2019 Volume 33 Issue 5 Pages 555-559
Angiolipoma is a rare histological variant of lipoma and is considered to be a benign tumor. Angiolipoma commonly occurs in subcutaneous tissues of the upper extremity and trunk; its occurrence in the chest wall is extremely rare. Only a few cases of angiolipoma involving infiltration of surrounding tissues have been reported; therefore, it is usually difficult to distinguish angiolipoma from other diseases, including malignancies. Herein, we describe a case of non-infiltrating angiolipoma of the chest wall that mimicked radiological infiltration of the rib. A 68-year-old woman was referred to our institute for further examination of an abnormal shadow that was incidentally detected on a chest radiograph. Computed tomography showed a soft tissue mass in her right chest wall as well as characteristics of bone resorbability in her eighth rib. On magnetic resonance imaging (MRI), the lesion showed a low signal on T1-weighted imaging (T1WI), high signal on T2-weighted imaging (T2WI), and homogeneous enhancement. MRI also showed continuity of the tumor with intercostal vessels. All findings except osteoclastic features of the rib suggested hemangioma. As malignancy could not be ruled out, surgical excision was performed for both diagnostic and therapeutic purposes. Histological examination of the tumor showed mature adipose tissue and capillary hyperplasia, which were consistent with angiolipoma. Infiltration of the rib was absent, but bone resorption due to tumor compression was revealed. Finally, we diagnosed it as non-infiltrating angiolipoma. She had an uneventful recovery and did not show recurrence until 35 months post-surgery.
