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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2226 - 20 December 2018 Posted By: Raul Perret

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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3 y old infant with an 8 cm mass located in the foot


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I see a lobulated adipocyte proliferation with many spindle cells, myxoid areas and entrapped skeletal muscle fibers. Rare mitotic figures are seen, Although I did not appreciate clear cut lipoblasts, my favored spot is lipoblastoma. 

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Agree with lipoblastoma. I miss some more myxoid matrix, but I can´t see any other diagnosis.

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Fully agree with my Colleagues (some myxoid Matrix in fig7 and lipoblast in the last one ). 

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Raul Perret

Posted (edited)

Dear colleagues, yes this was a case of lipoblastoma/lipoblastomatosis. Probably in the spectrum of the latter due to the irregular infiltration of skeletal muscle. The main point here is that almost any adipose tumor presenting in infants is a lipoblastoma, even without lipoblasts aka "maturing" or" mature" Lipomas do exist but they are extremely rare (septation goes against a dx of lipoma in this age group). Malignant adipocytic tumours are exceptional in infants and are mainly repredented by myxoid liposarcomas.  Lipoblastoma has a recurring molecular anomaly consisting of a plag1 rearrangement, usually with HAS2 or COL1A2, that can be reliably demonstrated by FISH analysis. Lipoblastoma is a completely benign neoplasm, recurrences may be seen, mainly in the cases of lipoblastomatosis. Good job everyone for spot on diagnosis, wish you a merry Christmas and a happy new year

Edited by Raul Perret

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