Lipoblastoma of the infratemporal pterygoid region: An unusual case report

Objectives: Lipoblastoma is a rare, benign tumor that arises from embryonic adipose tissue. It is more commonly found in males and is typically diagnosed in children under the age of 5. The tumor can occur in the head and neck region, including the cheek, jaw, and neck. Treatment involves complete surgical removal of the tumor. We present the clinical case of a lipoblastoma located in the pterygoid region, which has never been described before in the literature. The tumor was surgically treated using a transnasal transpterygoid endoscopic approach. Methods: An 11-year-old female patient presented to our hospital with a history of persistent, diffuse headaches lasting for 3 years, accompanied by nausea, vomiting, and intolerance to lights and sounds. A brain MRI revealed a lesion in the right pterygoid fat. A CT scan was performed to assess the bony structures. Nasal endoscopy was normal. Results: The patient underwent radical surgery under general anesthesia, with a transnasal transpterygoid endoscopic approach and reconstruction using a rescue flap. Pathological analysis confirmed the diagnosis of lipoblastoma. The postoperative course was uneventful and 3 months after surgery the patient reported no further headache. The patient was followed up for 5 years post-surgery, with no evidence of recurrence. Conclusions: The transnasal transpterygoid endoscopic approach is a safe and effective technique, even in pediatric patients, but it should only be performed by a qualified and experienced surgeon. Although lipoblastoma is an extremely rare tumor, it should be considered in the differential diagnosis of headache in children.