Benign lipoblastoma of the upper limb: a case report and literature review

Lipoblastoma is a rare mesenchymal tumor occurring primarily in pediatric patients and formed by lipoblasts that proliferate after the postnatal period. Despite its potential for local invasion and rapid growth, its prognosis is excellent. In this study, we report the case of a pediatric patient with a ponderous lesion in the right forearm that caused considerable functional impairment of the affected limb. We also discuss the relevant aspects concerning the differential diagnosis and management of the disease, as it has the potential to cause incapacity without proper treatment.

Keywords:
Lipoblastoma; Lipomatous tumors; Soft tissue tumors; Lipoblastomatosis

Authorship

EVANDRO JOSÉ SIQUEIRA

Plastic Surgeon by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Specialist Member of the Brazilian Society of Plastic Surgery (SBCP), Member of the Clinical Staff of the Circulo Operário Caxiense Hospital (COC), Pompéia Hospital and Healh Hospital, Plastic Surgeon at the Pro-Face Program of the COC Hospital, Caxias do Sul, RS, BrazilPlastic Surgeon by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Specialist Member of the Brazilian Society of Plastic Surgery (SBCP), Member of the Clinical Staff of the Circulo Operário Caxiense Hospital (COC), Pompéia Hospital and Healh Hospital, Plastic Surgeon at the Pro-Face Program of the COC Hospital, Caxias do Sul, RS, BrazilPlastic Surgeon by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Specialist Member of the Brazilian Society of Plastic Surgery (SBCP), Member of the Clinical Staff of the Circulo Operário Caxiense Hospital (COC), Pompéia Hospital and Healh Hospital, Plastic Surgeon at the Pro-Face Program of the COC Hospital, Caxias do Sul, RS, Brazil

GUSTAVO STEFFEN ALVAREZ

Plastic Surgeon by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Specialist Member of the Brazilian Society of Plastic Surgery (SBCP), PhD Student of Medicine and Health Sciences at the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Plastic Surgeon at the MOB Clinic, Porto Alegre, RS, BrazilPlastic Surgeon by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Specialist Member of the Brazilian Society of Plastic Surgery (SBCP), PhD Student of Medicine and Health Sciences at the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Plastic Surgeon at the MOB Clinic, Porto Alegre, RS, BrazilPlastic Surgeon by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Specialist Member of the Brazilian Society of Plastic Surgery (SBCP), PhD Student of Medicine and Health Sciences at the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Plastic Surgeon at the MOB Clinic, Porto Alegre, RS, Brazil

LOURENÇO FRIGERI TEIXEIRA

Plastic Surgeon by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Specialist Member of the Brazilian Society of Plastic Surgery (SBCP), Caxias do Sul, RS, BrazilPlastic Surgeon by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Specialist Member of the Brazilian Society of Plastic Surgery (SBCP), Caxias do Sul, RS, BrazilPlastic Surgeon by the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Specialist Member of the Brazilian Society of Plastic Surgery (SBCP), Caxias do Sul, RS, Brazil

JEFFERSON BRAGA SILVA ^**Corresponding author: Jefferson Braga Silva Pontifícia Universidade Católica do Rio Grande do Sul, Faculty of Medicine, Department of Surgery - Av. Ipiranga, 6690, conj:216, Centro Clínico PUCRS - Jardim Botânico - Porto Alegre, RS, Brazil, CEP 90610-000 - Phone: +55 (51) 3315-6277, E-mail: jeffmao@terra.com.br

Full Professor at the Federal University of São Paulo (UNIFESP), Lecturer in the Department of Surgery of the Faculty of Medicine (FAMED) of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Chief of Service at the Hand and Reconstructive Microsurgery Service at the São Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Former President of the Brazilian Society for Hand Surgery (SBCM), Director of the Faculty of Medicine (FAMED) of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Caxias do Sul, RS, BrazilFull Professor at the Federal University of São Paulo (UNIFESP), Lecturer in the Department of Surgery of the Faculty of Medicine (FAMED) of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Chief of Service at the Hand and Reconstructive Microsurgery Service at the São Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Former President of the Brazilian Society for Hand Surgery (SBCM), Director of the Faculty of Medicine (FAMED) of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Caxias do Sul, RS, BrazilFull Professor at the Federal University of São Paulo (UNIFESP), Lecturer in the Department of Surgery of the Faculty of Medicine (FAMED) of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Chief of Service at the Hand and Reconstructive Microsurgery Service at the São Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Former President of the Brazilian Society for Hand Surgery (SBCM), Director of the Faculty of Medicine (FAMED) of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Caxias do Sul, RS, Brazil

