Abstract
Objective: To present a novel paradigm in the management of congenital infiltrating lipomatosis (CIL) using surgical intervention combined with perioperative chemotherapy.
Method: Case study and review of literature.
Results: CIL is a benign yet locally invasive lipomatous tumor. Current treatment involves subtotal resection and recontouring. Invasion of vital structures often prohibits complete excision; there is currently no consensus on the most appropriate timing or scope of resection. We present the case of a teenager with extensive CIL involving the left face who had undergone multiple previous surgeries with limited success. In this case, preoperative thalidomide and celecoxib was given followed by an aggressive soft tissue resection. Postoperatively, imatinib was started based on immunohistochemical findings. At 6 months the patient has improved facial symmetry without evidence of disease progression.
Conclusion: This multidisciplinary approach to treatment of CIL represents a completely new paradigm. Current algorithms advocating early surgical resection or observation alone lead to unacceptably high rates of recurrence and potential morbidity; combining surgical and medical interventions may provide a synergistic approach to controlling this rare disease.
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