Case and Research Letters
Frontal congenital lipoma and lipoma of the corpus callosum in an infant: A case report
Lipoma frontal congA(c)nito y lipoma del cuerpo calloso en un lactante: Informe de un caso
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Navarrete-Dechent, M. Curi-Tuma, M. Sandoval-Osses" "autores" => array:3 [ 0 => array:3 [ "nombre" => "C." "apellidos" => "Navarrete-Dechent" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Curi-Tuma" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "M." "apellidos" => "Sandoval-Osses" "email" => array:1 [ 0 => "msandovalosses@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Dermatology, Facultad de Medicina, Pontificia Universidad CatA3lica de Chile, Santiago, Chile" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Facultad de Medicina, Pontificia Universidad CatA3lica de Chile, Santiago, Chile" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lipoma frontal congA(c)nito y lipoma del cuerpo calloso en un lactante: Informe de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 949 "Ancho" => 1000 "Tamanyo" => 83959 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A soft, mobile, asymptomatic nodule in the frontal midline area of a 4-month-old girl.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An otherwise healthy 4-month-old girl who had been born full-term without birth trauma or prenatal or neonatal complications was brought to our practice because of a frontal tumor that had been present since birth. Physical examination revealed a deep frontal tumor of medium consistency that was mobile, unattached to the deeper layers, and without epidermal changes (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The rest of the examination was normal. No hypertelorism, nasal alterations, or dysmorphic facial features were observed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A soft-tissue cranial ultrasound performed when the infant was 2 days old showed slight thickening of the subcutaneous tissue; this was also visible in a second ultrasound performed 2 months later. The diagnosis was congenital frontal lipoma.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was lost to follow-up but returned when she was 8 months old. A brain magnetic resonance imaging (MRI) study showed an interhemispheric hyperintense mass on both T1- and T2-weighted sequences and a hypointense mass on fat-suppressed T2-weighted images. These findings were consistent with a lipoma (1.8<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>A-<span class="elsevierStyleHsp" style=""></span>0.7<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>A-<span class="elsevierStyleHsp" style=""></span>0.6<span class="elsevierStyleHsp" style=""></span>cm on the anteroposterior, longitudinal, and transverse planes, respectively) associated with hypoplasia of the splenium of the corpus callosum. No tracts or other forms of communications were observed between the cerebral and frontal lipomas.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was referred to a pediatric neurosurgeon, who decided to keep her in clinical follow-up. A second MRI study was performed 6 months later and no changes were observed (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The patient was also referred to the otolaryngologist to rule out Pai syndrome; the results of nasal fibroscopy were within normal limits. A year after diagnosis, the patient is still in follow-up, with excellent developmental milestones and no evidence of neurological complications.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Although lipomas are the most common type of benign soft-tissue tumors in adults, congenital presentation is rare.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Furthermore, they are uncommon in children and account for just about 6% of all soft-tissue tumors in pediatric patients.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Midline lipomas may be associated with central nervous system malformations, and in such cases, diverse radiologic studies and clinical follow-up are mandatory.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Intracranial lipomas are also rare, accounting for just 0.06Y_"0.46% of intracranial lesions.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Most are located in the midline/interhemispheric region, most often in the corpus callosum. In about 50% of cases other disturbances, frequently associated with varying degrees of hypoplasia or agenesis of the corpus callosum, are identified in the surrounding nervous structures.