Benign mesenteric lipomatous tumor in a child: a case report and literature review

Abstract

Background: Lipomatous tumors are the most common type of soft-tissue tumors. Benign lipomatous tumors are lipomas and lipoblastoma. We herein report a case of benign mesenteric lipomatous tumor and the largest collection of known benign mesenteric lipomatous tumors in children in the literature.

Case presentation: A 3-year-old girl presented with repeated dull abdominal pain and left abdominal mass swelling. On a physical examination, the child had a soft, moderately distended left abdomen that was not tender when palpated. Computed tomography and magnetic resonance imaging demonstrated a large fatty mass within the mesentery, measuring approximately 8 × 6 cm. The mass extended from the right upper quadrant to the lower pole of the kidneys. Laparotomy with resection of the mesenteric tumor was performed under general anesthesia. A well-capsuled tumor was a soft, yellow mass and found loosely attached to the mesenterium of the ileum. A histopathological examination demonstrated the lobular proliferation of mature adipocytes. Atypical lipoblasts were not seen. These features are compatible with benign lipomatous tumor, such as lipoma or lipoblastoma with maturation.

Conclusion: In conclusion, benign mesenteric lipomatous tumors tend to be large in size over 10 cm in longitudinal length. However, resection is well tolerated in the vast majority of cases with benign post-operative courses.

Keywords: Benign mesenteric lipomatous tumors; Children; Lipoblastoma; Lipoma.

Fig. 1

Computed tomography obtained a large low-density mass within the mesentery, measuring approximately 8 × 6 cm

Fig. 2

Magnetic resonance imaging coronal section image obtained a well-encapsulated soft-tissue mass lesion with high intensity in the mesenteric region, a T1-weighted image obtained the mass lesion with high intensity signal. b Fat suppression inversion recovery imaging obtained an interposing fat component showing a reduced signal

Fig. 3

A well-encapsulated tumor measuring 8 × 6 cm was found loosely attached to the mesenteric tumor

Fig. 4

A histopathologic examination revealed the tumor cells demonstrated the lobular proliferation of mature adipocytes (a). Immunohistochemistry results were as follows: adipocytic cells positive for p16 (b), positive for cyclin-dependent kinase 4 (c), and negative for murine double minutes (d)