The transformation of an embryonic lipoma to a common lipoma

Abstract

were fully informed of the likelihood of associated abnormalities, were most anxious to have the child's life preserved. The meningocele was therefore excised without anaesthesia when the baby was 5 hours old; no neural elements were observed in the wall of the sac, but the gap was so large that skin-flaps extending on to the buttocks and up over the shoulders had to be utilized to cover it. A cerebrospinal fistula appeared at the junction of the flaps, but dried up in a fortnight, when the child was discharged in perfect health. Four months later it began to show signs of hydrocephalus; the circumference of the head increased from 18% in. at the age of 7 months to 192 in. at 13 months and 202 in. at 16 months, the corresponding average measurements in normal girl children being 17 in., 172 in., and 18 in, with a variation of ha!f an inch either way (Tredgold, 1937). The child appeared listless and took no interest in its surroundings. It was then sent by its doctor to a neurological hospital whence it returned with an offer to cauterize its choroid plexuses ; this was refused.In the meantime I had been informed (Jefferson) of the existence of the Arnold-Chiari malformation ; I thereupon performed a cerebello-medullary decompression and found a perfect example of the condition (Fig. 421). The bone, being soft, was very easy to remove, and on opening the dura the herniated cerebellum and flattened medulla were seen to extend on the posterior surface of the cord as far downwards as the posterior arch of the third cervical vertebra, which was included in the decompression. No exudate or adhesions were seen in the subarachnoid space ; it was not, of course, possible to ascertain the condition of the cerebral gyri, but there was no radiological evidence of craniolacuna. Suture of the upper part of the wound in layers was difficult on account of the absence of layers and cerebrospinal fistula appeared here. The child became drowsy and irritable a week after operation and its condition gave rise to considerable anxiety, but the fistula closed spontaneously and the child was again discharged.The head measurements have reverted to a normal rate of increase, and the parents are delighted. They say that the child at 6 months after operation is much brighter and more interested in its surroundings and is beginning to talk, and clinical observation confirms this favourable impression. It will be some considerable time, however, before it is possible to assess the extent of the cerebral recovery; my only regret is that I was not aware earlier of the existence of the syndrome, so that the development of hydrocephalus could have been arrested or prevented before the brain became distended. The child has in addition a mild degree of congenital dislocation of one hip which hinders its attempts at walking, but which should respond readily to treatment, and slight impairment of circulation in the same leg, which is already improving spontaneously.Comment.-The advice given to many parents in the past has been that in view of the gloo...

Lipoblastoma/lipoblastomatosis: a clinicopathologic study of 16 cases in Taiwan

“…These tumors are generally benign, and no reports of metastasis have been published. Histological evaluation of recurrent lipoblastoma/lipoblastomatosis tumors at each exploration exhibited a pattern of continuous differentiation into a mature lipoma [19]. However, in our investigation, one primary tumor of circumscribed type recurred 13 months postoperatively with a relatively immature pattern of myxoid diffuse type.…”

Fine Needle Aspiration Diagnosis of Lipoblastoma of the Parotid Region

“…3,5,6 Transformation of lipoblastoma into lipoma has been reported. 10 In summary, this case is a good example of a lipoblastoma diagnosed using FNA. Due to the striking resemblance of lipoblastoma to myxoid liposarcoma, careful consideration of all available clinical, radiologic, cytogenetic and morphologic data is recommended before establishing the diagnosis.…”

“…8,9 Due to its immature appearance and young-patient presentation, lipoblastoma has received a variety of names in the literature: lipoblastosis, lipoblastomatosis, fetal lipoma, embryonic lipoma, congenital lipomatoid tumor and lipoblastic tumor of childhood. [3][4][5][6][8][9][10] Lipoblastomas of the head and neck area are extremely rare; only two cases have occurred in the parotid. 11,12 Cytologic diagnosis of lipoblastoma is also a rare event, previously reported to occur in six cases.…”

An unusual tumor of the neck and mediastinum: lipoblastomatosis resulting in paraparesis

“…Moreover, foci of cartilaginous metaplasia may also be observed. Lipoblastomatous tumors may mature to ordinary lipomas with time [6].…”