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

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

  • Head and Neck Radiology Radiologia Del Capo e Del Collo
  • Published:
La radiologia medica Aims and scope Submit manuscript

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.

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.

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References/Bibliografia

  1. Kransdorf FM (1995) Benign softtissue in a large referral population: distribution of specific diagnoses by age, sex, and localisation. Am J Roentgenol 164:395–402

    CAS  Google Scholar 

  2. Som PM, Scherl MP, Rao VM, Biller HF (1986) Presentation of ordinary lipomas of the head and neck: a review. Am J Neuroradiol 7:657–664

    PubMed  CAS  Google Scholar 

  3. Abdullah BJJ, Liam CK, Kaur H, Mathew KM (1997) Parapharyngeal space lipoma causing sleep apnoea. BJR 70:1063–1065

    PubMed  CAS  Google Scholar 

  4. Ghandour K, Issa M (1992) Lipoma of the floor of the mouth. Oral Surg Oral Med Oral Pathol 73:59–60

    Article  PubMed  CAS  Google Scholar 

  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 78:122–125

    PubMed  CAS  Google Scholar 

  6. Canchois R, Laccourreye O, Rotenberg M et al (1995) Intrinsic infiltrating intramuscular laryngeal lipoma. Otolaryngol Head Neck Surg 112:777–779

    Article  Google Scholar 

  7. Benson-Mitchell R, Tolley N, Croft CB, Roberts D (1994) Lipoma of the left tonsillar fossa. J Laryngol Otol 108:507–508

    PubMed  CAS  Google Scholar 

  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 125:820–821

    PubMed  CAS  Google Scholar 

  9. Eckel HE, Jungehulsing O (1994) Lipoma of the hypopharynx. Preoperative diagnosis and transoral resection. J Laryngol Otol 108:174–177

    Article  PubMed  CAS  Google Scholar 

  10. Chaudhhry S, Sirpal YM (1997) Lipoma, a rare tumour of nasopharynx. Indian J Cancer 34:177–178

    Google Scholar 

  11. Yoshihara T, Kawano K, Mita N (1998) Retropharyngeal lipoma causing severe dysphagia and dyspnea. J Otolaryngol 27:363–366

    PubMed  CAS  Google Scholar 

  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 84:88–95

    Article  PubMed  CAS  Google Scholar 

  13. Gopinath SP (1992) Intraosseous lipoma of the skull. J Neurosurg 77:976

    PubMed  CAS  Google Scholar 

  14. Arslan G, Karaali K, Cubuk M et al (2000) Intraosseous lipoma of the frontal bone. Acta Radiologica 41:320–321

    Article  PubMed  CAS  Google Scholar 

  15. Sakashita H, Miyata M, Okabe K (1998) Intraosseous lipoma of the maxilla. A case report. Int J Oral Maxillofac Surg 27:63–64

    Article  PubMed  CAS  Google Scholar 

  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 59:1367–1371

    Article  PubMed  Google Scholar 

  17. Milgram JW (1988) Intraosseous lipomas. Radiologic and pathologic manifestations. Radiology 167:155

    PubMed  CAS  Google Scholar 

  18. Milgram JW (1990) Malignant transformation in bone lipomas. Skel Radiol 19:347

    Article  CAS  Google Scholar 

  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 31:388–390

    Article  CAS  Google Scholar 

  20. Piattelli A, Fioroni M, Rubini C (2000) Intramuscular lipoma of the cheek: a case report. J Oral Maxillofac Surg 58:817–819

    Article  PubMed  CAS  Google Scholar 

  21. Dionne GP, Seemayer TA (1974) Infiltrating lipomas and angiolipoma rivisited. Cancer 33:732–738

    Article  PubMed  CAS  Google Scholar 

  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 57:446–448

    Article  PubMed  CAS  Google Scholar 

  23. Bennhoff DF, Wood JW (1978) Infiltrating lipomata of the head and neck. Laryngoscope 88:839–848

    PubMed  CAS  Google Scholar 

  24. Garavaglia J, Gnepp DR (1987) Intramuscular (infiltrating) lipoma of the tongue. Oral Surg Oral Med Oral Pathol 63:348–350

    Article  PubMed  CAS  Google Scholar 

  25. Takeda Y (1989) Intramuscular lipoma of the tongue. Ann Dent 48:22–24

    PubMed  CAS  Google Scholar 

  26. Shirasuna k, Saka M, Watatani K, Kogo M, Matsuya T (1989) Intramuscular lipoma of the tongue. Int J Oral Maxillofac Surg 18:68–69

    Article  PubMed  CAS  Google Scholar 

  27. Bataineh AB, Mansour MJ, Abalkhail A (1996) Oral infiltrating lipomas. Br J Oral Maxillofac Surg 31:520–523

    Article  Google Scholar 

  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 58:1113–1117

    Article  PubMed  CAS  Google Scholar 

  29. Ergün SS, Kurul S, Ulay M, BilgiÇ B (2001) Infiltrating lipomatosis of the face. Ann Plast Surg 47:346–348

    Article  PubMed  Google Scholar 

  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 98:127–132

    CAS  Google Scholar 

  31. Munk PL, Lee MJ, Janzen DJ et al. (1997) Lipoma and liposarcoma: evaluation using CT and MR imaging. Am J Roentgenol 169:589–594

    CAS  Google Scholar 

  32. Moore PL, Goede A, Phillips DE (2001) Atypical lipoma of the tongue. J Laryngol Otol 11:859–861

    Google Scholar 

  33. Abenavoli FM, Corelli R, D’Erme G (2002) Madelung’s disease: which surgical treatment? Br J Plast Surg 55:536–537

    Article  PubMed  Google Scholar 

  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 185:581–586

    PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. DU di Internistica Clinica e Sperimentale Magrassi-Lanzara, Sez. Diagnostica per Immagini, Seconda Università degli Studi di Napoli, Napoli, Italy

    S. Cappabianca, M. G. Pezzullo, A. Russo, F. Iaselli & A. Rotondo

  2. Dipartimento di Patologia Testa e Collo, Via Amendola 8, 81055, Santa Maria Capua Vetere, Caserta, Italy

    G. Colella

  3. Dip. Scienze per la salute, Sez. Diagnostica per Immagini, Università del Molise, Campobasso, Italy

    L. Brunese

Authors
  1. S. Cappabianca
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  2. G. Colella
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  3. M. G. Pezzullo
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  4. A. Russo
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  5. F. Iaselli
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  6. L. Brunese
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  7. A. Rotondo
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Correspondence to S. Cappabianca.

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Cappabianca, S., Colella, G., Pezzullo, M.G. et al. Lipomatous lesions of the head and neck region: imaging findings in comparison with histological type. Radiol med 113, 758–770 (2008). https://doi.org/10.1007/s11547-008-0258-5

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  • DOI: https://doi.org/10.1007/s11547-008-0258-5

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