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Forehead lipoblastoma mimicking a hemangioma
C S Perlis1, M H Collins, P J Honig
1University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Insights
This case report highlights a rare forehead lipoblastoma in an infant that mimicked a hemangioma. Increased suspicion for atypical hemangiomas is crucial for accurate pediatric diagnosis and timely treatment.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
Background:
- Lipoblastoma is a rare, benign tumor of immature fat cells predominantly affecting the pediatric population.
- These tumors typically present as rapidly enlarging, soft, lobular masses, often on the extremities.
Observation:
- A 2-month-old male infant presented with a rapidly growing forehead mass exhibiting increased vascularity, initially suspected to be a hemangioma.
- The lesion was unresponsive to steroid therapy, and magnetic resonance imaging (MRI) findings further supported a diagnosis of hemangioma due to its hypervascular nature.
Findings:
- Pathologic examination of the surgically excised mass revealed a primitive lipoblastoma, not a hemangioma.
- This case underscores the diagnostic challenge, as preoperative imaging and clinical presentation were misleading.
Implications:
- Pediatricians should consider lipoblastoma in the differential diagnosis of atypical infantile hemangiomas, especially those with rapid growth and lack of response to steroids.
- Accurate preoperative diagnosis of lipoblastoma is challenging but essential for appropriate management and surgical planning.
Abstract:
A case of forehead lipoblastoma simulating a hemangioma in a male infant is reported, to alert pediatricians to this rare tumor and to increase the index of suspicion in atypical hemangiomas. A 2-month-old male infant developed a protruding forehead mass with increased vascularity. It demonstrated progressive and accelerated growth over the subsequent 6 months, unresponsive to steroid therapy. A magnetic resonance imaging scan supported the diagnosis of hemangioma because of the hypervascular nature of the lesion. Surgical excision was performed because of visual obstruction. Pathologic examination of the specimen was consistent with a very primitive lipoblastoma. This tumor is a rare, benign lesion of immature fat cells that is found almost exclusively in the pediatric population. Lipoblastomas are more common in males than females and frequently present as asymptomatic, rapidly enlarging, soft lobular masses on the extremities. Complete surgical excision is the definitive treatment. In the vast majority of reported cases, however, the preoperative diagnosis was incorrect, underscoring the diagnostic dilemma presented by these rare tumors.