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Submucosal Colonic Lipoblastoma Presenting With Colo-colonic Intussusception in an Infant
Marie-Anne Brundler1,2,3, Kyle C Kurek2, Kamlesh Patel4
11 Department of Histopathology, Birmingham Children's Hospital, Birmingham, UK.
Insights
A rare intestinal lipoblastoma, a benign tumor, caused intussusception in an infant. This case highlights lipoblastoma as a potential cause of this pediatric emergency.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Pathology
Background:
- Lipoblastoma is a rare, benign adipose tumor typically found in infants.
- Intestinal complications from lipoblastoma are exceptionally rare, usually involving intra-abdominal or retroperitoneal sites.
Observation:
- A case of a primary intestinal lipoblastoma originating in the transverse colon submucosa is presented.
- An 18-month-old boy experienced rectal prolapse, bleeding, and abdominal pain, initially managed for constipation.
- Imaging revealed colo-colonic intussusception, with a fatty mass identified during surgery.
Findings:
- Pathological analysis confirmed a submucosal lipoblastoma with mature adipose tissue and specific spindle cell characteristics.
- The tumor was identified as the lead point for the intussusception.
Implications:
- Lipoblastoma should be considered in the differential diagnosis of intussusception in young children.
- This case underscores the importance of identifying a pathologic lead point in pediatric intussusception.
Abstract:
Lipoblastoma is a benign adipose tumor typically presenting in infancy in superficial soft tissues of extremities. Intestinal complications secondary to intraabdominal or retroperitoneal involvement are exceedingly rare. We describe a unique case of a primary intestinal lipoblastoma arising from the submucosa of the transverse colon in an otherwise healthy 18-month-old boy. He presented with a history of reducible rectal prolapse, rectal bleeding, and episodic abdominal pain and was initially treated for constipation. Imaging identified a short colo-colonic intussusception, confirmed at laparotomy, and a fatty mass thought to arise from the mesentery. Pathological examination of the resected transverse colon revealed a submucosal tumor composed of a mixture of mature adipose tissue, foci of myxoid mesenchymal tissue with desmin positive, HMGA2 negative spindle cells, and scattered lipoblasts, characteristic of lipoblastoma. Lipoblastoma should be considered as a potential albeit rare cause of intussusception in young children, where a pathologic lead point is infrequently identified.
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