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Chondrolipoma in the pelvic cavity: a case report.

Hwang HS, Lee WJ, Lim HK, Chun HK, Ahn GH - Korean J Radiol (2008 Nov-Dec)

Bottom Line: Chondrolipomas may be found in almost any part of the body, particularly in the connective tissue of the breast, head and neck area, as well as in the skeletal muscle.However, to the best of our knowledge, chondrolipomas located in the pelvic cavity have not been reported.In this case report, we describe a case of a chondrolipoma in the pelvis, and show that it has its own characteristic imaging findings, which included the composition of fatty tissue and calcification in most parts, as well as some focal areas of chondroid tissue based on the CT and MR findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center of Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
A chondrolipoma is an extremely rare form of a benign mesenchymal tumor containing mature cartilage and fatty tissue. Chondrolipomas may be found in almost any part of the body, particularly in the connective tissue of the breast, head and neck area, as well as in the skeletal muscle. However, to the best of our knowledge, chondrolipomas located in the pelvic cavity have not been reported. In this case report, we describe a case of a chondrolipoma in the pelvis, and show that it has its own characteristic imaging findings, which included the composition of fatty tissue and calcification in most parts, as well as some focal areas of chondroid tissue based on the CT and MR findings.

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Related in: MedlinePlus

Chondrolipoma in pelvic cavity in 55-year-old man.A, B. Transverse (A) and coronal (B) CT images show 8 cm, well-defined mass occupying left side of presacral space of pelvic cavity. Mass seems to have long stalk arising from left gluteus medius muscle. Stalk traverses along surface of left iliac bone, and further passes through left sciatic foramen, and finally connects with mass. Mass is mainly composed of fatty tissue and calcification. Note that calcifications in mass are located peripherally in linear and rosary pattern, with most of stalk becoming calcified. There are some focal areas of intermediate attenuation (arrows) between fat tissue and calcification, which corresponds to chondroid tissue histologically.C-E. Plain T1-weighted transverse (C), T2-weighted transverse (D), T2-weighted coronal (E) MR images without fat suppression show same mass mainly composed of hyperintense areas and signal void areas on both T1- and T2-weighted images which represent fatty tissue and calcification, respectively. Also seen are focal areas of intermediate signal intensity (arrows), which corresponded to chondroid tissue, as seen on CT images.F, G. Gadolinium-enhanced T1-weighted sagittal MR images without fat suppression, obtained 30 seconds (F) and 3 minutes (G) after contrast injection, show same fatty mass with extensive calcifications. Note focal areas of intermediate signal intensity around calcifications (arrows) in F become isointense as with surrounding fatty tissue in G. This represents delayed enhancement.H. Cut surface of resected specimen shows 13 cm, yellowish mass with whitish area in upper portion, which inidcates that this mass is composed of yellowish fatty tissue and whitish calcification.I. Photomicrograph of resected specimen indicates mature, fatty (black arrows), chondroid (white arrows), and fibrous (white arrowheads) tissues (Hematoxylin & Eosin staining, ×100). These findings are consistent with chondrolipoma.
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Figure 1: Chondrolipoma in pelvic cavity in 55-year-old man.A, B. Transverse (A) and coronal (B) CT images show 8 cm, well-defined mass occupying left side of presacral space of pelvic cavity. Mass seems to have long stalk arising from left gluteus medius muscle. Stalk traverses along surface of left iliac bone, and further passes through left sciatic foramen, and finally connects with mass. Mass is mainly composed of fatty tissue and calcification. Note that calcifications in mass are located peripherally in linear and rosary pattern, with most of stalk becoming calcified. There are some focal areas of intermediate attenuation (arrows) between fat tissue and calcification, which corresponds to chondroid tissue histologically.C-E. Plain T1-weighted transverse (C), T2-weighted transverse (D), T2-weighted coronal (E) MR images without fat suppression show same mass mainly composed of hyperintense areas and signal void areas on both T1- and T2-weighted images which represent fatty tissue and calcification, respectively. Also seen are focal areas of intermediate signal intensity (arrows), which corresponded to chondroid tissue, as seen on CT images.F, G. Gadolinium-enhanced T1-weighted sagittal MR images without fat suppression, obtained 30 seconds (F) and 3 minutes (G) after contrast injection, show same fatty mass with extensive calcifications. Note focal areas of intermediate signal intensity around calcifications (arrows) in F become isointense as with surrounding fatty tissue in G. This represents delayed enhancement.H. Cut surface of resected specimen shows 13 cm, yellowish mass with whitish area in upper portion, which inidcates that this mass is composed of yellowish fatty tissue and whitish calcification.I. Photomicrograph of resected specimen indicates mature, fatty (black arrows), chondroid (white arrows), and fibrous (white arrowheads) tissues (Hematoxylin & Eosin staining, ×100). These findings are consistent with chondrolipoma.

