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El Amine O, Belghith M, Salhi H, Goucha A, Gamoudi A. Submandibular lipoblastoma: Case report of a rare tumor in childhood. Avicenna J Med 2021; 8:55-57. [PMID: 29682479 PMCID: PMC5898184 DOI: 10.4103/ajm.ajm_81_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Lipoblastoma is a rare, benign tumor usually occurring in childhood. It is essentially localized in the extremities and trunk, with few cases reported in the neck. We report the case of a 2-year-old girl with a rapidly enlarging, painless neck mass. Magnetic resonance imaging (MRI) revealed a 3-cm mass in the right submandibular region. Review of literature, diagnostic methods, and genetics of lipomatous tumors are discussed. Complete surgical excision via a lateral cervical approach demonstrated a white soft tissue with an adherent ganglion. Histology and immunohistochemistry confirmed the diagnosis of lipoblastoma. Cervical lipoblastoma is rare, and typically asymptomatic, rarely causing nerve compression or airway obstruction. MRI can help identifying the lipomatous nature of the mass, but the findings can be inconsistent due to variable maturity of fat cells and the mesenchymal content of the tumor. Diagnosis is always based on pathological examination. Further chromosomal analysis is useful in differentiating lipoblastoma from liposarcoma. Complete surgical excision is the recommended treatment.
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Affiliation(s)
- Olfa El Amine
- Department of Pathology, Salah Azaiez Institute, Tunis 1006, Tunisia
| | - Meyssa Belghith
- Department of Pathology, Salah Azaiez Institute, Tunis 1006, Tunisia
| | - Hasna Salhi
- Department of Surgical Oncology, Salah Azaiez Institute, Tunis 1006, Tunisia
| | - Aida Goucha
- Department of Pathology, Salah Azaiez Institute, Tunis 1006, Tunisia
| | - Amor Gamoudi
- Department of Pathology, Salah Azaiez Institute, Tunis 1006, Tunisia
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2
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Degnan AJ, Jelinek JS, Murphey MD. Lipoblastoma: computed tomographic and magnetic resonance imaging features correlate with tumor behavior and pathology. Pediatr Radiol 2021; 51:614-621. [PMID: 33151344 DOI: 10.1007/s00247-020-04882-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/02/2020] [Accepted: 10/08/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Lipoblastoma is a rare benign neoplasm of immature fat cells in children. Imaging appearances are frequently complex, sometimes simulating liposarcoma. OBJECTIVE To characterize features of lipoblastoma on MRI and CT in comparison with recurrence risk. MATERIALS AND METHODS We identified cases via retrospective review of histopathology-proven lipoblastoma cases in a large referral database and a pediatric medical center. Two radiologists scored CT and MRI on the basis of lesion features. RESULTS We included a total of 56 children (32 boys and 24 girls) with a mean age of 2.6 years (range 0.1-13 years). Extremity lesions were most common (27%), followed by neck (19%), gluteal region (18%), chest (14%) and mesentery (14%). Children most commonly presented with painless masses (73%), followed by dyspnea (9%), distension (9%) and pain (7%). Non-adipose soft-tissue components were identified on CT and MRI in 78% of cases. Significant (moderate or marked) septations were noted in 59% and enhancement in 35%. Compartmental invasion was present in 43% of cases. Of paraspinal cases, 38% involved the neural foramina or central canal. Lesion complexity did not significantly correlate with age. Recurrence was observed in 9% of cases and was significantly correlated with compartmental invasion (correlation: 0.303, P=0.009) and septation complexity (correlation: 0.227, P=0.038) on initial imaging. CONCLUSION Although lipoblastoma is a fat-containing entity, many lesions demonstrate marked complexity and local infiltration that resemble liposarcoma, which is exceedingly rare in younger children. Compartmental invasion and thicker septations appear to confer greater risk of recurrence following resection.
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Affiliation(s)
- Andrew J Degnan
- American Institute for Radiologic Pathology, Silver Spring, MD, USA. .,Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA. .,Department of Radiology, Abington Hospital Jefferson Health, Abington, PA, USA.
| | - James S Jelinek
- Department of Radiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Mark D Murphey
- American Institute for Radiologic Pathology, Silver Spring, MD, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Department of Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
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3
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A Rare Case of Giant Mesenteric Lipoblastoma in a 6-Year-Old Child and Review of the Literature. Case Rep Surg 2020; 2020:3018065. [PMID: 32774976 PMCID: PMC7396037 DOI: 10.1155/2020/3018065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/16/2020] [Indexed: 12/17/2022] Open
Abstract
Giant mesenteric lipoblastoma is a rare benign tumor arising from the adipocytes. It can mimic malignant tumors, and its diagnosis is difficult before surgery. Imaging studies could lead the diagnosis but not confirm it. Those tumors arising in the abdomen are usually larger and can cause symptoms of compression. Surgical excision is the treatment of choice, and a long-term follow-up is necessary to detect local recurrences. Only a few cases of lipoblastomas arising from the mesentery are reported in literature. We present a case of a rare giant lipoblastoma arising from the mesentery of a 6-year-old girl, with a history of postprandial abdominal pain.
