Giant omental lipoblastoma in a 10-month-old infant composing 20% of total body weight

Department of Pediatric Surgery, Hospital Clínico Universitario de Santiago, 15706 Santiago de Compostela, A Coruña, Spain.
Journal of Pediatric Surgery (Impact Factor: 1.39). 07/2007; 42(6):1149-52. DOI: 10.1016/j.jpedsurg.2007.02.031
Source: PubMed


Lipoblastoma of the greater omentum is an extremely rare benign tumor with less than 10 cases reported in the available literature. We report an unusual case of a 10-month-old girl with a giant omental lipoblastoma that composed 20% of her total body weight (1480 g, 17 x 12 x 16 cm). Complete excision of the tumor was performed. Histology confirmed the diagnosis of omental lipoblastoma.

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    ABSTRACT: Lipoblastoma is a rare benign tumour of embryonal fat that occurs almost exclusively in infants and children. It has an excellent prognosis despite its potential to local invasion and rapid growth. Asymptomatic abdominal mass, progressive abdominal distension and intraperitoneal radiolucent fat density mass on computed tomography are the main diagnostic criteria for omental lipoblastoma. This tumour presents in two forms: a localized well-circumscribed lesion (lipoblastoma) or a multicentric type (lipoblastomatosis). Treatment is surgical excision. An unusual case of omental lipoblastoma in a 2-year-old girl is presented in this report.
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    ABSTRACT: A large intra-abdominal mass was discovered in a 6-month-old boy during a routine well-child examination. Imaging studies revealed a solid mass which appeared to arise from the left lobe of the liver, extending caudally and filling the entire pelvis. At the time of surgical excision, the mass was found to be unassociated with the liver, but was instead localized to the omentum. Histologic examination revealed adipocytes of varying stages of maturation arranged in a lobular architecture, consistent with a lipoblastoma. This unusual tumor is only the eighth reported omental lipoblastoma [J. Hicks, A. Dilley, D. Patel, J. Barrish, S. Zhu, M. Brandt, Lipoblastoma and lipoblastomatosis in infancy and childhood: histologic, ultrastructural, and cytogenetic features. Ultrastruct. Pathol. 25 (2001) 321-333; J. Harrer, G. Hammon, T. Wagner, M. Bolkenius, Lipoblastoma and lipoblastomatosis: a report of two cases and review of the literature. Eur. J. Pediatr. Surg. 11 (2001) 342-349; S. Weiss and J. Goldblum, Enzinger and Weiss's Soft Tissue Tumors, fourth ed., Mosby, St. Louis, MO, 2001, pp. 601-605, 670-686; S. Soin, S. Andronikou, R. Lisle, K. Platt, K. Lakhoo, Omental lipoblastoma in a child; diagnosis based in CT density measurements. J. Pediatr. Hematol. Oncol. 28(1) (2006) 57-58; A. Prando, S. Wallace, J.L. Marins, R.M. Pereira, E.R. de Oliveira, M. Alvarenga, Sonographic features of benign intraperitoneal lipomatous tumors in children-report of 4 cases. Pediatr. Radiol. 20(8) (1990) 571-574; C. Blank, E. Schoenmakers, P. Rogalla, E. Huys, A. Van Rijk, N. Drieschner, J. Bullerdiek, Intragenic breakpoint within RAD51L1 in a t(6;14)(p21.3;q24) of a pulmonary chondroid hamartoma. Cytogenet. Cell Genet. 95 (2001) 17-19; S. Ingraham, R. Lynch, S. Kathiresan, A. Buckler, A. Menon, hREC2, a RAD51-like gene, is disrupted by t(12;14)(q15;q24.1) in a uterine leiomyoma. Cancer Genet. Cytogenet. 115 (1999) 56-61]. Cytogenetics revealed a karyotype of 46,XY,t(8;14)(q13;q24). While lipoblastomas characteristically involve 8q, only one prior case has been reported with 14q24 as its fusion partner [M. He, K. Das, M. Blacksin, J. Benevenia, M. Hameed, A translocation involving the placental growth factor gene is identified in an epithelioid hemangioendothelioma. Cancer Genet. Cytogenet. 168 (2006) 150-154]. We report this unique case of an omental lipoblastoma with a focus on its unusual karyotype, as well as its differentiation from myxoid liposarcoma.
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