An Unusual Paediatric Neck Mass: Cervical Lipoblastoma with Spinal Involvement

Area of Science:

• Pediatric Oncology
• Surgical Pathology
• Neurosurgery

Background:

• Lipoblastoma is a rare, benign tumor originating from embryonic white fat, predominantly affecting children.
• Spinal involvement of lipoblastoma is exceptionally rare, with limited documented cases.
• This report focuses on a unique presentation of spinal lipoblastoma in a pediatric patient.

Purpose of the Study:

• To report a rare case of spinal lipoblastoma in a 7-year-old boy.
• To illustrate the diagnostic process and imaging findings of spinal lipoblastoma.
• To discuss the surgical management and outcomes of this rare pediatric spinal tumor.

Main Methods:

• Case presentation of a 7-year-old boy with a long-standing neck mass.
• Utilized Ultrasound, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI) for lesion characterization.
• Performed near-total surgical excision with histopathological confirmation.

Main Results:

• A large, multilobulated lipomatous lesion extending to the C3-C5 spinal foramina was identified, causing spinal cord displacement.
• Near-total tumor excision was achieved, with a small remnant left due to adherence to the vertebral artery.
• Histopathology confirmed the diagnosis of lipoblastoma. Postoperative ptosis and miosis resolved within two months.

Conclusions:

• Spinal lipoblastoma, though rare, should be considered in the differential diagnosis of pediatric neck masses with spinal extension.
• Multimodality imaging is crucial for delineating the extent of spinal lipoblastoma.
• Surgical management can be effective, even with challenges like vertebral artery adherence, with favorable outcomes and no recurrence observed.