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4
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Response to letter to the editor. Pediatr Surg Int 2020; 36:857-859. [PMID: 32415354 DOI: 10.1007/s00383-020-04661-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
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5
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Squillaro AI, Chow MD, Arias F, Sadimin ET, Lee YH. A Giant Childhood Mesenteric Lipoblastoma With Extensive Maturation. Front Pediatr 2020; 8:404. [PMID: 32793530 PMCID: PMC7393439 DOI: 10.3389/fped.2020.00404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/12/2020] [Indexed: 12/11/2022] Open
Abstract
Abdominal lipoblastomas are uncommon soft tissue tumors in children and rarely arise from the mesentery. Due to intraabdominal location and slow growth, these masses can go unnoticed for long periods of time and often found on surgical exploration. We present a case of a 12-year-old male with years of abdominal distension accompanied by new onset early satiety that was found to have an intra-abdominal mass. He underwent an exploratory laparotomy revealing a large 33 x 27 x 15 cm rubbery mesenteric mass displacing the entire intra-abdominal contents, connected by a single vascular pedicle and encasing a loop of small intestine. The mass was resected and the patient did well without signs of recurrence. Histology confirmed the presence of mature adipocytes but on further cytogenetic analysis, a translocation between chromosomes 2 and 8 at the 12q arm was detected, which is often associated with lipoblastomas. This case represents the one of the largest mesenteric lipoblastomas that matured extensively to lipoma-like histology at the time of surgical resection.
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Affiliation(s)
- Anthony I Squillaro
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Monica D Chow
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Fernando Arias
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Evita T Sadimin
- Department of Pathology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Yi-Horng Lee
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States.,Division of Pediatric Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
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6
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Fanna M, Rougemont AL, Arni D, Toso C, Anooshiravani-Dumont M, Wildhaber BE. Giant Intrahepatic Lipoblastoma in a Child. J Pediatr 2019; 210:235-236.e1. [PMID: 30955788 DOI: 10.1016/j.jpeds.2019.02.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Martina Fanna
- University Center of Pediatric Surgery of Western Switzerland, Division of Pediatric Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Anne-Laure Rougemont
- Division of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Delphine Arni
- University Center of Pediatric Surgery of Western Switzerland, Division of Pediatric Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Christian Toso
- Division of Visceral Surgery, Geneva University Hospitals, Geneva, Switzerland
| | | | - Barbara E Wildhaber
- University Center of Pediatric Surgery of Western Switzerland, Division of Pediatric Surgery, Geneva University Hospitals, Geneva, Switzerland
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7
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Kim JH, Choi LH, Kim YC, Baek SK. A case of neck lipoblastoma in a pediatric patient. ACTA ACUST UNITED AC 2019. [DOI: 10.21593/kjhno/2019.35.1.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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8
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Criss CN, Grant C, Ralls MW, Geiger JD. Robotic resection of recurrent pediatric lipoblastoma. Asian J Endosc Surg 2019; 12:128-131. [PMID: 29747240 DOI: 10.1111/ases.12493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/22/2018] [Indexed: 11/29/2022]
Abstract
This case demonstrates successful resection of a rare, recurrent presacral-pelvic lipoblastoma in a 19-year-old female patient. Because of the anatomical location of the mass and its proximity to vital structures, the robotic approach allowed for both optimal visualization and effective debulking of the mass. Furthermore, with the use of an articulating laparoscopic camera, key visualization of the posterior lateral pelvis was possible. Using a wide breadth of technologies and resources is essential to broadening the surgical armamentarium and achieving resectability in otherwise challenging cases.
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Affiliation(s)
- Cory N Criss
- Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA
| | - Christa Grant
- Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew W Ralls
- Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA
| | - James D Geiger
- Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA
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9
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Slavchev SA, Georgiev GP. A Giant Deep-seated Lipoma in a Child's Forearm. J Hand Surg Asian Pac Vol 2017; 22:97-99. [PMID: 28205466 DOI: 10.1142/s0218810417720029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Deep-seated giant lipomas are rare relative to the overall incidence of the tumor and their occurrence grows more frequent with age. A case of an unusual deep-seated giant lipoma in the forearm of a four-year-old child is reported.
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Affiliation(s)
- Svetoslav A Slavchev
- 1 Department of Orthopaedics and Traumatology, University Hospital of Orthopaedics "Prof. B. Boychev", Medical University of Sofia, Sofia, Bulgaria
| | - Georgi P Georgiev
- 2 Department of Orthopaedics and Traumatology, University Hospital Queen Giovanna-ISUL, Medical University of Sofia, Sofia, Bulgaria
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10
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Ng CSH, Wan S, Sihoe ADL, Arifi AA, Chan WY, Lee TW, Chik KW, Yim APC. Giant Mediastinal Lipoblastoma. Asian Cardiovasc Thorac Ann 2016. [DOI: 10.1177/021849230100900424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 3-year-old girl with fever, increasing cough, and nasal discharge for 2 weeks, was found to have a giant mediastinal lipoblastoma. The tumor weighing 556 g was successfully resected.