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Subcutaneous lipomas in association with intracranial lipomas are even rarer. The association could be related to the abnormal migration and proliferation of neural crest cells. Abnormal neural crest development results in many craniofacial malformations, known as neurocristopathies, including facial midline clefts.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5Y_"7</span></a> Intracranial and extracranial lipomas may be independent entities or connected through a frontal bone defect on the skull.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Frontonasal dysplasia (FND) is a developmental alteration of the craniofacial region that comprises a spectrum of anomalies of the frontonasal area, including hypertelorism, nasal anomalies, and/or lip-palate cleft. The exact origin of FND is unknown and most cases are sporadic,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> although a mutation in the <span class="elsevierStyleItalic">TGIF</span> gene has been observed in familial cases of FND, which are very rare.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Patients with FND may present with hypoplasia or agenesis of the corpus callosum and/or a corpus callosum lipoma.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> In a case series of patients with FND, all 8 patients had lipoma of the corpus callosum.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Markers strongly associated with FND are falx cerebri calcifications and extracranial lipomas.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Midline lipomas of the face and other craniofacial anomalies may be associated with intracranial malformations, including intracranial lipomas.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Brain MRI for the study of intracranial structures combined with clinical follow-up to monitor neurological changes seems to be the gold standard.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Pai syndrome should be included in the differential diagnosis of FND-spectrum anomalies. This syndrome consists of pericallosal lipomas associated with facial abnormalities such as cutaneous polyps of the face and nasal mucosa, midline cleft, and midline pericallosal lipoma.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> As with our patient, a nasal fibroscopy should be performed to rule out this syndrome.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Although the majority of patients with intracranial lipomas are asymptomatic,<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10,11</span></a> a small number of patients may present neurological symptoms such as seizures, headache, and/or behavioral or psychosocial disorders.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Routine neurosurgical treatment is not recommended because the surgical risk usually outweighs the benefits of the intervention.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Surgical resolution of extracranial lipoma may provide cosmetic improvement and better quality of life.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The prognosis and psychomotor development of patients with intracranial lipomas is not clear, but based on data from patients with FND and Pai syndrome, their prognosis would appear to be favorable, with normal psychomotor development and no neurological impairment.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8-10</span></a> Some patients with FND may have psychological alterations such as misanthropy and shyness.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Lipomas are rare in children and are even rarer at birth. Facial midline lipomas should be assessed by a multidisciplinary team consisting of a dermatologist, neurosurgeons, an otolaryngologist, and radiologists. Neurologic images should be taken and in cases associated with corpus callosum or pericallosal lipoma, FND and Pai syndrome must be ruled out. Whether our patient represents an isolated case of frontal congenital lipoma with associated cerebral lipoma or an incomplete case within the spectrum of FND is currently unknown.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Navarrete-Dechent C, Curi-Tuma M, Sandoval-Osses M. Frontal congenital lipoma and lipoma of the corpus callosumin an infant: A case report. Actas Dermosifiliogr. 2014;105:800–802.