A case of lipoblastoma in a pediatric patient.

Lipoblastoma is a benign soft tissue tumor that originates from embryonic white fat. Lipoblastoma presents as a slow-growing mass that commonly occurs in the extremities of young children. Histological examination remains the gold standard in confirming lipoblastoma; however, radiology examination can help identify and evaluate the extent and characterization of the mass prior to the excision. Here, we report a 7-year-old male patient who presented with a painless mass in the right popliteal extending to the proximal cruris areas, and the imaging modalities suggested the presence of fat within the mass. The patient then underwent complete excision, and histopathology examination revealed lipoblastoma. This study highlights the possibility of lipoblastoma in older children and the role of imaging examinations in the diagnosis.

Correction: Stunting is not a synonym of malnutrition.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Stunting is not a synonym of malnutrition.

BACKGROUND: WHO documents characterize stunting as, "…impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation." The equation of stunting with malnutrition is common. This contrasts with historic and modern observations indicating that growth in height is largely independent of the extent and nature of the diet. SUBJECTS: We measured 1716 Indonesian children, aged 6.0-13.2 years, from urban Kupang/West-Timor and rural Soe/West-Timor, urban Ubud/Bali, and rural Marbau/North Sumatra. We clinically assessed signs of malnutrition and skin infections. RESULTS: There was no relevant correlation between nutritional status (indicated by skinfold thickness) and height SDS (hSDS). In total 53% of boys, and 46% girls in rural Soe were stunted, with no meaningful association between mean of triceps and subscapular skinfolds (x̅SF) and height. Skinfold thickness was close to German values. Shortest and tallest children did not differ relevantly in skinfold thickness. The same applied for the association between hSDS and mid-upper-arm circumference (MUAC) using linear mixed effects models with both fixed and random effects. In total 35.6% boys and 29.2% girls in urban Ubud were overweight; 21.4% boys and 12.4% girls obese, but with mean hSDS = -0.3, still short. Relevant associations between hSDS and x̅SF and MUAC were only found among the overweight urban children confirming that growth is accelerated in overweight and obese children. There were no visible clinical signs of malnutrition or chronic infection in the stunted children. CONCLUSION: The present data seriously question the concept of stunting as prima facie evidence of malnutrition and chronic infection.

Surgery on aggressive fibroma of the posterior compartment of the knee: A case report.

INTRODUCTION: Fibroma is a benign tumor. More than 99% fibroma arises from tendon sheaths or tendons. Aggressive Fibroma at posterior compartment knee is a rare case. This report presents one case of fibroma at posterior compartment of the knee with the treatment. CASE REPORT: A boy with 4-year history of knee discomfort and lump at posterior knee joint, no history of infection and trauma. Physical examination revealed a mass (10 × 9 × 7 cm) with limited Range of Motion extension 30°, flexion 70°. MRI revealed a soft tissue mass at posterior knee compartment. Histologic examination showed a circumscribed and lobulated hypo cellular mass containing spindle cells diagnosed as aggressive fibroma. The patient underwent popliteal resection. An ellipse incision was made 2 cm margin of skin around the biopsy site. Fasciocutaneous flaps were created and retracted to expose the posterior compartment. The tumor had a partial well-defined capsule, popliteal artery and vein embedded and pressing the sciatic nerve. The tumor and enveloping muscles were elevated from the base of the compartment. The sciatic nerve was preserved with epineurotomy. The popliteal artery was reconstructed with saphenous veins graft. After the tumor was resected, the heads of gastrocnemius were sutured to each other and to the hamstring muscles to cover popliteal space. After one year postoperative, there was a good vascularization, no recurrence and neurological deficit with Musculoskeletal Tumour Society Scoring System 80%. CONCLUSION: One year postoperative with popliteal resection surgery yields a good result. A follow-up is needed for risk of recurrence and malignancy.