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Affiliation(s)
- Calvin SH Ng
- Division of Cardiothoracic Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin, New Territories, Hong Kong People's Republic of China
| | - Song Wan
- Division of Cardiothoracic Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin, New Territories, Hong Kong People's Republic of China
| | - Alan DL Sihoe
- Division of Cardiothoracic Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin, New Territories, Hong Kong People's Republic of China
| | - Ahmed A Arifi
- Division of Cardiothoracic Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin, New Territories, Hong Kong People's Republic of China
| | - Wing Yee Chan
- Division of Cardiothoracic Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin, New Territories, Hong Kong People's Republic of China
| | - Tak Wai Lee
- Division of Cardiothoracic Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin, New Territories, Hong Kong People's Republic of China
| | - Ki Wai Chik
- Division of Cardiothoracic Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin, New Territories, Hong Kong People's Republic of China
| | - Anthony PC Yim
- Division of Cardiothoracic Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin, New Territories, Hong Kong People's Republic of China
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11
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Choi J, Bouron Dal Soglio D, Fortier A, Fetni R, Mathonnet G, Cournoyer S, Lallier M, Isler M, Beaulieu Bergeron M, Patey N. Diagnostic utility of molecular and cytogenetic analysis in lipoblastoma: a study of two cases and review of the literature. Histopathology 2014; 64:731-40. [DOI: 10.1111/his.12317] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 10/24/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Jungah Choi
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
| | - Dorothée Bouron Dal Soglio
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
- Research Center of CHU Sainte Justine; Montreal QC Canada
- University of Montreal; Montreal QC Canada
| | - Amanda Fortier
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
| | - Raouf Fetni
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
| | | | | | - Michel Lallier
- Department of Surgery; CHU Sainte Justine; Montreal QC Canada
| | - Marc Isler
- Department of Surgery; CHU Sainte Justine; Montreal QC Canada
| | - Mélanie Beaulieu Bergeron
- Department of Genetics; Children's Hospital of Eastern Ontario; Ottawa ON Canada
- Department of Pathology and Laboratory Medicine; University of Ottawa; Ottawa ON Canada
| | - Natalie Patey
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
- Research Center of CHU Sainte Justine; Montreal QC Canada
- University of Montreal; Montreal QC Canada
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12
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Nagano Y, Uchida K, Inoue M, Ide S, Shimura T, Hashimoto K, Koike Y, Kusunoki M. Mesenteric lipoblastoma presenting as a small intestinal volvulus in an infant: A case report and literature review. Asian J Surg 2013; 40:70-73. [PMID: 28034384 DOI: 10.1016/j.asjsur.2013.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 01/15/2013] [Accepted: 01/16/2013] [Indexed: 12/24/2022] Open
Abstract
A 1-year-old boy with no underlying disorder presented with non-bilious vomiting since 4 days before admission. He was referred to our hospital and was diagnosed with a small bowel obstruction due to an intraabdominal tumor. Laparotomy revealed an intestinal volvulus with a soft and lobulated tumor arising from the mesentery. The resected tumor with a small part of the small bowel was diagnosed as lipoblastoma histologically. From a literature review, mesenteric lipoblastoma with an intestinal volvulus showed different characteristics such as greater frequency of vomiting and less frequency of abdominal mass as clinical symptoms, and the size of the tumor was smaller than that of the tumor without the intestinal volvulus.
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Affiliation(s)
- Yuka Nagano
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Keiichi Uchida
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
| | - Mikihiro Inoue
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Shozo Ide
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Tadanobu Shimura
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kiyoshi Hashimoto
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yuki Koike
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masato Kusunoki
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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13
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Kirkham YA, Yarbrough CM, Pippi Salle JL, Allen LM. A rare case of inguinolabial lipoblastoma in a 13-month-old female. J Pediatr Urol 2013; 9:e64-7. [PMID: 23103129 DOI: 10.1016/j.jpurol.2012.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 08/22/2012] [Indexed: 11/18/2022]
Abstract
Lipoblastoma is a rare, rapidly growing, benign mesenchymal tumor composed of various stages of maturing adipocytes that most often occurs in children under the age of 3. The common locations are the extremities and the trunk. Presentation in the genitoinguinal area is rare. We report a case of a 13-month-old female infant with a 4-month history of a progressively enlarging left labial mass that encompassed her left labium majora and inguinal region. Pelvic MRI confirmed growth from previous ultrasound size of 3 × 2 × 1 cm to 7 × 2 × 2 cm. Composition was suggestive of adipose tissue. The mass was excised through a left inguinal incision. The final pathology results described a lipoblastoma. Six year follow-up has not revealed any signs or symptoms of recurrence. Circumscribed lipoblastomas should be distinguished from their infiltrative counterpart, diffuse lipoblastoma or lipoblastomatosis, which can be more difficult to excise and thus, more likely to recur. Lipoblastoma should also be distinguished from myxoid liposarcoma, which has malignant features, carries a high risk of recurrence, and requires a more aggressive management protocol. Although rare, lipoblastoma should be considered as part of the differential diagnosis of a rapidly growing vulvar mass in prepubertal children.
