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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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 2 | 5 | 7 |
| 2024 Octubre | 98 | 50 | 148 |
| 2024 Septiembre | 113 | 30 | 143 |
| 2024 Agosto | 124 | 71 | 195 |
| 2024 Julio | 112 | 38 | 150 |
| 2024 Junio | 112 | 45 | 157 |
| 2024 Mayo | 106 | 41 | 147 |
| 2024 Abril | 80 | 26 | 106 |
| 2024 Marzo | 97 | 23 | 120 |
| 2024 Febrero | 104 | 28 | 132 |
| 2024 Enero | 110 | 38 | 148 |
| 2023 Diciembre | 107 | 24 | 131 |
| 2023 Noviembre | 114 | 24 | 138 |
| 2023 Octubre | 135 | 33 | 168 |
| 2023 Septiembre | 120 | 30 | 150 |
| 2023 Agosto | 100 | 17 | 117 |
| 2023 Julio | 138 | 31 | 169 |
| 2023 Junio | 82 | 21 | 103 |
| 2023 Mayo | 82 | 26 | 108 |
| 2023 Abril | 74 | 20 | 94 |
| 2023 Marzo | 47 | 16 | 63 |
| 2023 Febrero | 44 | 22 | 66 |
| 2023 Enero | 48 | 26 | 74 |
| 2022 Diciembre | 43 | 38 | 81 |
| 2022 Noviembre | 24 | 22 | 46 |
| 2022 Octubre | 27 | 20 | 47 |
| 2022 Septiembre | 23 | 25 | 48 |
| 2022 Agosto | 25 | 32 | 57 |
| 2022 Julio | 31 | 30 | 61 |
| 2022 Junio | 51 | 30 | 81 |
| 2022 Mayo | 31 | 47 | 78 |
| 2022 Abril | 36 | 35 | 71 |
| 2022 Marzo | 28 | 31 | 59 |
| 2022 Febrero | 26 | 25 | 51 |
| 2022 Enero | 31 | 34 | 65 |
| 2021 Diciembre | 21 | 33 | 54 |
| 2021 Noviembre | 40 | 39 | 79 |
| 2021 Octubre | 28 | 49 | 77 |
| 2021 Septiembre | 31 | 36 | 67 |
| 2021 Agosto | 32 | 31 | 63 |
| 2021 Julio | 27 | 25 | 52 |
| 2021 Junio | 27 | 26 | 53 |
| 2021 Mayo | 19 | 32 | 51 |
| 2021 Abril | 64 | 44 | 108 |
| 2021 Marzo | 37 | 14 | 51 |
| 2021 Febrero | 43 | 18 | 61 |
| 2021 Enero | 30 | 13 | 43 |
| 2020 Diciembre | 17 | 4 | 21 |
| 2020 Noviembre | 9 | 11 | 20 |
| 2020 Octubre | 26 | 16 | 42 |
| 2020 Septiembre | 24 | 9 | 33 |
| 2020 Agosto | 10 | 7 | 17 |
| 2020 Julio | 21 | 13 | 34 |
| 2020 Junio | 22 | 17 | 39 |
| 2020 Mayo | 16 | 16 | 32 |
| 2020 Abril | 14 | 16 | 30 |
| 2020 Marzo | 17 | 10 | 27 |
| 2020 Febrero | 4 | 0 | 4 |
| 2020 Enero | 4 | 2 | 6 |
| 2019 Diciembre | 6 | 0 | 6 |
| 2019 Noviembre | 4 | 0 | 4 |
| 2019 Agosto | 6 | 0 | 6 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 4 | 0 | 4 |
| 2019 Mayo | 5 | 3 | 8 |
| 2019 Abril | 4 | 5 | 9 |
| 2019 Marzo | 2 | 6 | 8 |
| 2019 Enero | 2 | 0 | 2 |
| 2018 Diciembre | 1 | 0 | 1 |
| 2018 Noviembre | 3 | 0 | 3 |
| 2018 Octubre | 4 | 0 | 4 |
| 2018 Septiembre | 2 | 1 | 3 |
| 2018 Julio | 0 | 1 | 1 |
| 2018 Mayo | 0 | 4 | 4 |
| 2018 Abril | 0 | 1 | 1 |
| 2018 Marzo | 1 | 0 | 1 |
| 2018 Febrero | 20 | 1 | 21 |
| 2018 Enero | 43 | 9 | 52 |
| 2017 Diciembre | 30 | 11 | 41 |
| 2017 Noviembre | 33 | 5 | 38 |
| 2017 Octubre | 28 | 5 | 33 |
| 2017 Septiembre | 13 | 17 | 30 |
| 2017 Agosto | 25 | 8 | 33 |
| 2017 Julio | 35 | 9 | 44 |
| 2017 Junio | 30 | 16 | 46 |
| 2017 Mayo | 24 | 14 | 38 |
| 2017 Abril | 20 | 7 | 27 |
| 2017 Marzo | 15 | 31 | 46 |
| 2017 Febrero | 12 | 15 | 27 |
| 2017 Enero | 11 | 5 | 16 |
| 2016 Diciembre | 17 | 5 | 22 |
| 2016 Noviembre | 22 | 7 | 29 |
| 2016 Octubre | 18 | 21 | 39 |
| 2016 Septiembre | 2 | 3 | 5 |
| 2016 Agosto | 0 | 1 | 1 |
| 2016 Julio | 6 | 1 | 7 |
| 2016 Junio | 15 | 0 | 15 |
| 2016 Mayo | 14 | 10 | 24 |
| 2016 Abril | 7 | 1 | 8 |
| 2016 Marzo | 6 | 0 | 6 |
| 2016 Febrero | 11 | 2 | 13 |
| 2016 Enero | 9 | 2 | 11 |
| 2015 Diciembre | 21 | 0 | 21 |
| 2015 Noviembre | 11 | 0 | 11 |
| 2015 Octubre | 11 | 2 | 13 |
| 2015 Septiembre | 5 | 2 | 7 |
| 2015 Agosto | 19 | 2 | 21 |
| 2015 Julio | 24 | 5 | 29 |
| 2015 Junio | 11 | 2 | 13 |
| 2015 Mayo | 23 | 6 | 29 |
| 2015 Abril | 7 | 4 | 11 |
| 2015 Marzo | 5 | 1 | 6 |
| 2015 Febrero | 8 | 2 | 10 |
| 2015 Enero | 1 | 0 | 1 |
| 2014 Diciembre | 1 | 0 | 1 |
| 2014 Noviembre | 1 | 1 | 2 |
| 2014 Octubre | 6 | 1 | 7 |
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