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 949 "Ancho" => 1000 "Tamanyo" => 83959 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A soft, mobile, asymptomatic nodule in the frontal midline area of a 4-month-old girl.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 643 "Ancho" => 1300 "Tamanyo" => 82656 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Interhemispheric hyperintense structure on T1-weighted image consistent with a lipoma associated with hypoplasia of the splenium of the corpus callosum (bright fat tissue on T1 sequence). (A) Sagittal plane. (B) Transverse/axial plane.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pediatric soft-tissue tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Aflatoon" 1 => "A.J. Aboulafia" 2 => "E.F. McCarthy Jr." 3 => "F.J. Frassica" 4 => "A.M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 10 | 20 |
| 2024 October | 98 | 50 | 148 |
| 2024 September | 113 | 30 | 143 |
| 2024 August | 124 | 71 | 195 |
| 2024 July | 112 | 38 | 150 |
| 2024 June | 112 | 45 | 157 |
| 2024 May | 106 | 41 | 147 |
| 2024 April | 80 | 26 | 106 |
| 2024 March | 97 | 23 | 120 |
| 2024 February | 104 | 28 | 132 |
| 2024 January | 110 | 38 | 148 |
| 2023 December | 107 | 24 | 131 |
| 2023 November | 114 | 24 | 138 |
| 2023 October | 135 | 33 | 168 |
| 2023 September | 120 | 30 | 150 |
| 2023 August | 100 | 17 | 117 |
| 2023 July | 138 | 31 | 169 |
| 2023 June | 82 | 21 | 103 |
| 2023 May | 82 | 26 | 108 |
| 2023 April | 74 | 20 | 94 |
| 2023 March | 47 | 16 | 63 |
| 2023 February | 44 | 22 | 66 |
| 2023 January | 48 | 26 | 74 |
| 2022 December | 43 | 38 | 81 |
| 2022 November | 24 | 22 | 46 |
| 2022 October | 27 | 20 | 47 |
| 2022 September | 23 | 25 | 48 |
| 2022 August | 25 | 32 | 57 |
| 2022 July | 31 | 30 | 61 |
| 2022 June | 51 | 30 | 81 |
| 2022 May | 31 | 47 | 78 |
| 2022 April | 36 | 35 | 71 |
| 2022 March | 28 | 31 | 59 |
| 2022 February | 26 | 25 | 51 |
| 2022 January | 31 | 34 | 65 |
| 2021 December | 21 | 33 | 54 |
| 2021 November | 40 | 39 | 79 |
| 2021 October | 28 | 49 | 77 |
| 2021 September | 31 | 36 | 67 |
| 2021 August | 32 | 31 | 63 |
| 2021 July | 27 | 25 | 52 |
| 2021 June | 27 | 26 | 53 |
| 2021 May | 19 | 32 | 51 |
| 2021 April | 64 | 44 | 108 |
| 2021 March | 37 | 14 | 51 |
| 2021 February | 43 | 18 | 61 |
| 2021 January | 30 | 13 | 43 |
| 2020 December | 17 | 4 | 21 |
| 2020 November | 9 | 11 | 20 |
| 2020 October | 26 | 16 | 42 |
| 2020 September | 24 | 9 | 33 |
| 2020 August | 10 | 7 | 17 |
| 2020 July | 21 | 13 | 34 |
| 2020 June | 22 | 17 | 39 |
| 2020 May | 16 | 16 | 32 |
| 2020 April | 14 | 16 | 30 |
| 2020 March | 17 | 10 | 27 |
| 2020 February | 4 | 0 | 4 |
| 2020 January | 4 | 2 | 6 |
| 2019 December | 6 | 0 | 6 |
| 2019 November | 4 | 0 | 4 |
| 2019 August | 6 | 0 | 6 |
| 2019 July | 4 | 0 | 4 |
| 2019 June | 4 | 0 | 4 |
| 2019 May | 5 | 3 | 8 |
| 2019 April | 4 | 5 | 9 |
| 2019 March | 2 | 6 | 8 |
| 2019 January | 2 | 0 | 2 |
| 2018 December | 1 | 0 | 1 |
| 2018 November | 3 | 0 | 3 |
| 2018 October | 4 | 0 | 4 |
| 2018 September | 2 | 1 | 3 |
| 2018 July | 0 | 1 | 1 |
| 2018 May | 0 | 4 | 4 |
| 2018 April | 0 | 1 | 1 |
| 2018 March | 1 | 0 | 1 |
| 2018 February | 20 | 1 | 21 |
| 2018 January | 43 | 9 | 52 |
| 2017 December | 30 | 11 | 41 |
| 2017 November | 33 | 5 | 38 |
| 2017 October | 28 | 5 | 33 |
| 2017 September | 13 | 17 | 30 |
| 2017 August | 25 | 8 | 33 |
| 2017 July | 35 | 9 | 44 |
| 2017 June | 30 | 16 | 46 |
| 2017 May | 24 | 14 | 38 |
| 2017 April | 20 | 7 | 27 |
| 2017 March | 15 | 31 | 46 |
| 2017 February | 12 | 15 | 27 |
| 2017 January | 11 | 5 | 16 |
| 2016 December | 17 | 5 | 22 |
| 2016 November | 22 | 7 | 29 |
| 2016 October | 18 | 21 | 39 |
| 2016 September | 2 | 3 | 5 |
| 2016 August | 0 | 1 | 1 |
| 2016 July | 6 | 1 | 7 |
| 2016 June | 15 | 0 | 15 |
| 2016 May | 14 | 10 | 24 |
| 2016 April | 7 | 1 | 8 |
| 2016 March | 6 | 0 | 6 |
| 2016 February | 11 | 2 | 13 |
| 2016 January | 9 | 2 | 11 |
| 2015 December | 21 | 0 | 21 |
| 2015 November | 11 | 0 | 11 |
| 2015 October | 11 | 2 | 13 |
| 2015 September | 5 | 2 | 7 |
| 2015 August | 19 | 2 | 21 |
| 2015 July | 24 | 5 | 29 |
| 2015 June | 11 | 2 | 13 |
| 2015 May | 23 | 6 | 29 |
| 2015 April | 7 | 4 | 11 |
| 2015 March | 5 | 1 | 6 |
| 2015 February | 8 | 2 | 10 |
| 2015 January | 1 | 0 | 1 |
| 2014 December | 1 | 0 | 1 |
| 2014 November | 1 | 1 | 2 |
| 2014 October | 6 | 1 | 7 |
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