*Corresponding author: Jefferson Braga Silva Pontifícia Universidade Católica do Rio Grande do Sul, Faculty of Medicine, Department of Surgery - Av. Ipiranga, 6690, conj:216, Centro Clínico PUCRS - Jardim Botânico - Porto Alegre, RS, Brazil, CEP 90610-000 - Phone: +55 (51) 3315-6277, E-mail: jeffmao@terra.com.br

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (8)

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Figure 1
Patient at the age of 1 year 7 months, with a ponderous tumor in the forearm that limits all movements of the right upper limb.

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Figure 2
Tumor localized along the forearm and in the proximal third of the right arm, fixed, with the consistency of a lipoma and apparently attached to the deep planes, which occasionally leads to compression with relevant functional consequences.

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Figure 3
Computed tomography angiography (CTA). Fusiform thickening of the soft tissues along the right upper limb, mostly affecting the two proximal ends of the forearm, with increased diameter of that portion of the arm.

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Figure 4
Computed tomography angiography (CTA) with image reconstruction, showing alterations in the normal vessels of the forearm due to compression by the tumor. The arrow points the radial artery, which remained pulsatile and permeable despite the proximity with the tumor.

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Figure 5
Surgery for resection of the lesion resembling a lipoma, encapsulated and of considerable size. The lesion was approached through the anterior part of the forearm and was carefully detached form the critical structures in the affected area.

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Figure 6
Four months after surgery. Important decrease in the volume of the forearm was observed after the previously described approach and resection of the tumor.

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Figure 7
Four months after surgery. The movements of the hand were recovered after tumor resection. No functional consequences were detected.

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Figure 8
Optical microscopy image (magnification 100×; hematoxylin and eosin stain), showing the lipoblast clusters (immature adipocytes, arrow). In the upper left and right corners, mature adipocytes can be seen.

Figure 1 Patient at the age of 1 year 7 months, with a ponderous tumor in the forearm that limits all movements of the right upper limb.

Figure 2 Tumor localized along the forearm and in the proximal third of the right arm, fixed, with the consistency of a lipoma and apparently attached to the deep planes, which occasionally leads to compression with relevant functional consequences.

Figure 3 Computed tomography angiography (CTA). Fusiform thickening of the soft tissues along the right upper limb, mostly affecting the two proximal ends of the forearm, with increased diameter of that portion of the arm.

Figure 4 Computed tomography angiography (CTA) with image reconstruction, showing alterations in the normal vessels of the forearm due to compression by the tumor. The arrow points the radial artery, which remained pulsatile and permeable despite the proximity with the tumor.

Figure 5 Surgery for resection of the lesion resembling a lipoma, encapsulated and of considerable size. The lesion was approached through the anterior part of the forearm and was carefully detached form the critical structures in the affected area.

Figure 6 Four months after surgery. Important decrease in the volume of the forearm was observed after the previously described approach and resection of the tumor.

Figure 7 Four months after surgery. The movements of the hand were recovered after tumor resection. No functional consequences were detected.

Figure 8 Optical microscopy image (magnification 100×; hematoxylin and eosin stain), showing the lipoblast clusters (immature adipocytes, arrow). In the upper left and right corners, mature adipocytes can be seen.

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Benign lipoblastoma of the upper limb: a case report and literature review

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[1] *Corresponding author: Jefferson Braga Silva Pontifícia Universidade Católica do Rio Grande do Sul, Faculty of Medicine, Department of Surgery - Av. Ipiranga, 6690, conj:216, Centro Clínico PUCRS - Jardim Botânico - Porto Alegre, RS, Brazil, CEP 90610-000 - Phone: +55 (51) 3315-6277, E-mail: jeffmao@terra.com.br