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Wednesday, January 7, 2009

Surgery Scheduled For Friday

This was a totally unexpected occurrence! However, the "Lipoblastoma" on Logen's leg will be removed Friday morning (We need to be at the hospital at 5:30am). We saw a Pediatric Surgeon this morning to discuss what to do with this spot- he wanted it removed. The scheduling lady came in and put us down for the 1st case Friday. We can do it as an outpatient procedure as long as Logen does ok with the general anesthesia and doesn't have any seizure issues.

The Dr is going to use 'inside' sutures and some sort of pain pump inside the site.

I will pictures of this (before and after)-- I did not bring the USB cord to connect the computer and my camera.

We are trying to figure out what we are going to do with Mr Parker! It gets a little tricky when you are so far from home.


There was article in the Journal of Surgical Oncology by one of the Dr's where Logen will have his surgery. I didn't pay for the article, so this is what I was able to read- I thought the stats where interesting.

Lipoblastoma is a rare benign neoplasm of fetal-embryonal fat tissue with a 14% tendency to recur. It occurs almost exclusively in infants and children. To my knowledge, less than 100 cases, including children and adults, have been reported in the English literature. Two retroperitoneal and one case of mesenteric lipoblastoma, all presenting as a large palpable abdominal mass, are described. Our patients, aged 12 years, 7 months, and 11 months, were treated by total surgical excision of the tumors. They are alive and well 5, 4, and 3 years postoperative, respectively, with no evidence of recurrence and no indication for any adjunctive therapy. Pathologic evaluation was decisive for the best treatment and prognosis.

Diagnosis: Lipoblastoma (linked to the article)
Discussion: Lipoblastoma is a rare tumor believed to arise from embryonic white fat and typically seen before 3 years of age. Though histologically benign, it is locally invasive, implying a high risk of relapse if incompletely removed. Despite its low incidence, the diagnosis of lipoblastoma must be considered in children with mass in soft tissue, mainly if they are younger than one year. Two forms of this lesion have been described: a well circumscribed, encapsulated type occurring superficially (lipoblastoma), and a diffuse, infiltrating type occurring in deep soft tissues (lipoblastomatosis). Most lipoblastomas are found in the extremities and trunk, although retroperitoneal, mesenteric, mediastinal, and head and neck locations have been reported. Despite their potential rapid growth and local invasion, these tumors have an excellent prognosis, especially if resected completely. The histopathological picture bears a striking similarity to myxoid liposarcoma, and at times may be indistinguishable. Recent studies describe rearrangements of chromosome 8 q11-q13 regions as a new discriminative marker that distinguishes lipoblastoma and lipoblastomatosis from myxoid liposarcoma. Ultrasound and MRI are the best imaging modalities to diagnose lipoblastoma by revealing structures and local growth pattern that appear specific for this rare tumor. The imaging characteristics of the lipoblastoma also need to be correlated with the age of patients to exclude other entities. The treatment of choice is surgical resection. Following complete excision, the prognosis is excellent, though recent reports indicate a recurrence rate of up to 25%, particularly for infiltrating tumors. Metastases have not been reported in this tumor, although local invasion is possible.

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1 comment:

  1. Wow Jess. Little Logen continues to be in my thoughts and prayers. I really hope that the surgery goes well.

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