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Cardoen L, Nicolas N, Le Gaudu V, Gauthier A, Carton M, Berrebi D, Cyrta J, Collignon C, Cordero C, Pierron G, Pannier S, Philippe-Chomette P, Orbach D, Brisse HJ. Fat-Containing Soft Tissue Tumors in Children, Adolescents, and Young Adults: Which Require Biopsy? Cancers (Basel) 2023; 15:3228. [PMID: 37370837 DOI: 10.3390/cancers15123228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE To confirm the overall benignity of fat-containing soft tissue tumors (STT) on a pediatric cohort and to define the clinical and imaging features that warrant a biopsy. METHODS A retrospective monocentric study was conducted on patients aged less than 25 years consecutively referred for fat-containing STT to our Comprehensive Cancer Center between 1998 and 2022. Tumor imaging characteristics at diagnosis (US, CT, or MRI) were correlated with pathology. RESULTS The database extraction identified 63 fat-containing tumors with clinical, histologic, and imaging data available for review. In total, 58 (92%) were benign tumors: 36 lipoblastomas and lipomas, 12 fibrous hamartomas of infancy (FHI), 5 lipofibromatosis, 2 lipomas arborescens, 2 lipomatosis and 1 spindle-cell lipoma. Five patients (8%) were diagnosed with liposarcoma. Factors significantly correlated with malignancy were age >10 years old (p < 0.001), having a cancer-predisposing condition (p < 0.001), a percentage of fat <25% (p = 0.002), and a presence of myxoid zones (p < 0.001) on imaging. CONCLUSION Most fat-containing STT in children may be classified as benign tumors based on clinics and imaging. The indication for biopsy could be limited to patients aged 10 years or more with either a cancer-predisposing condition or imaging features demonstrating either a low-fat component (<25%) or the presence of myxoid zones.
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Affiliation(s)
| | - Nayla Nicolas
- Department of Imaging, Institut Curie, 75005 Paris, France
| | | | - Arnaud Gauthier
- Department of Pathology, Institut Curie, 75005 Paris, France
| | - Matthieu Carton
- Department of Biostatistics, Institut Curie, 75005 Paris, France
| | - Dominique Berrebi
- Department of Pathology, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades, 75015 Paris, France
| | - Joanna Cyrta
- Department of Pathology, Institut Curie, 75005 Paris, France
| | - Charlotte Collignon
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL University, 75005 Paris, France
| | - Camille Cordero
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL University, 75005 Paris, France
| | - Gaëlle Pierron
- Department of Somatic Genetics, Institut Curie, 75005 Paris, France
| | - Stéphanie Pannier
- Paediatric Orthopaedic Service, Assistance Publique des Hôpitaux de Paris, Université Paris Cité, Hôpital Necker, 75015 Paris, France
| | - Pascale Philippe-Chomette
- Department of Pediatric Surgery, Assistance Publique des Hôpitaux de Paris, Hôpital Robert Debré, 75019 Paris, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL University, 75005 Paris, France
| | - Hervé J Brisse
- Department of Imaging, Institut Curie, 75005 Paris, France
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Zhang W, Zhang S, Yang Z, Zhang Y, Wang Z. Lipoblastoma in one adult and 35 pediatric patients: Retrospective analysis of 36 cases. Exp Ther Med 2022; 25:11. [PMID: 36561624 PMCID: PMC9748941 DOI: 10.3892/etm.2022.11710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Lipoblastoma is a rare benign mesenchymal neoplasm that typically occurs at various sites in infants and children but may also occur in adults. Thus, differential diagnoses are often performed. To understand this tumor type, the present study described clinicopathological features, diagnosis and differential diagnosis of different morphological lipoblastomas. A single-institution retrospective review of 36 lipoblastoma cases diagnosed between 2015 and 2021 was performed. Formalin-fixed paraffin-embedded tissue was used for S-100, CD34, P16 and desmin immunohistochemistry analysis, along with rapid fluorescence in situ hybridization (FISH) detection with pleiomorphic adenoma gene 1 (PLAG1). The 36 cases included 14 females and 22 males [age range, 7 days to 33 years (median, 16.5 years); 28 patients were aged ≤3 years] and the tumors were located in the trunk (n=16), limbs (n=12), head and neck (n=6), and perineum (n=2). Histologically, lipoblastomas were divided into classic (n=15), lipoma-like (n=13) and myxoid (n=8) subtypes. They comprised lobules of mature adipose tissue of varying size and a fine capillary network surrounded by mucinous stroma. Single- or multivesicular lipoblasts positive for S-100 (29/36, 81%) were observed, with occasional mature adipocytes. Peripheral vessels and cytoplasm of primitive mesenchymal cells were diffusely positive for CD34 (36/36, 100%), whereas primitive mesenchymal cells and striated muscle tissue were positive for desmin (26/36, 72%). Most tumor cells were negative while only few were positive for P16 (8/36, 22%). FISH revealed PLAG1 breakage and rearrangement in 24/32 (75%) patients. In total, 28 patients were followed up post-operatively (range, 2-84 months; median, 41 months; 3 patients relapsed and 8 were lost to follow-up). In conclusion, diagnosis of a typical lipoblastoma is not difficult and PLAG1 breakage detection is key for the diagnosis.
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Affiliation(s)
- Wenchuan Zhang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Shuwan Zhang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Zixin Yang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Ying Zhang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Zhe Wang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China,Correspondence to: Professor Zhe Wang, Department of Pathology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning 110004, P.R. China
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McRae JJLH, Hashmi A, Radulescu A, Carter CS, Khan FA. Lipoblastomas and liposarcomas in paediatric patients: A case series. J Int Med Res 2021; 49:300060520981362. [PMID: 33730887 PMCID: PMC8166409 DOI: 10.1177/0300060520981362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Lipoblastomas and liposarcomas are rare causes of soft tissue masses in paediatric patients. In this retrospective clinical case series we identified 11 patients from our paediatric database (10 with a lipoblastoma and one with a liposarcoma) who had attended our hospital between 1998 and 2019. The median age of patients with lipoblastoma was 29 months. All lipoblastoma cases were managed with surgical excision and histological examination. The 18-year old patient with liposarcoma presented with a metastatic and unresectable tumour that was unresponsive to chemotherapy and radiation. Our experience demonstrates the importance of differentiating the type of soft tissue mass in children.
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Affiliation(s)
| | - Asra Hashmi
- School of Medicine, Loma Linda University, Loma Linda, CA, USA.,Department of Plastic Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Andrei Radulescu
- School of Medicine, Loma Linda University, Loma Linda, CA, USA.,Division of Paediatric Surgery, Department of Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Cody S Carter
- School of Medicine, Loma Linda University, Loma Linda, CA, USA.,Division of Paediatric Surgery, Department of Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Faraz A Khan
- School of Medicine, Loma Linda University, Loma Linda, CA, USA.,Division of Paediatric Surgery, Department of Surgery, Loma Linda University, Loma Linda, CA, USA
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