Submucosal Colonic Lipoblastoma Presenting With Colo-colonic Intussusception in an Infant

Abstract

Lipoblastoma is a benign adipose tumor typically presenting in infancy in superficial soft tissues of extremities. Intestinal complications secondary to intraabdominal or retroperitoneal involvement are exceedingly rare. We describe a unique case of a primary intestinal lipoblastoma arising from the submucosa of the transverse colon in an otherwise healthy 18-month-old boy. He presented with a history of reducible rectal prolapse, rectal bleeding, and episodic abdominal pain and was initially treated for constipation. Imaging identified a short colo-colonic intussusception, confirmed at laparotomy, and a fatty mass thought to arise from the mesentery. Pathological examination of the resected transverse colon revealed a submucosal tumor composed of a mixture of mature adipose tissue, foci of myxoid mesenchymal tissue with desmin positive, HMGA2 negative spindle cells, and scattered lipoblasts, characteristic of lipoblastoma. Lipoblastoma should be considered as a potential albeit rare cause of intussusception in young children, where a pathologic lead point is infrequently identified.

A Rare Case of Giant Mesenteric Lipoblastoma in a 6-Year-Old Child and Review of the Literature

“…Microscopic features consist of lobular architecture and myxoid areas with spindle cells and lipoblasts at various stages of differentiation [28,29].…”

“…Rearrangements of chromosome 8q11 codifying for the oncogene PLAG1 are found in more than 70% of cases [ 2 – 4 , 28 – 30 ]. The different molecular alteration found in adipocytic tumors could help in differentiating between lipoma, lipoblastoma, and liposarcoma [ 31 ].…”

Infantile Abdominal and Pelvic Lipoblastomas: A Case Series

“…It mostly occurs in infants and children under 3 years of age, and the most common locations are extremities and trunk, followed by head and neck. 3…”

Colocolic intussusception in children: A case series and literature review

“…Forty-one studies had undergone full-text review, and 21 were excluded because they were published before 2000, lacked incomplete data, did not report the outcome of interest, and were not about colocolic intussusception or pediatric cases. Twenty studies were included, and 37 patients, including our 10 patients, were evaluated (Table 3) [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”