Abstract
Aim: Spindle cell lipoma is a rare tumor. Although located subcutaneously, they are localized in the posterior neck, shoulder, and lumbar regions. It can radiologically mimic liposarcoma. It is important to differentiate spindle cell lipoma from atypical lipomatous tumors. In this study, we aimed to present our studies on our patients with spindle cell lipoma with histopathological and clinical findings and give brief information about the differential diagnosis of this rare lipomatous lesion.
Material and Methods: A total of 29 patients (27 male, 2 female) who underwent surgical treatment for spindle cell lipoma between January 2015 and December 2020 were included in this retrospective study. All patients were presented with mass lesions, and preoperative biopsy was performed in cases with low-fat content mass lesions.
Results: The mean age of the patients was 57.0±14.6 (range, 25-79) years and the mean follow-up period was 25.0±8.6 (range, 6-47) months. No additional disease was detected in the patients. Marginal resection was preferred in 5 (17.2%) patients with lesions close to neurovascular structures. Wide resection was performed in the other 24 (82.8%) patients. CD34 was positive in all lesions. In one patient, CDK4 was positive, and the diagnosis was made as atypical spindle cell lipoma. At the last follow-up, there was no complication and recurrence in any of the cases.
Conclusion: Spindle cell lipomas should be regarded in the differential diagnosis of lipomatous tumors. Local excision with negative margins may prevent a recurrence. Correct histopathologic differentiation from liposarcoma is of paramount importance for appropriate treatment.
Keywords
References
- Mizoshiri N, Shirai T, Terauchi R, Arai Y, Fujiwara H, Konishi E, et al. Intramuscular spindle cell lipoma of the deltoid: a case report. J Med Case Rep. 2015;9:38.
- Creytens D, van Gorp J, Savola S, Ferdinande L, Mentzel T, Libbrecht L. Atypical spindle cell lipoma: a clinicopathologic, immunohistochemical, and molecular study emphasising its relationship to classical spindle cell lipoma. Virchows Arch. 2014;465(1):97-108.
- Chen S, Huang H, He S, Wang W, Zhao R, Li L, et al. Spindle cell lipoma: clinicopathologic characterisation of 40 cases. Int J Exp Pathol. 2019;12(7):2613-21.
- Creytens D. What’s new in adipocytic neoplasia? Virchows Arch. 2020;476(1):29-39.
- Jebastin JAS, Perry KD, Chitale DA, Mott MP, Sanchez J, Fritchie KJ, et al. Atypical lipomatous tumor/well-differentiated liposarcoma with features mimicking spindle cell lipoma. Int J Surg Pathol. 2020;28(3):336-40.
- Creytens D, Marino-Enriquez A. Atypical spindle cell/pleomorphic lipomatous tumour. In: WHO Classification of Tumours Editorial Board, editors. Soft Tissue and Bone Tumours, WHO Classification of Tumours, 5th edition, volume 3. Lyon, France: IARC Press; 2020. p. 34-5.
- Ud Din N, Zhang P, Sukov WR, Sattler CA, Jenkins SM, Doyle LA, et al. Spindle cell lipomas arising at atypical locations. Am J Clin Pathol. 2016;146(4):487-95.
- Jelinek JS, Wu A, Wallace M, Kumar D, Henshaw RM, Murphey MJ, et al. Imaging of spindle cell lipoma. Clin Radiol. 2020;75(5):396.e15-21.
- Kallen ME, Hornick JL. The 2020 WHO classification: what’s new in soft tissue tumor pathology? Am J Surg Pathol. 2021;45(1):e1-23.
- Seo BF, Kang IS, Oh DY. Spindle cell lipoma: a rare, misunderstood entity. Arch Craniofac Surg. 2014;15(2):102-4.
- Deyrup AT, Chibon F, Guillou L, Lagarde P, Coindre JM, Weiss SW. Fibrosarcoma-like lipomatous neoplasm: a reappraisal of so-called spindle cell liposarcoma defining a unique lipomatous tumor unrelated to other liposarcomas. Am J Surg Pathol. 2013;37(9):1373-8.
- Balakrishnan C, Nanavati D, Balakrishnan A, Pane T. Giant lipomas of the upper extremity: Case reports and a literature review. Can J Plast Surg. 2012;20(3):e40-1.
Abstract
Amaç: İğsi hücreli lipom nadir görülen bir tümördür. Cilt altı yerleşimli olmakla birlikte arka boyun, omuz ve bel bölgesinde de yerleşim göstermektedirler. Radyolojik olarak liposarkomu taklit edebilmektedir. İğsi hücreli lipomanın atipik lipomatöz tümörlerden ayırımı önemlidir. Bu çalışmada, histopatolojik ve klinik bulguları olan iğsi hücreli lipomlu hastalarımıza ilişkin çalışmalarımızı sunmayı ve bu nadir gözlenen lipomatöz lezyonun ayırıcı tanıları hakkında kısaca bilgi vermeyi amaçladık.
