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Head and neck lipoblastoma in children: A case report and systematic review
Justyna Tyra1, Paulina Mierzwińska-Dolny2, Andrew J Fishman3
1Children's Hospital of Bydgoszcz, Department of Otolaryngology, Audiology and Phoniatrics, Pediatric Cochlear Implant Program, Bydgoszcz, Poland.
Insights
Lipoblastoma, a rare pediatric tumor, is best treated with complete surgical excision. Recurrence is possible, necessitating long-term follow-up for this rapidly growing adipose mass.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Lipoblastoma is a rare, benign tumor of embryonal fat cells, predominantly affecting infants and young children.
- This study reviews 83 pediatric cases of head and neck lipoblastoma from 1964-2022.
- A case of extensive infratemporal fossa and parapharyngeal space lipoblastoma in a 10-month-old is presented.
Observation:
- The review identified 83 pediatric lipoblastomas, with 27% in the head and 65% in the neck.
- Tumor locations varied, with a slight predominance in males (48%) versus females (45%).
- Patient ages ranged from neonates to 15 years.
Findings:
- Complete surgical excision is the primary treatment for lipoblastoma.
- Post-surgical recurrence was observed in 6% of cases.
- This case highlights the challenges of extensive head and neck lipoblastoma, involving V2 and V3 cranial nerves.
Implications:
- Complete surgical excision is the recommended treatment for lipoblastoma.
- Interdisciplinary teams and advanced techniques like endoscopy and microdebrider aid in complex cases.
- Long-term follow-up is crucial due to the potential for tumor recurrence.
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.
