Presentation
Rapidly enlarging left neck mass.
Patient Data
Left supra and infra-clavicular large well-defined mass lesion eliciting high signal on T1 & T2 WI showing signal suppression on fat sta sequences. It also shows fine internal septations which show mild post-contrast enhancement. The mass is smoothly abutting and displacing the adjacent muscles. It smoothly displaces the patent left carotid and jugular vessels medially. It completely encases the left axillary vessels which are also patent.
Bilateral few prominent reactive deep cervical lymph nodes.
Prominent thymic gland (Normal for age)
Case Discussion
The young age of the patient (2 years old), the rapid progressive enlargement, and the radiological criteria of the lesion were highly suggestive of lipoblastoma. That was subsequently confirmed pathologically after lesion excision.
The lesion shows well-defined margins, smoothly abutting the adjacent structures and eliciting signal typical for fatty lesions (high T1 & T2 signal with fat suppression on fat sat sequences). It also shows mildly enhancing internal septae.
Lipoblastoma is a rare, benign, encapsulated tumor arising from embryonic white fat and occurring in infancy and early childhood. Imaging features may reveal a mixture of fat and nonadipose tissue.
Lesion containing fat in a young child (less than 2 years old), even with prominent or predominant nonlipomatous components, is almost invariably a lipoblastoma.
This case is courtesy of Dr.Bahaa El Din Mahmoud.MD. Lecturer of Radiodiagnosis. Kasr El Ainy Hospital. Egypt.
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