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Affiliation(s)
- Yolanda A Kirkham
- Section of Pediatric and Adolescent Gynecology, Gynecology Clinic, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario, Canada.
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14
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Pedeutour F, Deville A, Steyaert H, Ranchere-Vince D, Ambrosetti D, Sirvent N. Rearrangement of HMGA2 in a case of infantile lipoblastoma without Plag1 alteration. Pediatr Blood Cancer 2012; 58:798-800. [PMID: 22223189 DOI: 10.1002/pbc.23335] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Accepted: 08/09/2011] [Indexed: 11/07/2022]
Abstract
Lipoblastoma is a rare benign adipocytic tumor that occurs usually in children. It can be difficult to distinguish a lipoblastoma from other lipogenic tumors. In such cases, the detection of a rearrangement of the PLAG1 gene by fluorescence in situ hybridization analysis is useful for characterizing a lipoblastoma. We present here a novel case of morphological infantile lipoblastoma showing a rearrangement of HMGA2 instead of the classical PLAG1 alteration. HMGA2 is the main target of clonal aberrations encountered in lipomas. This result supports the hypothesis that benign lipomatous tumors harboring PLAG1 or HMGA2 rearrangement could constitute a unique pathogenetic entity.
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15
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Dutton JJ, Escaravage GK, Fowler AM, Wright JD. Lipoblastomatosis: Case Report and Review of the Literature. Ophthalmic Plast Reconstr Surg 2011; 27:417-21. [DOI: 10.1097/iop.0b013e318221118c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Kamal NM, Jouini R, Yahya S, Haiba M. Benign intrascrotal lipoblastoma in a 4-month-old infant: a case report and review of literature. J Pediatr Surg 2011; 46:E9-12. [PMID: 21763825 DOI: 10.1016/j.jpedsurg.2011.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 03/08/2011] [Accepted: 03/10/2011] [Indexed: 11/18/2022]
Abstract
Lipoblastomas are rare benign soft tissue tumors that occur primarily in young children. Most lipoblastomas occur in the extremities, trunk, head, and neck. An intrascrotal location is unusual. We describe a case of a 4-month-old infant with an intrascrotal lipoblastoma and discuss the differential diagnosis and review the literature.
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17
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Torre M, Borel C, Saitua F, Ossandon F, Latorre JJ, Varela P. Lipoblastoma with unique localization requiring tracheal and esophageal resection. J Pediatr Surg 2010; 45:e21-3. [PMID: 20920704 DOI: 10.1016/j.jpedsurg.2010.06.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 06/17/2010] [Accepted: 06/19/2010] [Indexed: 10/19/2022]
Abstract
Lipoblastoma and lipoblastomatosis are rare tumors of infancy. They originate from embryonic fat and localize in soft tissues. We present the case of a lipoblastoma of the neck with localization in tracheal and esophageal walls that required an extended laryngotracheal and esophageal resection. To our knowledge, this is the first report of such localization of this tumor.
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Affiliation(s)
- Michele Torre
- Pediatric Surgery, Istituto Gaslini, Genova 16148, Italy.
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18
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Abstract
‘Blastomas’ are tumors virtually unique to childhood. Controversy surrounds their nomenclature and there is no globally accepted classification. They are thought to arise from immature, primitive tissues that present persistent embryonal elements on histology, affect a younger pediatric population and are usually malignant. The ‘commoner’ blastomas (neuroblastoma, nephroblastoma, hepatoblastoma, medulloblastoma) account for approximately 25% of solid tumors in the pediatric age range. We present examples of the more unusual blastematous pediatric tumors (lipoblastoma, osteoblastoma, chondroblastoma, hemangioblastoma, gonadoblastoma, sialoblastoma, pleuropulmonary blastoma, pancreatoblastoma, pineoblastoma, and medullomyoblastoma) that were recorded in our institution. Although these rare types of blastomas individually account for <1% of pediatric malignancies, collectively they may be responsible for up to 5% of pediatric tumors in a given population of young children. Imaging is often non-specific but plays an important role in their identification, management and follow-up. Some characteristic imaging features at diagnosis, encountered in cases diagnosed and treated in our institution, are described and reviewed.
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Affiliation(s)
- Georgia Papaioannou
- Department of Radiology, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK.