Mentions: A single-phase helical CT (LightSpeed Ultra; GE Healthcare, Milwaukee, WI), spanning the whole abdominopelvic cavity, was performed. The CT scanning parameters included a beam collimation of 8 × 1.25 mm, a reconstruction interval of 1.25 mm, a pitch of 1.35, a rotation time of 0.8 seconds, a table speed of 13.5 mm/rotation, 120 kV and 160 mAs. Transverse CT images were obtained 70 seconds after the intravenous injection of non-ionic contrast material (120 mL) at a rate of 3 mL/sec (Ultravist 300; Bayer Schering Pharma, Berlin, Germany). Multi-planar reformatted coronal images were reconstructed with the transverse images. The CT images revealed a large, well-defined mass in the presacral space of the pelvic cavity, which seemed to have a long stalk arising from the left gluteus medius muscle (Fig. 1A, B). The stalk traversed along the surface of the left iliac bone, and proceeded through the left sciatic foramen, and ended up connecting with the mass. The CT attenuation generated an easily recognizable mass, which was mainly composed of fatty tissue and calcification, with most of the stalk becoming calcified. The calcification in the mass was located peripherally in a linear and rosary pattern. Some focal areas of intermediate attenuation were identified as a mixture between fatty tissue and calcification, and occupied only a limited portion of the mass. These areas were revealed to correspond to chondroid tissue based on the histologic findings. MR imaging (Horizon 1.5T; GE Healthcare, Milwaukee, WI) was also performed with the use of a TORSO coil. On both the T1-weighted (366/8, echo train length of zero, 5-mm slice thickness, 2-mm gap, 256×192 matrix, 24-cm field of view, 2 signal acquired, and sequence duration of 3-4 minutes) and T2-weighted (4300/84, echo train length of ten, 5-mm slice thickness, 2-mm gap, 512×256 matrix, 24-cm field of view, 2 signal acquired, and sequence duration of 3-4 minutes) MR images, the mass was revealed to mainly consist of the hyperintense and signal void areas that represent fatty tissue and calcification, respectively (Fig. 1C-E). Also seen are the focal areas of intermediate signal intensity, as shown on the CT images. The gadolinium-enhanced T1-weighted MR images obtained 30 seconds, 60 seconds, and 3 minutes after the intravenous injection of contrast material (Gadovist; Bayer Schering Pharma, Berlin, Germany), and the focal areas of the intermediate signal intensity around the calcifications observed at 30 and 60 seconds post-injection, became isointense as the surrounding fat tissue at 3 minutes post-injection. This finding represented a delayed enhancement (Fig. 1F, G). No fat suppression technique was applied on our MR images.


Chondrolipoma in the pelvic cavity: a case report.

Hwang HS, Lee WJ, Lim HK, Chun HK, Ahn GH - Korean J Radiol (2008 Nov-Dec)

Chondrolipoma in pelvic cavity in 55-year-old man.A, B. Transverse (A) and coronal (B) CT images show 8 cm, well-defined mass occupying left side of presacral space of pelvic cavity. Mass seems to have long stalk arising from left gluteus medius muscle. Stalk traverses along surface of left iliac bone, and further passes through left sciatic foramen, and finally connects with mass. Mass is mainly composed of fatty tissue and calcification. Note that calcifications in mass are located peripherally in linear and rosary pattern, with most of stalk becoming calcified. There are some focal areas of intermediate attenuation (arrows) between fat tissue and calcification, which corresponds to chondroid tissue histologically.C-E. Plain T1-weighted transverse (C), T2-weighted transverse (D), T2-weighted coronal (E) MR images without fat suppression show same mass mainly composed of hyperintense areas and signal void areas on both T1- and T2-weighted images which represent fatty tissue and calcification, respectively. Also seen are focal areas of intermediate signal intensity (arrows), which corresponded to chondroid tissue, as seen on CT images.F, G. Gadolinium-enhanced T1-weighted sagittal MR images without fat suppression, obtained 30 seconds (F) and 3 minutes (G) after contrast injection, show same fatty mass with extensive calcifications. Note focal areas of intermediate signal intensity around calcifications (arrows) in F become isointense as with surrounding fatty tissue in G. This represents delayed enhancement.H. Cut surface of resected specimen shows 13 cm, yellowish mass with whitish area in upper portion, which inidcates that this mass is composed of yellowish fatty tissue and whitish calcification.I. Photomicrograph of resected specimen indicates mature, fatty (black arrows), chondroid (white arrows), and fibrous (white arrowheads) tissues (Hematoxylin & Eosin staining, ×100). These findings are consistent with chondrolipoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627234&req=5

