Large Parotid Gland Lipoblastoma in a Teenager

Head and neck lipoblastoma in children: A case report and systematic review

BACKGROUND

Lipoblastoma is a rare and benign tumor arising from embryonal fat cells. It develops primarily in infancy and early childhood. We present a case study of a 10-month-old child treated for an extensive tumor of the infratemporal fossa and parapharyngeal space. The systematic review of 60 reports in 80 children with lipoblastoma of the head and neck is also reported.

MATERIAL AND METHODS

Systematic review of all articles included lipoblastomas of the head and neck area in children published from 1964 to 2022 in the PubMed database was conducted. Clinical presentation of extensive lipoblastoma of the head and neck in a child.

RESULTS

On the basis of all inclusion criteria 83 articles were identified concerning pediatric lipoblastoma. There were 36 F (45%) and 39 M (48%), in 6 patients, (7%) gender was not specified. Ages ranged from 0mth (6h) to 15 yo (180mth). The tumor was located in the head in 22 (27%) cases, while the neck area accounted for 53 (65%) cases. General description without precise location was shown in 6 (7%) cases. All patients underwent complete surgical excision. Post surgical recurrence was noted in 6% clinical cases in the analyzed articles.

CONCLUSIONS

Lipoblastoma is characterized by a rapidly growing predominantly adipose mass. The treatment of choice is complete surgical excision. In selected cases when the pathology is hard to reach, as a consequence of the extensive penetration of the mass, we recommend performing the procedure with an interdisciplinary team. Endoscopy assistance and microdebrider significantly facilitated the removal of pathology in the described advanced case of lipoblastoma. This is the only case reported in the pediatric literature of a head and neck lipoblastoma, where due to extensive involvement and location of the disease the cranial nerves V2 and inferior alveolar branch of V3 could not be spared. Long-term follow-up even to 10 years is required because there is a reported tendency for these tumors to recur.

Lipoblastoma Arising in the Head and Neck: A Clinicopathologic Analysis of 20 Cases

BACKGROUND

Lipoblastomas (LPBs) are benign adipocytic neoplasms believed to recapitulate the development of embryonal fat.

METHODS

We investigated the clinicopathologic and immunohistochemical features of 20 lipoblastomas arising in the head and neck in 18 patients.

RESULTS

Patients included 6 males and 12 females (1:2 ratio) with age at diagnosis ranging from 4 months to 28 years. Tumors occurred more commonly in the neck (12, 66.7%) and less commonly in the forehead, scalp, and tongue (2, 11.1%). Tumor size ranged from 1.4 to 6.0 cm (median 5.0 cm). Two patients, a 4-month-old female and 3-year-old male, had local recurrence of neck tumors at 4 months and 3 years after excision, respectively. Microscopically, tumors had a lobulated growth pattern and consisted of adipocytes at varying stages of differentiation. In addition to the classical histologic features, lipoma-like and myxoid variants constituted 45% of cases. Metaplastic elements, including brown fat and cartilage, were identified in two cases.

CONCLUSIONS

LPBs arising in the head and neck region are not uncommon and occurred at a rate of 9% in our cohort. They should be kept in the differential diagnosis when a fatty tumor is encountered in an older child or occurring at an unusual location.

Lipoblastoma in one adult and 35 pediatric patients: Retrospective analysis of 36 cases

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.

Imaging of head and neck lipoblastoma: case report and systematic review

Lipoblastoma is a rare and benign tumour arising from embryonal fat cells, predominantly diagnosed in children younger than 3 years old. The most frequent locations are the extremities and trunk, while the head and neck areas are more rarely affected (10-15% of total cases). Clinically, the most common presentation is a fast-growing painless mass. Ultrasound is the first-line imaging examination, but Magnetic Resonance Imaging (MRI) allows for better definition of the relationships with the adjacent vascular and muscular structures. It can help to identify the lipomatous components, and it is useful for preoperative planning. However, the definitive diagnosis is provided by histopathological examination. Complete surgical excision is the first-line treatment, with a good prognosis in case of total eradication. We report the case of a 7-month-old male child with a rapidly growing mass that had typical radiological features of lipoblastoma.

Rapidly Growing Facial Tumor in a 5-Year-Old Girl

The aim of this study is to describe the clinical, radiological and histological characteristics that define lipoblastomas with special emphasis on differential diagnosis. The patient is a 5-year-old girl who consulted for a rapidly growing lower cheek tumor. This study analyzes, evaluates, and discusses the issues that need to be addressed throughout the process that affect treatment planning and provides an updated review of these rare head-and-neck tumors.

[Multivisceral resection of lipoblastoma of four anatomical areas of the head and neck with simultaneous neurotization of the facial muscles in an 8-months child. Clinical case]

The article describes diagnostics and surgical treatment of a rare benign tumor (lipoblastoma) of four anatomical areas of the head and neck in an 8-months child. Diagnostic data, surgical procedure performed using microsurgical techniques and intraoperative neuromonitoring and the patient's condition in the long-term postoperative period are presented. The histological conclusion about the removal of the tumor with negative resection margins suggests favorable prognosis of the disease.

Lipoblastoma of the left kidney: a case report and review of literature

A lipoblastoma is an infrequent benign tumor derived from embryonal adipose tissue. There are few reports on kidney lipoblastomas; there are fewer than three cases, including our case. An 80-year-old female was detected to have a left renal mass during a routine medical examination. Computed tomography (CT) and magnetic resonance imaging (MRI) indicated a heterogeneous mass before surgery, and histopathological tests subsequently revealed that the mass was a rare lipoblastoma. We present this case as a reminder to consider lipoblastomas in the differential diagnoses of kidney masses.