An extremely rare neoplasm 'atypical spindle cell pleomorphic lipomatous tumor': a case report

Abstract

Spindle cell lipoma is a rare histological variant of lipoma accounting for 1.5% of adipocytes tumors. It is composed of an admixture of mature adipocytes and fibroblast-like spindle cells in a myxoid stroma. Retroperitoneal atypical spindle cell lipomatous tumor are extremely rare only a single report in the literature reported. Herein we describe a case of a giant lipomatous tumor that was causing partial bowel obstruction. Successful excision with en block resection of the tumor, distal ureter and posterior wall of the bladder was achieved by teamwork between gastrointestinal surgeons and Urologist. The bladder defect was repaired, and left ureteric reimplantation was done. The patient made a good recovery with excellent progress. He has resumed his normal activities as a farmer.

Figure 1

Gross appearance showing generalised abdominal distention with marked wasting.

Figure 2

Radiological image.

Figure 3

Intraoperative en bloc excision of a large intraabdominal mass originating from the posterior wall of the urinary bladder.

Figure 4

(A) Low power: paracellular tissue with collagenous stroma. (C) Intermediate power: fibrofatty tissue with abundant hyaline-like fibro collagenous fibers and mature adipocytes, scant scattered hyperchromatic cells. Arrow showing a visible giant floret cell. (B, D) High power: mature adipocytes of variable size, scattered hyperchromatic spindle cells and mast cells as well as large prominent giant floret cells (Dr Atuganile Malango, Dr Fadia Ali).