Presenter Status

Fellow

Abstract Type

Case report

Primary Mentor

Pamela Nicklaus, MD

Start Date

4-5-2022 11:30 AM

End Date

4-5-2022 1:30 PM

Presentation Type

Poster Presentation

Description

Background: Lipoblastoma is a rare benign tumor arising from embryonic fat cells in children younger than 3 years of age. They rarely present in the neck and usually do not have spindle cell appearance. We therefore present a case of neck lipoblastoma with review of the literature.

Case Description: We present the case of a 14-month-old male who presented with 1 month history of a right supraclavicular neck mass that was enlarging gradually. On physical exam, it was non tender, mobile with no overlying skin changes. Patient did not have any respiratory distress. A fine needle aspirate (FNA) showed spindle cells with no mitotic activity. A computed tomography scan showed a 2.5x2.4x2.6 cm round, mildly lobulated mass in the right supraclavicular region near the midshaft of the clavicle. The patient was taken to the operating room where a lobulated yellow/tan soft mass, with minimal adhesions to surrounding structures, was excised along with its capsule. The mass had a gelatinous consistency.

Conclusions: Lipoblastomas are rare benign adipose tumors of the pediatric age group occurring mostly in children under the age of 3. They are commonly found in the extremities and the trunk however there are reports of diagnosis in the retroperitoneum, mediastinum and spine. They are less likely to present in the neck region. Adipose tumors comprise only 6% of soft tissue tumors in children, of these only 4.7% are lipoblastomas. Histologically, they are composed of mature and immature adipocytes and lipoblasts in a plexiform capillary network with a myxoid appearance. Typically, spindle cells are not visualized on FNA making the diagnosis in our case a challenging one. It is important to differentiate these tumors from liposarcomas that have a very different prognosis and treatment. Because of their ability to impinge on surrounding structures, excision of the neck lipoblastomas can be surgically challenging due to critical vessels and nerves in the region. Special attention should also be paid to the airway which can be compromised with increased tumor size. Lipoblastomas have excellent prognosis without a need for chemotherapy. Complete excision of the mass is usually curative. However, the need for follow up is essential as recurrance rates as high as 47% have been reported.

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Supraclavicular neck mass in a 14 month old boy.pdf (200 kB)
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May 4th, 11:30 AM May 4th, 1:30 PM

Supraclavicular neck mass in a 14 month old boy

Background: Lipoblastoma is a rare benign tumor arising from embryonic fat cells in children younger than 3 years of age. They rarely present in the neck and usually do not have spindle cell appearance. We therefore present a case of neck lipoblastoma with review of the literature.

Case Description: We present the case of a 14-month-old male who presented with 1 month history of a right supraclavicular neck mass that was enlarging gradually. On physical exam, it was non tender, mobile with no overlying skin changes. Patient did not have any respiratory distress. A fine needle aspirate (FNA) showed spindle cells with no mitotic activity. A computed tomography scan showed a 2.5x2.4x2.6 cm round, mildly lobulated mass in the right supraclavicular region near the midshaft of the clavicle. The patient was taken to the operating room where a lobulated yellow/tan soft mass, with minimal adhesions to surrounding structures, was excised along with its capsule. The mass had a gelatinous consistency.

Conclusions: Lipoblastomas are rare benign adipose tumors of the pediatric age group occurring mostly in children under the age of 3. They are commonly found in the extremities and the trunk however there are reports of diagnosis in the retroperitoneum, mediastinum and spine. They are less likely to present in the neck region. Adipose tumors comprise only 6% of soft tissue tumors in children, of these only 4.7% are lipoblastomas. Histologically, they are composed of mature and immature adipocytes and lipoblasts in a plexiform capillary network with a myxoid appearance. Typically, spindle cells are not visualized on FNA making the diagnosis in our case a challenging one. It is important to differentiate these tumors from liposarcomas that have a very different prognosis and treatment. Because of their ability to impinge on surrounding structures, excision of the neck lipoblastomas can be surgically challenging due to critical vessels and nerves in the region. Special attention should also be paid to the airway which can be compromised with increased tumor size. Lipoblastomas have excellent prognosis without a need for chemotherapy. Complete excision of the mass is usually curative. However, the need for follow up is essential as recurrance rates as high as 47% have been reported.

 

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