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19
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Yu DC, Javid PJ, Chikwava KR, Kozakewich HP, Debiec-Rychter M, Lillehei CW, Weldon CB. Mesenteric lipoblastoma presenting as a segmental volvulus. J Pediatr Surg 2009; 44:e25-8. [PMID: 19231517 DOI: 10.1016/j.jpedsurg.2008.11.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 11/03/2008] [Accepted: 11/05/2008] [Indexed: 11/26/2022]
Abstract
Mesenteric lipoblastoma is a rare tumor and, its presentation as a bowel obstruction with possible midgut volvulus has only been reported once before. A 7-year-old girl presented with nausea and vomiting but a benign abdominal examination. Upper gastrointestinal contrast study demonstrated possible malrotation with midgut volvulus. During emergency laparotomy, segmental small bowel volvulus secondary to a large mesenteric lipoblastoma was found. The lipoblastoma was resected with a segment of small bowel. Resection margins were negative for tumor, and the patient is doing well with no evidence of recurrence.
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Affiliation(s)
- David C Yu
- Department of Pediatric Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
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20
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Morerio C, Nozza P, Tassano E, Rosanda C, Granata C, Conte M, Panarello C. Differential diagnosis of lipoma-like lipoblastoma. Pediatr Blood Cancer 2009; 52:132-4. [PMID: 18798558 DOI: 10.1002/pbc.21747] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Lipoblastomas are rare benign tumors of white fatty tissue that occur primarily in young children. Occasionally, heterogeneity of morphological appearance and histological overlap with other lipogenic tumors are described. In such cases fluorescence in situ hybridization (FISH) analysis of PLAG1, a gene specifically rearranged in lipoblastoma, is necessary to prevent misdiagnosis. We present a case of lipoblastoma arising in an atypical site with histological features characteristic of lipoma. The correct diagnosis was made possible on cytogenetic grounds through the identification of the characteristic PLAG1-HAS2 fusion gene, thus allowing an appropriate clinical approach.
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Affiliation(s)
- Cristina Morerio
- Department of Pediatric Hematology/Oncology, Giannina Gaslini Institute, Genova, Italy
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21
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Cudnik R, Efron PA, Chen MK, Reith JD, Beierle EA. Mesenteric lipoblastoma: a rare location in children. J Pediatr Surg 2008; 43:e5-7. [PMID: 19040920 DOI: 10.1016/j.jpedsurg.2008.08.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2008] [Revised: 08/12/2008] [Accepted: 08/13/2008] [Indexed: 11/30/2022]
Abstract
Lipoblastoma is a rare childhood tumor composed of embryonic fat. It is benign and most often presents in children younger than 3 years. These tumors primarily present as a rapidly enlarging mass in the extremities or trunk with abdominal lipoblastomas comprising less than 10% of all reported cases. Abdominal lipoblastomas are most commonly found in the retroperitoneum with less than 15 reported cases arising in the mesentery. We report the unusual presentation of a lipoblastoma arising in the mesentery of a 3-year-old boy.
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Affiliation(s)
- Raymond Cudnik
- Division of Pediatric Surgery, University of Florida College of Medicine, Gainesville, FL 32610, USA
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Do NY, Cho SI, Park JH, Choi JY. Lipoblastoma arising from the submandibular region. J Pediatr Surg 2008; 43:e13-5. [PMID: 18970913 DOI: 10.1016/j.jpedsurg.2008.06.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 06/18/2008] [Accepted: 06/22/2008] [Indexed: 10/21/2022]
Abstract
A lipoblastoma is a rare, benign tumor arising from embryonic white fat. The tumors occur primarily in infancy and early childhood and commonly arise from the limbs and the trunk, but neck involvement is extremely rare. Our case arose in a 22-month-old male presenting with a rapidly enlarging soft mass in the right submandibular area. Lipoblastoma was diagnosed by histologic evaluation, the mass was completely removed, and there was no recurrence at 1-year follow-up.
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Affiliation(s)
- Nam-Yong Do
- Department of Otorhinolaryngology, Chosun University College of Medicine, Kwang-ju, South Korea
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Brodsky JR, Kim DY, Jiang Z. Cervical lipoblastoma: Case report, review of literature, and genetic analysis. Head Neck 2007; 29:1055-60. [PMID: 17427967 DOI: 10.1002/hed.20633] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Lipoblastoma is a rare, benign tumor of infants and children, usually occurring in the extremities and trunk, with only a few cases reported in the neck. METHODS We describe the case of an infant with a rapidly enlarging, painless neck mass. MRI revealed a 4-cm-diameter mass deep to the paraspinal muscles, in close proximity to the C2 vertebral foramen. Review of literature, diagnostic methods, and genetics of lipomatous tumors are discussed. RESULTS Complete surgical excision via a posterior cervical approach demonstrated irregular lobules of immature fat cells separated by a loose, myxoid connective tissue. Histology and genetic analysis confirmed the diagnosis of lipoblastoma. CONCLUSION Cervical lipoblastoma is rare, and typically presents as an asymptomatic, painless mass, rarely causing airway obstruction or nerve compression. MRI can be helpful in identifying the lipomatous nature of the mass, but the findings can be inconsistent due to variable maturity of fat cells and the mesenchymal content of the tumor. Chromosomal analysis is useful in differentiating lipoblastoma from liposarcoma. Recommended treatment is complete surgical excision.
