Spindle Cell Lipoma of the Tongue: A Clinicopathologic Study of 8 Cases and Review of the Literature

Abstract

Spindle cell lipoma is a histologically distinct variant of lipoma characteristically arising in the subcutis of the posterior neck, upper back, or shoulder. Spindle cell lipomas infrequently occur within the oral cavity and, in particular, rarely involve the tongue. The clinical and pathologic features of eight cases of spindle cell lipoma affecting the tongue were analyzed. The study group included five men and three women ranging in age from 35 to 80 years (mean 57.4 years). Most lesions presented as either a painless or slowly growing lingual mass. The tumors were well circumscribed and characterized microscopically by a mixture of mature adipocytes, cytologically bland spindle cells, and interspersed bundles of thick collagen fibers in variable proportions. Myxoid stroma was a prominent feature in three lesions. The spindle cells were positive with CD34, while negative with S-100 protein, desmin, and smooth muscle actin. Treatment consisted of local excision in all cases. There have been no recurrences to date, with clinical follow up information available for all patients (range 11-118 months; mean 50.8 months). Lingual examples of spindle cell lipoma should be distinguished from other fat containing spindle cell neoplasms that can arise at this anatomic site.

Low‐fat and fat‐free spindle cell lipomas in the oral cavity: Immunohistochemical analysis and review of the literature

“…To the best of our knowledge, the present cases are the first and second reports of fat‐free and low‐fat SCL, respectively, in the oral cavity. Moreover, given the difficulty of the initial microscopical diagnosis in the current cases, both lipoma variants should be included in the differential diagnosis especially when assessing oral reactive (eg, FH) and benign spindle cell lesions …”

“…The key to its histopathological diagnosis is recognition of the spindle cell population, which is similar to that observed in conventional or classic SCL. Sometimes, a variable amount of myxoid stroma can be visualized and it may mimic a non‐lipogenic myxoid neoplasm; however, the spindled cell arrangement and the presence of wiry to ropey collagen help to establish the diagnosis . Moreover, to differentiate low‐fat from fat‐free SCL, additional sampling may be necessary, a procedure that could detect some adipocytes in the fat‐free SCLs .…”

“…In addition to the morphological analysis, the immunohistochemical study shows important results that help to confirm the diagnosis. In fact, the spindle cell component of SCL is strongly immunoreactive for CD34 and, remarkably, Rb is deficient . MC tryptase antibody and toluidine blue stain highlight MCs throughout the tumor stroma, while alpha‐SMA and desmin are uniformly negative .…”

Spindle Cell Lipoma of the Buccal Mucosa- A Case Report

“…3 Oral Spindle cell lipomas usually occur in patients of an age range of 31 years to 78 years. 4 While some authors report a balanced distribution between males and females others report a male predominance for this lesion. 4,5 Oral spindle cell lipomas commonly present as a painless, wellcircumscribed submucosal slow growing mass of 1 cm in diameter.…”

“…They are soft in consistency and yellow in color and usually located on the lateral border of the dorsal anterior 2/3 rd of the tongue. 4,6 The tongue is the most common site for Spindle cell Lipomas followed by the floor of the mouth and the buccal mucosa. 4,7.8 Histologically, Spindle cell Lipomas are characterized by the presence of mature adipocytes surrounded by a thin fibrous capsule that originates in mature fat cells.…”