Sakamoto Saki, Hashizume Naoki, Fukahori Suguru, Ishii Shinji, Saikusa Nobuyuki, Yoshida Motomu, Masui Daisuke, Higashidate Naruki, Tsuruhisa Shiori, Ozono Shuich, Tanigawa Masahiko, Naito Yoshiki, Tanaka Yoshiaki, Yagi Minoru
Department of Pediatric Surgery, Kurume University School of Medicine.
Department of Pediatrics and Child Health, Kurume University School of Medicine.
Medicine (Baltimore). 2018 Oct;97(40):e12711. doi: 10.1097/MD.0000000000012711.
Lipoblastoma is a rare benign soft tissue tumor that occurs most commonly in infants and children. However, retroperitoneal lipoblastomas are rare, occurring in <5% of cases. We report a case of large retroperitoneal lipoblastoma and the largest collection of known retroperitoneal lipoblastomas in children in the literature.
A 3-year-old girl presented with left abdominal mass. Magnetic resonance imaging (MRI) revealed a soft tissue mass measuring 12 × 8 × 6 cm in the retroperitoneal region. The mass had a clearly defined margin and a reticular pattern with an interposing fat component. Based on these findings, the mass was suspected to be a soft-tissue tumor, most likely lipoblastoma.Laparotomy with resection of the retroperitoneal mass was performed. The tumor was easily dissected from the retroperitoneal space without injury to surrounding structure.A histopathological examination demonstrated the mature proliferation of adipocytes and spindle-shaped cells separated by fibrovascular septa accompanied by myxoid changes. The cells were separated into lobules by septa, and areas of immature adipocytes showing a signet-ring or multivacuolar appearance were present at the periphery. Histopathological diagnosis was lipoblastoma. Follow-up at 6 months revealed no evidence of recurrence.
Retroperitoneal lipoblastoma is rare and tends to be large in size when diagnosed at presentation. Complete resection should not be delayed, as impingement on the surrounding structures is imminent.
脂肪母细胞瘤是一种罕见的良性软组织肿瘤,最常见于婴幼儿。然而,腹膜后脂肪母细胞瘤罕见,发生率不到5%。我们报告一例巨大腹膜后脂肪母细胞瘤病例,这是文献中报道的儿童腹膜后脂肪母细胞瘤最大病例集。
一名3岁女孩因左腹部肿块就诊。磁共振成像(MRI)显示腹膜后区域有一个12×8×6 cm的软组织肿块。肿块边界清晰,呈网状结构,中间有脂肪成分。基于这些发现,该肿块被怀疑是一种软组织肿瘤,很可能是脂肪母细胞瘤。进行了剖腹手术切除腹膜后肿块。肿瘤很容易从腹膜后间隙分离,未损伤周围结构。组织病理学检查显示脂肪细胞和梭形细胞成熟增生,由纤维血管间隔分隔,伴有黏液样改变。细胞被间隔分隔成小叶,周边有呈印戒样或多泡状外观的未成熟脂肪细胞区域。组织病理学诊断为脂肪母细胞瘤。6个月的随访显示无复发迹象。
腹膜后脂肪母细胞瘤罕见,确诊时往往体积较大。不应延迟完整切除,因为即将对周围结构造成压迫。