Lipoblastoma of the extremities
Sanjna Rajput1, Saad A Alsubaie2, Kuldeep Singh2
1Mayo Clinic, Mayo Clinic Alix School of Medicine, Rochester, MN, United States.
Insights
Lipoblastoma, a rare benign tumor in children, can mimic liposarcoma on imaging. Definitive diagnosis requires tissue biopsy, and surgical resection offers a curative outcome with low recurrence risk.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Lipoblastoma is a rare benign tumor in infants and children.
- Radiographic findings can resemble malignant liposarcoma, necessitating accurate differentiation.
- Clinical features and advanced diagnostics are crucial for distinguishing lipoblastoma.
Purpose of the Study:
- To present institutional experience in diagnosing and managing lipoblastoma.
- To analyze diagnostic methods, treatments, and recurrence risks.
- To highlight the importance of differentiating lipoblastoma from liposarcoma.
Main Methods:
- Retrospective chart review of patients treated for lipoblastoma over 30 years.
- Evaluation of diagnostic modalities including ultrasound, MRI, X-ray, and CT.
- Analysis of treatment outcomes, including surgical resection and recurrence rates.
Main Results:
- 12 patients (9 males, 3 females) diagnosed with lipoblastoma.
- Tumor locations included lower (8) and upper extremities (4).
- Complete surgical resection was performed for all patients with no reported recurrences.
Conclusions:
- Lipoblastoma, though rare, requires accurate diagnosis, often necessitating core biopsy.
- Surgical resection is the curative treatment with minimal complications.
- Routine monitoring is not recommended due to the low likelihood of recurrence.
Background:
Lipoblastoma is a rare benign tumor of infancy and childhood, with similar radiographic imaging findings as malignant liposarcoma. Therefore, it is crucial to distinguish through other diagnostics and clinical features. We present our experience with the diagnosis and clinical management of this entity.
Methods:
A retrospective chart review was performed to identify children treated for lipoblastoma at our institution over a 30-year period. Charts were evaluated for diagnostic methods, treatment, and recurrence risk.
Results:
A total of 9 males and 3 females were identified. The age at diagnosis ranged from 8 months to 44 years. Imaging modalities employed included ultrasound (N = 5), MRI (N = 12), X-ray (N = 8), and CT (N = 3). The tumor location was reported in the lower extremity (N = 8) and upper extremity (N = 4). The tumor size ranged from 1.7 to 18 cm (mean=7.08 cm). All patients underwent complete resection. Available pathology reports noted masses featuring mature adipocytes (N = 1), fibrous septa (N = 2), focal myxoid changes (N = 1), and spindle cells (N = 2). Nine patients underwent chromosomal analysis, which demonstrated five chromosome 8 abnormalities. No recurrences were reported. Three patients had follow-up imaging, and 11 had follow-up visits between 2 weeks to 15 years.
Conclusion:
Lipoblastoma is an uncommon childhood neoplasm of embryonic white fat that can also be present in adolescence and adulthood. Imaging, especially MRI, is helpful in limiting the differential diagnosis, but definitive diagnosis requires tissue biopsy, which should be obtained with core biopsy rather than fine needle aspiration. Surgical resection is curative with few complications. We do not recommend routine monitoring as recurrence is unlikely.
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