Benign chest wall lipoblastoma of infancy producing underlying bone enlargement

Thoracic lipoblastoma in a 7-month-old infant

We report a rare case of a thoracic lipoblastoma in a 7-month-old infant who presented with respiratory infection, dyspnea, and a right-sided chest wall swelling. Imaging revealed a predominantly fatty mass, and biopsy confirmed the diagnosis. A right thoracotomy was performed, resulting in subtotal excision due to the tumor's friability. Two months later, a recurrent tumor was detected and was successfully treated with total excision. This case emphasizes the importance of complete surgical resection and regular follow-up to prevent local recurrence of thoracic lipoblastoma.

Lipoblastoma: a rare lesion in the differential diagnosis of childhood mediastinal tumors

Lipoblastoma is a rare, benign, fatty tissue tumor that occurs in childhood. The location of this tumor in the mediastinum and extension to the chest wall is uncommon. We describe a 12-month-old male infant with a mediastinal lipoblastoma discovered because of a chest wall swelling. Computed tomography showed the deep component and fatty content of the lesion suggestive of the diagnosis. Total excision of the mass was carried out. The histologic examination of the lesion confirmed the diagnosis of lipoblastoma. Mediastinal lipoblastoma should be considered among the possible diagnoses of a fatty mediastinal tumor in childhood.

The role of dynamic magnetic resonance urography in complex neonatal hydrometrocolpos

Urinary hydrometrocolpos is rarely diagnosed and is most often attributed to a persistent urogenital sinus or a cloaca. We report the case of a neonate in which the use of dynamic MRI allowed accurate preoperative diagnosis of urinary hydrometrocolpos secondary to ectopic drainage of a small left pelvic kidney, associated with a bicornuate uterus.

[Intrathoracic lipoblastoma with costal involvement]

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.

A thoracic wall lipoblastoma in a 3-month-old infant: A case report and review of the literature

Lipoblastoma is a rare benign tumor of adipose tissue seen almost always in infancy and early childhood. Lipoblastoma is present in 2 forms which are pathologically identical: circumscribed and diffuse. It is typically located in the extremities, and less frequently in head-neck region, trunk, and various organs. Lipoblastoma is a tumor with good prognosis with no reported metastases, despite its potential for local invasion and rapid growth. Our patient was a 3-month-old boy who was brought to our clinic for rapidly growing mass in the right hemithorax. With the aim of both diagnosis and treatment, the lipomatous mass was removed by local resection. In addition to the patient's age, histologic and cytogenetic analyses assisted the diagnosis of diffuse lipoblastoma. In the postoperative period, the thorax wall was unaffected, and after 6 years of follow-up no recurrence was observed. In the English literature, 8 cases of thoracic wall lipoblastoma have been previously reported, and only 3 of diffuse form. Here, we report, at our knowledge, the fourth case of thoracic diffuse lipoblastoma, in which cytogenetic analysis showed a previously undescribed karyotype aberration involving chromosomes 8, 13, and 16.

Radiological-pathological correlation in lipoblastoma and lipoblastomatosis

BACKGROUND

Lipoblastoma and lipoblastomatosis are uncommon benign mesenchymal lesions that predominantly occur in infancy and early childhood.

OBJECTIVE

To evaluate the imaging and histological features of lipoblastoma and lipoblastomatosis.

MATERIALS AND METHODS

Retrospective review of the radiological and pathological findings in children with lipoblastoma and lipoblastomatosis treated at a single centre between 1997 and 2004.

RESULTS

Eight children (median age 18 months) had undergone imaging and surgery at our institution. An infiltrative growth pattern was identified at imaging in two children with lipoblastomatosis, and a well-defined mass in six children with lipoblastoma. In all patients, imaging showed a lesion composed mostly, but not entirely, of fat. There were no recurrences at follow-up of between 1 and 91 months.

CONCLUSION

In infancy and early childhood, the identification of a tumour composed mostly of fat should suggest the diagnosis of lipoblastoma or lipoblastomatosis.

MR imaging diagnosis of uterovaginal anomalies: current state of the art

Uterovaginal anomalies are associated with a high incidence of decreased fertility and multiple obstetric problems. These anomalies are caused by alterations in development or fusion of the müllerian ducts. Uterovaginal anomalies are classified into three types: dysgenesis, vertical or lateral fusion defects, and unusual configurations. Systematic analysis of magnetic resonance (MR) images allows accurate morphologic demonstration and classification of uterovaginal anomalies, thereby indicating the appropriate treatment. The following parameters are recorded in MR images: uterine size, external fundal contour, intercornual distance, zonal anatomy, and presence of uterine or vaginal septa. Associated pelvic lesions or renal anomalies are to be reported. MR imaging allows diagnosis of obstructive uterovaginal anomalies; determining the site of obstruction is imperative for planning the proper surgical approach. MR imaging techniques, including planes, sequences, and the application of more recent advances, are discussed. Pelvic phase-array coils and endovaginal coils provide detailed images and can be problem-solving tools in complex anomalies. MR imaging findings associated with a variety of uterovaginal anomalies are shown. The author suggests a five-step approach for diagnosing uterovaginal anomalies with MR imaging.

Pulmonary lipoblastoma in an 18-month-old child: a unique tumor in children

Lipoblastoma, a rare benign tumor of adipose tissue, typically occurs in the superficial or deep layers of soft tissue on the trunk or extremities. Other sites of occurrence include the head, neck, and retroperitoneum. Lipoblastoma of the chest wall and parietal pleural have been reported, but occurrence within the lung has not been previously described. We report a case of pulmonary lipoblastoma in a young child presenting with complete opacification of the left hemithorax and mediastinal shift on chest radiograph. A lobectomy was performed, and the diagnosis was made by histological examination.

Lipoblastoma: pathophysiology and surgical management

BACKGROUND/PURPOSE

Lipoblastoma/lipoblastomatosis is a poorly understood and uncommon soft tissue tumor of infancy and early childhood. Twenty-four patients that presented to a single institution over a 15-year period were reviewed for clinical features and outcome.

METHODS

A retrospective review was conducted.

RESULTS

Twenty-five cases were identified; 1 chart was not available for review. Fourteen girls and 11 boys with a median age of 20 months (2 months, 10 years) presented with 26 separate tumors. Nineteen were focal and 7 diffuse. The tumors were located on the trunk (n = 13), leg (n = 6), arm (n = 3), and head and neck (n = 4). Five patients (all with diffuse type) had up to 3 recurrences.

CONCLUSIONS

Patients with focal lipoblastoma are unlikely to require further surgery after initial resection. Patients with diffuse lipoblastoma (lipoblastomatosis) are likely to have recurrent disease (usually within 2 years) and should undergo close follow-up. Genetic analysis of the specimen will help exclude liposarcoma. Recurrent lesions are best imaged with magnetic resonance imaging to assess extent and plan reconstruction if necessary.