Magnetic resonance imaging in lipoblastoma: can it be a diagnostic modality?

Magnetic resonance imaging (MRI) is generally an efficient tool for establishing the differential diagnosis of soft tissue tumours. We simultaneously encountered two patients with adipose tumours in the neck. Both had similar clinical features and MRI findings: lobular high intensity tumours on both T1-and T2-weighted images equivalent to subcutaneous fat with septal formation. The provisional diagnosis in both cases was lipoblastoma and both had complete excisions. Histopathological diagnoses, however, were different (lipoblastoma and fibrolipoma), indicating that while MRI is excellent for demonstrating the anatomical detail of soft tissue masses, it is not specific enough to be used alone for differentiating between adipose tumours. In this report, we assess the value of MRI and recommend a more appropriate and patient-friendly protocol for the evaluation for adipose tumours in children.