Exceptionally large, atypically located spindle cell lipoma

Abstract

Spindle cell lipomas are a rare subtype of lipoma typically occurring in the shawl region of middle-aged men with a characteristic histological appearance consisting of mature adipocytes, ropey collagen and spindle cells. Those of extraordinary size or atypical anatomic location require a proper immunohistological workup to rule out more ominous malignancy. The authors report the rare presentation of a 54-year-old man with a large mass of the left palm causing discomfort and paresthesia for 6 months. Radiographs showed a radiolucent mass without mineralisation or bony involvement. MRI demonstrated a non-contrast-enhancing homogeneous lipomatous mass encompassing flexor tendons of the palm. Elective excisional biopsy and immunohistological analysis were consistent with spindle cell lipoma measuring 11 cm × 7 cm × 4 cm. This case is the largest spindle cell lipoma of the hand reported in the literature and appears to be the largest described in the upper extremity.

Giant Pleomorphic Lipoma With Malignant Transformation in the Buttock: a Rare Case Report and Literature Review

“…Unique giant cells with overlapping nuclei and edge arrangement could also be found in pleomorphic liposarcoma [20,21]. In immunohistochemistry, MDM2 and CDK4 are positive, which are helpful to distinguish benign lipoma from other lipomas [13,20,22].…”

“…Unique giant cells with overlapping nuclei and edge arrangement could also be found in pleomorphic liposarcoma [20,21]. In immunohistochemistry, MDM2 and CDK4 are positive, which are helpful to distinguish benign lipoma from other lipomas [13,20,22]. CD34, B-cell lymphoma-2 (BCL-2), and CD99 are always strongly positive, while S-100 protein and signal transducer and activator of transcription 6 (STAT6) are usually negative [11,14,23,24].…”

Case Report: An exceptionally large spindle cell lipoma of the popliteal fossa

“…The rare cases with extraordinary size or atypical anatomical location require further investigations to rule out more worrisome malignancies. 9,[12][13][14][15] Radiologically, the images of the SCL are variable and no pathognomonic signs are identified. In most cases, tumor images are composed of a relatively equal ratio of spindle cells and fatty tissue.…”

“…16,18 Spindle cell lipoma and pleomorphic lipoma share many known non-pathognomonic genetic chromosomal abnormalities specifically losses at 16q and 13q chromosomes, but these abnormalities are not constant and do not interfere with the diagnosis. 12,19 The standard treatment of SCL is the surgical marginal resection, post excision recurrence rate is stated to be <1% with adequate marginal resection. 3,9 Conclusions It was noted that SCL is similar to many benign and malignant soft tissue tumors in pathologic morphology.…”