CLINICAL BRIEFS Indian J Pediatr 1993; 60 : 137-145 Lipoblastomatosis of the Neck Y.K. Satin and A.K. Sharma Department of Pediatric Surgery, S.M.S Medical College & attached Sir Padampat Mother and Child Health Institute, Jaipur L ipoblastomatosis is a rare example of benign mesenchymal tumor seen in early childhood that exhibits a tendency to invade locally, but not to metastasise. We report our experience with one such case, and briefly discuss the clinicopa- thological features of this unusual neo- plasm. CASE REPORT A 4 year old male child, was first admit- ted to Sir Padampat Mother and Child Health Institute in July 1989 with pain- less cervical swelling on the right side at one month duration. The mobility of this swelling over the underlying structures was restricted. There was no significant lymphadenopathy. Systemic examina- tion and routine investigations were es- sentially normal. Excision of the tumor was done which measured 3 X 3 X 2 cms. Histologic examination revealed it to be lipoblastomatosis. Characteristic lobules of immature adipose tissue'sepa- rated by fibrous septa were seen. Few focal foci of myxoid changes were also noted (Figure 1). The child was followed up for one year, and thought to be free of the disease. But 3 years later, the child was readmitted to the institution with recurrence at the local site. This time, the tumor measured 4 X 3 cms. clinically with features of adher- ence to the underlying structures as well as overlying scar. There was no evidence of major vessel infiltration or tracheal compression. Routine investigations and, chest X-ray films were normal. X-ray film of neck showed soft tissue shadow at the site of tumor. Exploration of the neck revealed a diffuse fatty tumor ex- tending down to the spinous processes of the vertebra. However, the major ves- sels and brachial plexus were fortunately free of tumor. Wide excision was done. Histologic examination revealed it to be lipoblastomatosis with few areas of more mature appearing lipocytes, suggestive of a tendency for maturation towards "adult lipoma' (Figure 2). Although there was evidence of infiltration of tumor into the skeletal muscles, surgical margins of the specimen were free of tumor. The child is under regular follow up. DISCUSSION Although term 'lipoblastomatosis' was Fig. 1. Low magnification photomicrograpPt showing characteristic lobular pat- tern of lipoblastomatosis.