Gereç ve Yöntemler: Bu geriye dönük çalışmaya Ocak 2015 ve Aralık 2020 tarihleri arasında iğsi hücreli lipom nedeniyle cerrahi tedavi uygulanmış olan toplam 29 hasta (27 erkek, 2 kadın) dahil edildi. Tüm hastalar kitle lezyonu ile başvurdular ve düşük yağ içerikli kitle lezyonu olan olgularda ameliyat öncesi biyopsi uygulandı.
Bulgular: Hastaların ortalama yaşı 57,0±14,6 (aralık, 25-79) yıl ve ortalama takip süresi ise 25,0±8,6 (aralık, 6-47) ay idi. Hastalarda başka herhangi bir ek hastalık saptanmadı. Nörovasküler yapılara yakın lezyonu olan 5 (%17,2) hastada marjinal rezeksiyon tercih edildi. Diğer 24 (%82,8) hastaya ise geniş rezeksiyon uygulandı. CD34 tüm lezyonlarda pozitifti. Bir hastada CDK4 pozitifti ve bu hastaya atipik iğsi hücreli lipom tanısı konuldu. Son kontrollerinde hiçbir vakada komplikasyon veya nüks saptanmadı.
Sonuç: Lipomatöz tümörlerin ayırıcı tanısında iğsi hücreli lipomlar düşünülmelidir. Negatif sınırlar ile lokal eksizyon nüksü önleyebilir. Uygun tedavi için liposarkomdan doğru histopatolojik ayrım oldukça önemlidir.
References
- Mizoshiri N, Shirai T, Terauchi R, Arai Y, Fujiwara H, Konishi E, et al. Intramuscular spindle cell lipoma of the deltoid: a case report. J Med Case Rep. 2015;9:38.
- Creytens D, van Gorp J, Savola S, Ferdinande L, Mentzel T, Libbrecht L. Atypical spindle cell lipoma: a clinicopathologic, immunohistochemical, and molecular study emphasising its relationship to classical spindle cell lipoma. Virchows Arch. 2014;465(1):97-108.
- Chen S, Huang H, He S, Wang W, Zhao R, Li L, et al. Spindle cell lipoma: clinicopathologic characterisation of 40 cases. Int J Exp Pathol. 2019;12(7):2613-21.
- Creytens D. What’s new in adipocytic neoplasia? Virchows Arch. 2020;476(1):29-39.
- Jebastin JAS, Perry KD, Chitale DA, Mott MP, Sanchez J, Fritchie KJ, et al. Atypical lipomatous tumor/well-differentiated liposarcoma with features mimicking spindle cell lipoma. Int J Surg Pathol. 2020;28(3):336-40.
- Creytens D, Marino-Enriquez A. Atypical spindle cell/pleomorphic lipomatous tumour. In: WHO Classification of Tumours Editorial Board, editors. Soft Tissue and Bone Tumours, WHO Classification of Tumours, 5th edition, volume 3. Lyon, France: IARC Press; 2020. p. 34-5.
- Ud Din N, Zhang P, Sukov WR, Sattler CA, Jenkins SM, Doyle LA, et al. Spindle cell lipomas arising at atypical locations. Am J Clin Pathol. 2016;146(4):487-95.
- Jelinek JS, Wu A, Wallace M, Kumar D, Henshaw RM, Murphey MJ, et al. Imaging of spindle cell lipoma. Clin Radiol. 2020;75(5):396.e15-21.
- Kallen ME, Hornick JL. The 2020 WHO classification: what’s new in soft tissue tumor pathology? Am J Surg Pathol. 2021;45(1):e1-23.
- Seo BF, Kang IS, Oh DY. Spindle cell lipoma: a rare, misunderstood entity. Arch Craniofac Surg. 2014;15(2):102-4.
- Deyrup AT, Chibon F, Guillou L, Lagarde P, Coindre JM, Weiss SW. Fibrosarcoma-like lipomatous neoplasm: a reappraisal of so-called spindle cell liposarcoma defining a unique lipomatous tumor unrelated to other liposarcomas. Am J Surg Pathol. 2013;37(9):1373-8.
- Balakrishnan C, Nanavati D, Balakrishnan A, Pane T. Giant lipomas of the upper extremity: Case reports and a literature review. Can J Plast Surg. 2012;20(3):e40-1.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Article |
| Authors | |
| Publication Date | December 30, 2021 |
| Submission Date | June 19, 2021 |
| Published in Issue | Year 2021 Volume: 23 Issue: 3 |
Cite
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