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Affiliation(s)
- Jacob R Brodsky
- Department of Otolaryngology-Head and Neck Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Abstract
OBJECTS The lipoblastoma is a rare benign pediatric neoplasm that derives from embryonic white fat cells. However, this tumor with spinal invasion in children is extremely rare. We report a case of a 3-year-old boy who had lipoblastoma with massive invasion into the lower lumbosacral spinal canal. CASE REPORT A 3-year-old boy had suffered from progressive urinary incontinence and uncontrolled defecation during past 3 months. Computed tomography and magnetic resonance imaging scans showed that a large lobulated pelvic cavity mass had invaded the lumbosacral spinal canal. The mass was located over the epidural space from L4 to the lower sacral spinal canal, resulting in the compression of the thecal sac. After total laminectomy from L4 to S3 with flavectomy, a subtotal mass removal for the intraspinal canal mass was done. Histopathologic diagnosis confirmed the lipoblastoma. CONCLUSION Lipoblastoma is a rare benign neoplasm and lumbosacral invasion is unique. Complete surgical excision is the treatment of choice. If an incomplete surgical excision is performed, close observation and clinical follow-up must be done because a recurrence is possible.
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Affiliation(s)
- Seung-Won Choi
- Department of Neurosurgery, College of Medicine Chungnam National University, 640, Daesa-dong, Jung-gu, Daejeon 301-721, South Korea
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25
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Del Sordo R, Cavaliere A, Sidoni A, Colella R, Bellezza G. Intrascrotal lipoblastoma: a case report and review of the literature. J Pediatr Surg 2007; 42:E9-11. [PMID: 17336178 DOI: 10.1016/j.jpedsurg.2006.12.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Lipoblastomas are rare benign soft tissue tumors that occur primarily in young children. Most lipoblastomas occur in the extremities, trunk, head, and neck. An intrascrotal location is unusual. We describe the case of a 4-year-old boy with an intrascrotal lipoblastoma and discuss the differential diagnosis in reviewing the literature.
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Affiliation(s)
- Rachele Del Sordo
- Division of Cancer Research, Institute of Pathologic Anatomy and Histology, Perugia Medical School, University of Perugia, Perugia, Italy.
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Gómez-Roselló E, Martínez-León MI, López-Ruiz P, Ceres-Ruiz L. [Intrathoracic lipoblastoma with costal involvement]. RADIOLOGIA 2007; 48:394-7. [PMID: 17323899 DOI: 10.1016/s0033-8338(06)75156-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We report the case of a two-year-old girl with a lipoblastoma arising from the chest wall with intrathoracic extension and costal involvement. The diagnosis was confirmed histologically after surgery. Plain-film chest x-rays showed an extrapleural mass; computed tomography (CT) and magnetic resonance imaging (MRI) suggested fatty contents. The differential diagnosis is mainly versus liposarcoma, which is extremely rare in children.
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Affiliation(s)
- E Gómez-Roselló
- Servicio de Radiodiagnóstico, Radiología Pediátrica, Hospital Materno-lnfantil del Complejo Hospitalario Universitario Carlos Haya, Málaga, España
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27
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Ramachandran M, Alshahrani DA, Umadevi KR. Lipoblastoma and infantile lipoma. Ann Saudi Med 2006; 26:486-7. [PMID: 17146210 PMCID: PMC6074329 DOI: 10.5144/0256-4947.2006.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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28
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Grandbois L, Vade A, Lim-Dunham J, Al-Masri H. MRI findings of an intermuscular lipoma in a 2-year-old. Pediatr Radiol 2006; 36:974-6. [PMID: 16752133 DOI: 10.1007/s00247-006-0227-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2006] [Accepted: 04/12/2006] [Indexed: 12/28/2022]
Abstract
We report the MRI findings of a large deep intermuscular lipoma in a 2-year-old child with a painless palpable shoulder mass, and its differentiation from liposarcoma and other soft-tissue masses. To our knowledge, the imaging features of deep lipomas in children have not been reported.
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Affiliation(s)
- Lindsey Grandbois
- Department of Radiology, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60153, USA.
