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Benign chest wall lipoblastoma of infancy producing underlying bone enlargement
M G Cowling1, S J Holmes, E J Adam
1Department of Diagnostic Radiology, St George's Hospital, Tooting, London, UK.
Insights
This case study details a chest wall lipoblastoma in an infant, a rare tumor. The tumor showed unusual rib expansion on X-ray and recurred twice after surgery.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Lipoblastomas are rare, benign tumors typically found in the limbs of children.
- Chest wall lipoblastomas are exceptionally uncommon, with limited case reports in existing literature.
- Early diagnosis and complete surgical resection are crucial for managing lipoblastomas.
Observation:
- A 6-month-old infant presented with a posterior chest wall mass.
- Chest X-ray revealed expansion of the posterior ribs, an undocumented feature for this condition.
- CT scan identified a fatty mass invading the extra-pleural space, causing muscle compression.
Findings:
- Histological examination confirmed a well-differentiated lipoblastoma.
- The tumor demonstrated aggressive local invasion and significant local muscle atrophy.
- Two recurrences necessitated repeat surgical interventions.
Implications:
- This case highlights the importance of considering lipoblastoma in infants with chest wall masses.
- The described radiological finding of rib expansion may aid in earlier diagnosis.
- Recurrence potential underscores the need for vigilant follow-up and potentially more extensive resection margins.
Abstract:
We report a case of a chest wall lipoblastoma first presenting in a 6-month-old infant. Clinical presentation was with a posterior chest wall mass. Chest X-ray showed expansion of the posterior ribs on the left, a feature not previously described in this condition. CT scanning delineated a mass of predominantly fat attenuation, which was invading between the ribs to line the extra-pleural space, and was causing compression and atrophy of muscles locally. There were two recurrences requiring further surgery. Histology showed a well-differentiated lipoblastoma.