Figure 1: Chondrolipoma in pelvic cavity in 55-year-old man.A, B. Transverse (A) and coronal (B) CT images show 8 cm, well-defined mass occupying left side of presacral space of pelvic cavity. Mass seems to have long stalk arising from left gluteus medius muscle. Stalk traverses along surface of left iliac bone, and further passes through left sciatic foramen, and finally connects with mass. Mass is mainly composed of fatty tissue and calcification. Note that calcifications in mass are located peripherally in linear and rosary pattern, with most of stalk becoming calcified. There are some focal areas of intermediate attenuation (arrows) between fat tissue and calcification, which corresponds to chondroid tissue histologically.C-E. Plain T1-weighted transverse (C), T2-weighted transverse (D), T2-weighted coronal (E) MR images without fat suppression show same mass mainly composed of hyperintense areas and signal void areas on both T1- and T2-weighted images which represent fatty tissue and calcification, respectively. Also seen are focal areas of intermediate signal intensity (arrows), which corresponded to chondroid tissue, as seen on CT images.F, G. Gadolinium-enhanced T1-weighted sagittal MR images without fat suppression, obtained 30 seconds (F) and 3 minutes (G) after contrast injection, show same fatty mass with extensive calcifications. Note focal areas of intermediate signal intensity around calcifications (arrows) in F become isointense as with surrounding fatty tissue in G. This represents delayed enhancement.H. Cut surface of resected specimen shows 13 cm, yellowish mass with whitish area in upper portion, which inidcates that this mass is composed of yellowish fatty tissue and whitish calcification.I. Photomicrograph of resected specimen indicates mature, fatty (black arrows), chondroid (white arrows), and fibrous (white arrowheads) tissues (Hematoxylin & Eosin staining, ×100). These findings are consistent with chondrolipoma.
Mentions: A single-phase helical CT (LightSpeed Ultra; GE Healthcare, Milwaukee, WI), spanning the whole abdominopelvic cavity, was performed. The CT scanning parameters included a beam collimation of 8 × 1.25 mm, a reconstruction interval of 1.25 mm, a pitch of 1.35, a rotation time of 0.8 seconds, a table speed of 13.5 mm/rotation, 120 kV and 160 mAs. Transverse CT images were obtained 70 seconds after the intravenous injection of non-ionic contrast material (120 mL) at a rate of 3 mL/sec (Ultravist 300; Bayer Schering Pharma, Berlin, Germany). Multi-planar reformatted coronal images were reconstructed with the transverse images. The CT images revealed a large, well-defined mass in the presacral space of the pelvic cavity, which seemed to have a long stalk arising from the left gluteus medius muscle (Fig. 1A, B). The stalk traversed along the surface of the left iliac bone, and proceeded through the left sciatic foramen, and ended up connecting with the mass. The CT attenuation generated an easily recognizable mass, which was mainly composed of fatty tissue and calcification, with most of the stalk becoming calcified. The calcification in the mass was located peripherally in a linear and rosary pattern. Some focal areas of intermediate attenuation were identified as a mixture between fatty tissue and calcification, and occupied only a limited portion of the mass. These areas were revealed to correspond to chondroid tissue based on the histologic findings. MR imaging (Horizon 1.5T; GE Healthcare, Milwaukee, WI) was also performed with the use of a TORSO coil. On both the T1-weighted (366/8, echo train length of zero, 5-mm slice thickness, 2-mm gap, 256×192 matrix, 24-cm field of view, 2 signal acquired, and sequence duration of 3-4 minutes) and T2-weighted (4300/84, echo train length of ten, 5-mm slice thickness, 2-mm gap, 512×256 matrix, 24-cm field of view, 2 signal acquired, and sequence duration of 3-4 minutes) MR images, the mass was revealed to mainly consist of the hyperintense and signal void areas that represent fatty tissue and calcification, respectively (Fig. 1C-E). Also seen are the focal areas of intermediate signal intensity, as shown on the CT images. The gadolinium-enhanced T1-weighted MR images obtained 30 seconds, 60 seconds, and 3 minutes after the intravenous injection of contrast material (Gadovist; Bayer Schering Pharma, Berlin, Germany), and the focal areas of the intermediate signal intensity around the calcifications observed at 30 and 60 seconds post-injection, became isointense as the surrounding fat tissue at 3 minutes post-injection. This finding represented a delayed enhancement (Fig. 1F, G). No fat suppression technique was applied on our MR images.

Bottom Line: Chondrolipomas may be found in almost any part of the body, particularly in the connective tissue of the breast, head and neck area, as well as in the skeletal muscle.However, to the best of our knowledge, chondrolipomas located in the pelvic cavity have not been reported.In this case report, we describe a case of a chondrolipoma in the pelvis, and show that it has its own characteristic imaging findings, which included the composition of fatty tissue and calcification in most parts, as well as some focal areas of chondroid tissue based on the CT and MR findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center of Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
A chondrolipoma is an extremely rare form of a benign mesenchymal tumor containing mature cartilage and fatty tissue. Chondrolipomas may be found in almost any part of the body, particularly in the connective tissue of the breast, head and neck area, as well as in the skeletal muscle. However, to the best of our knowledge, chondrolipomas located in the pelvic cavity have not been reported. In this case report, we describe a case of a chondrolipoma in the pelvis, and show that it has its own characteristic imaging findings, which included the composition of fatty tissue and calcification in most parts, as well as some focal areas of chondroid tissue based on the CT and MR findings.

Show MeSH
Related in: MedlinePlus