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29
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Brandal P, Bjerkehagen B, Heim S. Rearrangement of chromosomal region 8q11-13 in lipomatous tumours: correlation with lipoblastoma morphology. J Pathol 2006; 208:388-94. [PMID: 16308870 DOI: 10.1002/path.1879] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cytogenetics is of considerable value when diagnosing lipomatous tumours, as different tumour types have different more or less specific chromosomal abnormalities. One such entity is lipoblastoma, which is a benign lipomatous tumour that often exhibits rearrangements of chromosome bands 8q11-13, and the gene PLAG1 has been implicated as the target of these chromosomal changes. All lipomatous tumours karyotyped at the Norwegian Radium Hospital were reviewed, looking for rearrangements of 8q11-13. Five tumours exhibiting chromosomal abnormalities affecting this region were found. Only one of them was morphologically diagnosed as a lipoblastoma, two being classified as lipomas, one as a hibernoma, and one as a well-differentiated liposarcoma. The two tumours successfully analysed with bacterial artificial chromosomes (BACs) covering the gene PLAG1 showed involvement of this gene in the rearrangement. The findings raise the question as to what extent the diagnosis lipoblastoma should be based on histopathological or cytogenetic/molecular data or a combination thereof. When karyotypic information from this series was combined with available literature data, it was found that the sensitivity of 8q11-13 rearrangements for diagnosing lipoblastomas when found in a lipomatous tumour was 77% and that the corresponding specificity was 98%. The validity of these calculations of the diagnostic information provided by the cytogenetic findings is, of course, totally dependent on the morphological diagnosis made in each case. Regardless of what the precise phenotypic diagnosis was, it is suggested that lipomatous tumours with 8q11-13 rearrangement constitute a distinct pathogenetic entity. When selective therapies tailor-made against the specific pathogenetic rearrangement become available, it will become mandatory to pay more attention to the genetic constitution of the tumour cells than to their phenotypic appearance.
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Affiliation(s)
- Petter Brandal
- Department of Cancer Genetics, The Norwegian Radium Hospital, Oslo, Norway
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30
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Murphey MD, Carroll JF, Flemming DJ, Pope TL, Gannon FH, Kransdorf MJ. From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics 2005; 24:1433-66. [PMID: 15371618 DOI: 10.1148/rg.245045120] [Citation(s) in RCA: 452] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Benign lipomatous lesions involving soft tissue are common musculoskeletal masses that are classified into nine distinct diagnoses: lipoma, lipomatosis, lipomatosis of nerve, lipoblastoma or lipoblastomatosis, angiolipoma, myolipoma of soft tissue, chondroid lipoma, spindle cell lipoma and pleomorphic lipoma, and hibernoma. Soft-tissue lipoma accounts for almost 50% of all soft-tissue tumors. Radiologic evaluation is diagnostic in up to 71% of cases. These lesions are identical to subcutaneous fat on computed tomographic (CT) and magnetic resonance (MR) images and may contain thin septa. Lipomatosis represents a diffuse overgrowth of mature fat affecting either subcutaneous tissue, muscle or nerve, and imaging is needed to evaluate lesion extent. Lipoblastoma is a tumor of immature fat occurring in young children, and imaging features may reveal a mixture of fat and nonadipose tissue. Angiolipoma, myolipoma, and chondroid lipoma are rare lipomatous lesions that are infrequently imaged. Spindle cell and pleomorphic lipoma appear as a subcutaneous lipomatous mass in the posterior neck or shoulder, with frequent nonadipose components. Hibernoma appears as a lipomatous mass with serpentine vascular elements. Benign lipomatous lesions affecting bone, joint, or tendon sheath include intraosseous lipoma, parosteal lipoma, liposclerosing myxofibrous tumor, discrete lipoma of joint or tendon sheath, and lipoma arborescens. Intraosseous and parosteal lipoma have a pathognomonic CT or MR appearance, with fat in the marrow space or on the bone surface, respectively. Liposclerosing myxofibrous tumor is a rare intermixed histologic lesion commonly located in the medullary canal of the intertrochanteric femur. Benign lipomatous lesions may occur focally in a joint or tendon sheath or with diffuse villonodular proliferation in the synovium (lipoma arborescens) and are diagnosed based on location and identification of fat. Understanding the spectrum of appearances of the various benign musculoskeletal lipomatous lesions improves radiologic assessment and is vital for optimal patient management.
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Affiliation(s)
- Mark D Murphey
- Department of Radiologic Pathology, Armed Forces Institute of Pathology, 6825 16th St NW, Bldg 54, Rm M-133A, Washington, DC 20306, USA.
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Own AI, Salam IMA, Mahmoud MA, Elamin EM, El Hassan AM. Lipoblastoma in a four-year-old African child. Fetal Pediatr Pathol 2005; 24:133-9. [PMID: 16338874 DOI: 10.1080/15227950500304192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A four-year old Sudanese child presented with a growing mass in the medial aspect of the right thigh. The mass appeared during the neonatal period. On clinical examination a diagnosis of lipoblastoma was entertained on the basis of the patient's age and the clinical features of the mass. The tumor was completely excised surgically. The clinical diagnosis of lipoblastoma was confirmed pathologically. Follow-up of the patient for 6 months postoperatively showed no evidence of recurrence.
