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Case Reports
. 2021 Sep-Dec;9(3):267-270.
doi: 10.4103/sjmms.sjmms_63_21. Epub 2021 Aug 21.

Unusual Presentation of Lipofibromatosis-Like Neural Tumor in an Adult: A Case Report

Muhammad Samsoor Zarak  1 , Taylor Sliker  2 , Tiffany Javadi  3 , Asad Ullah  2 , Saleh G Heneidi  2 , Paul Biddinger  2 , Natasha M Savage  2 , Kelly Homlar  4 , Joe Clarence  5 , Joseph White  2
Affiliations
Case Reports

Unusual Presentation of Lipofibromatosis-Like Neural Tumor in an Adult: A Case Report

Muhammad Samsoor Zarak et al. Saudi J Med Med Sci. 2021 Sep-Dec.

Abstract

Lipofibromatosis-like neural tumor (LPF-NT) is a rare variant of lipofibromatosis. Standard lipofibromatosis tumors show a predilection for the distal extremities of male children or young adults and are typically painless, slow-growing, subcutaneous or deep soft tissue masses. We present a case of a 50-year-old male with a slowly expanding, right foot mass. Physical examination revealed a painful, non-tender firm mass on the right medial foot. Magnetic imaging studies revealed a poorly defined soft tissue mass extending through subcutaneous tissue up to the dermis. Histologic examination revealed a spindle cell neoplasm. Immunohistochemistry showed co-expression of S100 protein, CD34 and TRK. In addition, the lesion was found to be positive for the LMNA-NTRK1 fusion by next-generation sequencing. These findings were supportive of a diagnosis of LPF-NT. At 3-month post-excision, the patient had no pain and repeat imaging indicated no evidence of tumor. The authors recommended including LPF-NT in the differential diagnosis of masses or lesions that are fibro-fatty tumors.

Keywords: Adult; NTRK; foot; immunohistochemistry; infiltrative; lipofibromatosis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Magnetic resonance imaging showing poorly defined soft tissue mass extending into subcutaneous tissue
Figure 2
Figure 2
(a) Spindled neoplastic cells of lipofibromatosis-like neural tumor growing in a fascicular pattern, while infiltrating adjacent connective tissue (×100 magnification). (b) Lipofibromatosis-like neural tumor cells infiltrating throughout the surrounding subcutaneous adipose and connective tissue (×200 magnification). (c) Spindled fibroblasts showing mild nuclear hyperchromasia and atypia with scattered pleomorphism characteristic of lipofibromatosis-like neural tumor (×400 magnification; all H&E stain)
Figure 3
Figure 3
(a) Strong membranous CD34 positive tumor cells (×100) (b) Cytoplasmic S100 staining (×100) (c) Diffuse cytoplasmic Pan-TRK staining of core needle biopsy (×200 magnification; all immunohistochemical stains)
See this image and copyright information in PMC

References

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