar
  17. 17.
    Milgram JW (1988) Intraosseous lipomas. Radiologic and pathologic manifestations. Radiology 167:155PubMedGoogle Scholar
  18. 18.
    Milgram JW (1990) Malignant transformation in bone lipomas. Skel Radiol 19:347CrossRefGoogle Scholar
  19. 19.
    Ayasaka N, Chino Jr T, Chino T et al (1993) Infiltrating lipoma of the mental region: report of a case. Br J Oral and Maxillofac Surg 31:388–390CrossRefGoogle Scholar
  20. 20.
    Piattelli A, Fioroni M, Rubini C (2000) Intramuscular lipoma of the cheek: a case report. J Oral Maxillofac Surg 58:817–819PubMedCrossRefGoogle Scholar
  21. 21.
    Dionne GP, Seemayer TA (1974) Infiltrating lipomas and angiolipoma rivisited. Cancer 33:732–738PubMedCrossRefGoogle Scholar
  22. 22.
    Sugiura J, Fujiwara K, Kurahashi I, Kimura Y (1999) Infiltrating angiolipoma of the mucolabial fold: a case report and review of the literature. J Oral Maxillofac Surg 57:446–448PubMedCrossRefGoogle Scholar
  23. 23.
    Bennhoff DF, Wood JW (1978) Infiltrating lipomata of the head and neck. Laryngoscope 88:839–848PubMedGoogle Scholar
  24. 24.
    Garavaglia J, Gnepp DR (1987) Intramuscular (infiltrating) lipoma of the tongue. Oral Surg Oral Med Oral Pathol 63:348–350PubMedCrossRefGoogle Scholar
  25. 25.
    Takeda Y (1989) Intramuscular lipoma of the tongue. Ann Dent 48:22–24PubMedGoogle Scholar
  26. 26.
    Shirasuna k, Saka M, Watatani K, Kogo M, Matsuya T (1989) Intramuscular lipoma of the tongue. Int J Oral Maxillofac Surg 18:68–69PubMedCrossRefGoogle Scholar
  27. 27.
    Bataineh AB, Mansour MJ, Abalkhail A (1996) Oral infiltrating lipomas. Br J Oral Maxillofac Surg 31:520–523CrossRefGoogle Scholar
  28. 28.
    Epivatianos A, Markopoulos AK, Papanayotou P (2000) Benign tumors of adipose tissue of the oral cavity: a clinicopathologic study of 13 cases. J Oral Maxillofac Surg 58:1113–1117PubMedCrossRefGoogle Scholar
  29. 29.
    Ergün SS, Kurul S, Ulay M, BilgiÇ B (2001) Infiltrating lipomatosis of the face. Ann Plast Surg 47:346–348PubMedCrossRefGoogle Scholar
  30. 30.
    Cappabianca S, De Luca AM, Iscaro FM et al (1999) The identification of the criteria of malignancy and the tissue characterization of expansive processes in periskeletal soft tissues. The current role of magnetic resonance. Radiol Med 98:127–132Google Scholar
  31. 31.
    Munk PL, Lee MJ, Janzen DJ et al. (1997) Lipoma and liposarcoma: evaluation using CT and MR imaging. Am J Roentgenol 169:589–594Google Scholar
  32. 32.
    Moore PL, Goede A, Phillips DE (2001) Atypical lipoma of the tongue. J Laryngol Otol 11:859–861Google Scholar
  33. 33.
    Abenavoli FM, Corelli R, D’Erme G (2002) Madelung’s disease: which surgical treatment? Br J Plast Surg 55:536–537PubMedCrossRefGoogle Scholar
  34. 34.
    Crim JR, Seeger LL, Yao L et al. (1992) Diagnosis of soft-tissue masses with MR Imaging: can benign masses be differentiated from malignant ones? Radiology 185:581–586PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • S. Cappabianca
    • 1
    Email author
  • G. Colella
    • 2
  • M. G. Pezzullo
    • 1
  • A. Russo
    • 1
  • F. Iaselli
    • 1
  • L. Brunese
    • 3
  • A. Rotondo
    • 1
  1. 1.DU di Internistica Clinica e Sperimentale Magrassi-Lanzara, Sez. Diagnostica per ImmaginiSeconda Università degli Studi di NapoliNapoliItaly
  2. 2.Dipartimento di Patologia Testa e ColloSanta Maria Capua Vetere, CasertaItaly
  3. 3.Dip. Scienze per la salute, Sez. Diagnostica per ImmaginiUniversità del MoliseCampobassoItaly

Personalised recommendations