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Affiliation(s)
- A I Own
- Department of Surgery, The Academy of Medical Sciences and Technology, The Academy Charity Teaching Hospital, Khartoum, Sudan
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Sakaida M, Shimizu T, Kishioka C, Majima Y. Lipoblastoma of the neck: a case report and literature review. Am J Otolaryngol 2004; 25:266-9. [PMID: 15239035 DOI: 10.1016/j.amjoto.2003.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Lipoblastoma is a rare benign tumor arising from embryonic white fat. We describe a case of huge lipoblastoma of the neck in a 1-year-old boy. Magnetic resonance imaging (MRI) revealed a 7 x 7 cm neck mass that extruded into the parapharyngeal and paratracheal spaces. At the operation, a well-circumscribed and extensively growing tumor was completely removed. Histopathologic examination showed that the tumor contained lobulated mature adipose tissue and myxoid tissue with lipoblasts and other immature fat cells. The postoperative course was uneventful, and no recurrence of tumor has been noted in more than 2 years follow-up.
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Affiliation(s)
- Mayuko Sakaida
- Department of Otorhinolaryngology, Mie University School of Medicine, Japan.
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33
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Sandberg AA. Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors: lipoma. ACTA ACUST UNITED AC 2004; 150:93-115. [PMID: 15066317 DOI: 10.1016/j.cancergencyto.2003.12.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2003] [Revised: 12/22/2003] [Accepted: 12/24/2003] [Indexed: 02/02/2023]
Affiliation(s)
- Avery A Sandberg
- Department of DNA Diagnostics, St. Joseph's Hospital and Medical Center, 350 West Thomas Road, Phoenix, AZ 85013, USA.
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34
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Camilleri AC, Smith WP, Kaiser L. Infantile cervical lipoblastoma: a case report and review of the literature. J Oral Maxillofac Surg 2004; 62:383-6. [PMID: 15015175 DOI: 10.1016/j.joms.2003.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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35
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Ching ASC, Lee SF, Chan YL. Diagnosing paediatric mediastinal lipoblastoma using ultrasound-guided percutaneous needle biopsy: review and report. Clin Imaging 2002; 26:23-6. [PMID: 11814748 DOI: 10.1016/s0899-7071(01)00339-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Lipoblastoma is a rare tumor of embryonal fat occurring predominantly in the first three years of life. This benign tumor has potentials to local invasion and rapid growth. We reported a rare case of mediastinal lipoblastoma. The computed tomography (CT) and ultrasound (US) features, and the roles of percutaneous transthoracic US-guided needle biopsy, are discussed.
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Affiliation(s)
- A S C Ching
- Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR, China.
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36
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Gisselsson D, Hibbard MK, Dal Cin P, Sciot R, Hsi BL, Kozakewich HP, Fletcher JA. PLAG1 alterations in lipoblastoma: involvement in varied mesenchymal cell types and evidence for alternative oncogenic mechanisms. THE AMERICAN JOURNAL OF PATHOLOGY 2001; 159:955-62. [PMID: 11549588 PMCID: PMC1850475 DOI: 10.1016/s0002-9440(10)61771-3] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Lipoblastomas are rare soft tissue tumors that occur primarily in young children. They typically contain variably differentiated adipocytes, primitive mesenchymal cells, myxoid matrix, and fibrous trabeculae. Abnormalities in chromosome 8, leading to rearrangements of the PLAG1 gene, were demonstrated recently in four lipoblastomas. In the present report, we determine the frequency of PLAG1 alterations in 16 lipoblastomas from children aged 13 years or younger, and we also evaluate the stages of lipoblastoma differentiation at which PLAG1 genomic alterations are found. Eleven lipoblastomas (69%), including those with either classic or lipoma-like histology, had rearrangements of the 8q12 PLAG1 region. Another three lipoblastomas had polysomy for chromosome 8 in the absence of PLAG1 rearrangement. Only two cases (13%) lacked a chromosome 8 abnormality. Notably, the lipoblastomas with chromosome 8 polysomy had up to five copies of chromosome 8 as an isolated cytogenetic finding in an otherwise diploid cell. We also demonstrate that PLAG1 alterations are found in a spectrum of mesenchymal cell types in lipoblastomas, including lipoblasts, mature adipocytes, primitive mesenchymal cells, and fibroblast-like cells. This finding is consistent with neoplastic origin in a primitive mesenchymal precursor and with variable differentiation to a mature adipocyte end-point. Hence, our studies provide biological validation for the clinical observation that lipoblastomas can evolve into mature, lipoma-like, lesions. They also suggest that PLAG1 dosage alterations caused by polysomy 8 might represent an alternative oncogenic mechanism in lipoblastoma.
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Affiliation(s)
- David Gisselsson
- Brigham and Women’s Hospital, Boston, Massachusetts; the Department of Pathology,¶
| | - Michele K. Hibbard
- Brigham and Women’s Hospital, Boston, Massachusetts; the Department of Pathology,¶
| | - Paola Dal Cin
- Brigham and Women’s Hospital, Boston, Massachusetts; the Department of Pathology,¶
| | - Raf Sciot
- University Hospital, Leuven, Belgium
| | - Bae-Li Hsi
- Brigham and Women’s Hospital, Boston, Massachusetts; the Department of Pathology,¶
| | | | - Jonathan A. Fletcher
- Brigham and Women’s Hospital, Boston, Massachusetts; the Department of Pathology,¶
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