LIPOBLASTOMA OF THE NECK IN AN 8 MONTHS-OLD GIRL

K. A. Diers¹. M. Albrecht¹, C. Utech², J. Waldschmidt³, R. Götte¹

¹Kinderklinik, ²Institut für Pathologie, St. Joseph-Krankenhaus. Berlin,

Germany; ³Abteilung für Kinderchirurgie. Universitätsklinikum Benjamin-Franklin,

Berlin, Germany

BACKGROUND: Lipoblastoma is a very rare benign tumour usually affecting the limbs and the trunk. Only few cases of localisation in the neck have been reported so far. In childhood lipoblastomas are rarely seen and may be confused with liposarcomas. The origin of the lipoblastoma is embryonic fat. Other differential diagnosis are lipoblastomatosis and more frequent fatty tumours.

CASE REPORT: An 8 months-old girl presented with a lump at the right side of her neck. The swelling had been detected 3 weeks prior and was reported to have been steadily increasing in size to a final 5x5 cm. There were no inflammatory signs. The development of the infant was normal, no weight loss was reported. Clinical examination did not reveal any further pathological condition, no enlargement of lymphnodes was detected. Laboratory findings including catecholamines were within normal range. On ultrasound the tumour showed septated, cystic, and partly echo-rich signals. Using Doppler-sonography several large vessels with slow blood-flow were seen. In magnetic resonance imaging (MRI) the tissue displaced neck muscles and showed a high intensity in both T1 and T2 weightings and strong uptake of contrast medium. The tumour was extirpated in toto and diagnosis was established by histology. The tissue exhibited areas of immature vacuolized adipocytes of various size within a myxoid stroma tabulated by collagenous septa without any signs of malignancy.

CONCLUSION: With this case report we demonstrate that lipoblastoma has to be considered as a differential diagnosis in soft tissue lumps of younger children. This lesion may mimic more usual childhood tumours like lipoma, hemangioma. fibroma or lymphangioma, respectively. Lipoblastoma and lipoblastomatosis have to be distinguished from liposarcoma. Presurgical diagnostic clues are obtained by ultrasound and MRI, definite diagnosis is confirmed by histology after complete surgical excision.