Spindle Cell Lipoma of the Neck: Review of the Literature and Case Report

Abstract

Spindle cell lipomas (SCL) are benign, slow growing tumors arising most frequently in the subcutaneous tissue of the upper back, posterior neck, and shoulders in males aged 40-70 years. Local excision is generally curative. Classification of lipomatous tumors has progressed recently, and tumors of similar morphology and unusual presentation are increasingly reported, thereby making correct diagnosis even more vital. SCL require pathologic differentiation from liposarcoma, other spindle cell neoplasms, and myxoid lesions for treatment purposes. Cytology, histology, and cytogenetics, in conjunction with clinical presentation, are paramount in arriving at the correct diagnosis of spindle cell lipoma. We present a case report with characteristics typical of an SCL along with a literature review to further elucidate the diagnosis and surgical treatment of this soft tissue tumor.

Fig. 1.

Lateral view of the posterior cervical mass while patient prone for surgical excision.

Fig. 2.

Posterior view of the mass just before surgical excision.

Fig. 3.

Gross specimen of the spindle cell lipoma. The 16 × 9.1 × 6.5 cm specimen with cystic structure and a gel-like fluid.

Fig. 4.

Pathologic analysis established a spindle cell neoplasm with abundant myxoid stroma and cleft-like spaces. The cells were fairly monotonous, admixed with mature fat cells. No lipoblasts noted.