Asymptomatic lipofibroadenoma in a 17-year-old male: a case report and literature review of a rare entity

Michael A. den Bakker*, Marijn A. Vermeulen, Cornelis P. van de Ven, Simone A.J. ter Horst, Lennart Kester, Ronald R. de Krijger

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

2 Citations (Scopus)
21 Downloads (Pure)

Abstract

Background:
The most common thymic tumours, thymomas, are derived from thymic epithelium and are generally low-grade neoplasm. Frankly malignant tumours, thymic carcinomas are rarer still. Exceedingly rare thymic tumours contain a mesenchymal tissue component such as fibrous connective tissue and/or mature fat. Lipofibroadenoma (LFA) is a very rare mixed epithelial-mesenchymal thymic tumour, included in the category of thymic epithelial tumors. LFA in addition to a mature adipocytic component, contains variable epithelial and mesenchymal tissue components. Owing to the presence of an epithelial component in LFA, this entity, in contrast to thymolipoma, is included in the World Health Organization (WHO) category of thymic epithelial neoplasm. Currently only 12 LFA cases have been described. The 12 previously reported cases all behaved in a benign fashion, although four cases were associated with a conventional type of thymoma. We here present a new, 13th, case of LFA.

Case Description:
The LFA was discovered incidentally in a previously healthy 17-year-old male after investigations for suspected pneumonia. On imaging a mass was discovered in the anterior mediastinum which was subsequently surgically removed. The resected tumour was extensively investigated, including the first instance of full molecular analysis of this rare entity and all available literature on LFA was sourced to provide a comprehensive overview. The histology of this LFA was similar to previously described cases. No gene mutations or rearrangements were identified. The patient made an uneventful recovery and after 13 months of follow-up remained well.

Conclusions:
An additional, 13th case of LFA is presented. Based on the available literature it appears that LFA may be considered a benign composite thymic tumour, although the combination of an additional conventional thymoma component may warrant closer follow-up.

Original languageEnglish
Article number19
Number of pages8
JournalMediastinum
Volume7
DOIs
Publication statusPublished - 25 Jun 2023

Bibliographical note

Funding Information:
The authors thank Prof. Wentao Fang and Dr. Xiuxiu Hao for assisting with interpretation of the manuscript by Wang et al. (4). The assistance of Dr. Lucia Suzuki-Groenenbos and Mr. Yokichi Suzuki with the interpretation of the data in the articles by Hamada et al. (9) and Kojima et al. (11) is acknowledged.

Publisher Copyright:
© Mediastinum. All rights reserved.

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