A Rare Case of Pediatric Lipoblastoma: Diagnostic and Surgical Insights

Abstract

Aims: Lipoblastoma occurs mostly in young children and is extremely rare in adults, with most cases are found in children less than 3 years of age. It can present with a rapid growth rate, exerting pressure on surrounding structures or be slow growing and more difficult to detect. Case Presentation: A 3 year old female was brought to OPD with complaints of a swelling over lower back on right side since 3 months. A computed tomography of thorax was done that was suggestive of a well defined fat density lesion in intermuscular plane of posterior abdominal wall of right lumbar region. A core needle biopsy was suggestive of a lipomatous neoplasm. A final immunohistochemistry was suggestive of a benign adipocytic tumor. A wide local excision incorporating the scar of biopsy was carried out. A gross margin of 1 cm was taken on all sides. Discussion: Lipoblastoma arise from abnormal proliferation of immature fat cells. Histologically there is an overlap between lipoblastoma and myxoid liposarcoma. Lipoblastomas appear as rapidly growing, localized well-circumscribed masses. Lipoblastomatosis is a more severe and diffuse form and has a higher recurrence rate due to infiltrative characteristics. The treatment of choice consists of complete surgical resection with free margins to prevent recurrence. A more conservative approach in children with large invasive lesions or lesions in locations like the extremities that would lead to mutilating surgical excision has been described. Conclusion: Lipoblastoma is a poorly understood and uncommon soft tissue tumour in the infancy and early childhood.