Cervicothoracic lipoma in a child: A case report

IF 0.2 Q4 PEDIATRICS
Garett L. Ozmer , Jaclyn R. Dempsey , Nikhil R. Shah , Susana Fortich , Bindi Naik-Mathuria
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Abstract

Introduction

Lipomas are typically slow-growing tumors with the highest incidence in the fourth through sixth decades of life, less commonly occurring in pediatric patients, particularly extending across multiple body compartments. Excision is often reserved for cases that cause cosmetic or compressive symptoms and, due to the slow growth pattern, is less likely to be necessary in younger patients.

Case presentation

A 2-year-old female with congenital albinism presented with a painless but visible 3 × 4 cm non-mobile left lateral neck mass that had been present for 2 months. MRI without contrast demonstrated a lobulated lesion in the left inferolateral supraclavicular region extending into the left thoracic inlet and thoracic apex. Due to concern for developing mass effect on carotid space structures, resection of the mass was performed. Complete excision was achieved through a single lower cervical incision, requiring dissection from the brachial plexus, carotid sheath, subclavian vessels, and extrapleural thoracic apex. Final pathology revealed an adipocytic neoplasm consistent with a lipoma with a total specimen size measuring 9 x 6.5 × 5 cm. The patient was discharged on postoperative day one and was healing well without complaint at the time of follow-up.

Conclusion

Despite their benign nature, cases such as the one presented here demonstrate the capability of lipomas to adhere to and involve surrounding critical structures, particularly when located in the cervicothoracic region and occurring in younger patients. However, with careful surgical planning involving cross-sectional imaging, such lesions can successfully be completely resected through a single cervical incision without morbidity.
儿童颈胸脂肪瘤1例
脂肪瘤是一种典型的生长缓慢的肿瘤,发病率最高的年龄段为40 - 60岁,在儿科患者中发病率较低,尤其是跨越多个身体隔区。切除通常用于引起美观或压迫症状的病例,由于生长模式缓慢,年轻患者不太可能需要切除。1例2岁先天性白化病女性患者,表现为无痛但可见的3 × 4 cm不可移动的左侧颈部肿块,已存在2个月。未经对比的MRI显示左侧锁骨上外侧内区呈分叶状病变,延伸至左侧胸入口和胸尖。由于担心肿块对颈动脉空间结构的影响,我们切除了肿块。完全切除是通过一个颈部下切口实现的,需要从臂丛、颈动脉鞘、锁骨下血管和胸膜外胸椎尖处切除。最终病理显示脂肪细胞肿瘤与脂肪瘤一致,总标本大小为9 x 6.5 x 5 cm。患者术后第一天出院,随访时愈合良好,无投诉。结论:尽管脂肪瘤的本质是良性的,但像本病例这样的病例表明,脂肪瘤能够粘附并累及周围的关键结构,特别是当位于颈胸区域并发生在年轻患者身上时。然而,通过仔细的手术计划和横断面成像,这样的病变可以通过一个宫颈切口成功地完全切除而不会发病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
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