Horovitz David, Matic Damir B
Schulich School of Medicine, University of Western Ontario, London, Ontario.
Can J Plast Surg. 2007 Fall;15(3):173-4. doi: 10.1177/229255030701500312.
A forehead lipoma is a rare finding in a child, and one that penetrates the underlying layers of muscle and bone to attach to dura has not previously been reported. Two such cases, both in children who underwent uneventful deliveries aided by forceps, are presented. Both lesions were present at birth and, based on clinical findings, were originally thought to be dermoid cysts. Dermoid cysts could not be ruled out with computed tomography and magnetic resonance imaging. Histopathology identified fibrofatty tissue consistent with lipoma. Both lesions extended from the subcutaneous tissue through the frontalis muscle and frontal bone to the dura. Given these findings and the history of forceps delivery, the most likely diagnosis is post-traumatic pseudolipoma. This lesion should be considered in the differential diagnosis of congenital lesions of the forehead, particularly if there is a history of forceps delivery or other trauma to the area.
小儿前额脂肪瘤实属罕见，而脂肪瘤穿透深层肌肉和骨骼并附着于硬脑膜的情况此前未见报道。本文报告两例此类病例，患儿均为顺产时使用产钳助产。两处病变均在出生时即存在，根据临床表现，最初被认为是皮样囊肿。计算机断层扫描和磁共振成像均无法排除皮样囊肿。组织病理学检查发现纤维脂肪组织，符合脂肪瘤特征。两处病变均从皮下组织延伸，穿过额肌和额骨直至硬脑膜。鉴于这些发现以及产钳助产史，最可能的诊断为创伤后假脂肪瘤。在鉴别诊断前额先天性病变时应考虑到这种病变，尤其是当该区域有产钳助产史或其他外伤史时。
