Spindle cell lipoma

Abstract

Spindle cell lipomas (SCLs) are a group of benign lipogenic tumours, typically arising in the posterior neck, upper back and shoulder of elderly male patients. Approximately 80% of these tumours arise in characteristic location, but 20% arise in unusual locations, thereby making these cases more difficult to diagnose. We present a case of SCL occurring in the right periorbital region of a 14-year-old boy. The MRI was suggestive of possible malignancy. Diagnosis of neurofibroma was made on incisional biopsy. However, the histopathological and immunohistochemical analyses of the excised lesion confirmed the diagnosis of SCL.

Figure 1

Photograph showing swelling around the right eye causing compression of the eye.

Figure 2

Photograph showing swelling and increased hair growth over the skin of involved area.

Figure 3

Coronal CT image showing soft tissue density lesion along the lateral wall of right orbit involving temporalis muscle.

Figure 4

Coronal and axial MRI T2-weighted images showing heterogeneous area of altered signal intensity involving the temporalis muscle.

Figure 5

Intraoperative photograph.

Figure 6

Photomicrograph showing histopathological features. (A) predominance of spindle component; (B) parallel arrangement of spindle cells; (C) whorled pattern of spindle cells and (D) myxoid area.

Figure 7

High power views showing bland and uniform short spindle cells along with mast cells in a fibrous stroma.

Figure 8

Immunohistochemistry photomicrographs showing strong and diffused positivity of spindle cells for CD34.

Figure 9

Immunohistochemistry photomicrograph showing negative staining of spindle cells for S-100 protein.