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Intramuscular spindle cell lipoma of the deltoid: a case report.

Mizoshiri N, Shirai T, Terauchi R, Arai Y, Fujiwara H, Konishi E, Tsuchiya H, Kubo T - J Med Case Rep (2015)

Bottom Line: There are several kinds of lipomas.There are only five other reported cases of intramuscular spindle cell lipoma in the literature, to our knowledge.The case of our patient is very interesting, as to date there have been few reported patients with a diagnosis of an intramuscular spindle cell lipoma in a deltoid.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, 602-8566, Japan. mizo715@koto.kpu-m.ac.jp.

ABSTRACT

Introduction: Spindle cell lipoma is an uncommon adipocytic tumor. Intramuscular lesions of this tumor are very rare. In this report, we describe a case of a patient with intramuscular spindle cell lipoma localized in a deltoid.

Case presentation: A 58-year-old Japanese man visited us because of a soft tissue mass on the lateral aspect of the left shoulder that had been noticed 2 years prior. The spherical tumor, which measured 5 cm × 4 cm, was elastic and firm on palpation and immobile. Magnetic resonance imaging revealed that the lesion was localized in the left deltoid muscle. A needle biopsy was performed to make a histological diagnosis. With a pre-operative diagnosis of intramuscular lipoma, we removed the tumor with the patient under general anesthesia. The tumor was removed with surrounding musculature and fascia. The pathological diagnosis was intramuscular spindle cell lipoma in the left deltoid muscle.

Conclusions: There are several kinds of lipomas. Spindle cell lipoma is a relatively rare variant (1.5% of all adipocytic neoplasms) that is histologically distinct and characterized by the replacement of mature fat by a mixture of mature adipocytes and undifferentiated spindle cells. There are only five other reported cases of intramuscular spindle cell lipoma in the literature, to our knowledge. The case of our patient is very interesting, as to date there have been few reported patients with a diagnosis of an intramuscular spindle cell lipoma in a deltoid.

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Intra-operative photograph of the tumor. During surgery, it was confirmed that the whole lesion was localized underneath the fascia and embedded within the deltoid.
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Fig2: Intra-operative photograph of the tumor. During surgery, it was confirmed that the whole lesion was localized underneath the fascia and embedded within the deltoid.

Mentions: On the basis of the pre-operative diagnosis of intramuscular lipoma, we removed the tumor with the patient under general anesthesia. During surgery, it was confirmed that the whole lesion was localized underneath the fascia and embedded within the deltoid. There was no adhesion to the surrounding tissues (Figure 2). The tumor was removed with surrounding musculature and fascia. The excised tumor was 5cm×4cm×3cm in size and had a yellowish color like that of a lipoma (Figure 3). However, it was slightly harder than a typical lipoma. The bisected surface was whiter than a typical lipoma (Figure 4a and b). To make a pathological diagnosis, formalin-fixed, paraffin-embedded specimens were stained with hematoxylin and eosin. The tumor consisted of spindle cells, collagen fibers and lipocytes (Figure 5a and b). The striated muscle fibers were infiltrated and entrapped by mature lipocytes in a diffuse manner. There were no lipoblasts or atypical cells. The results of immunohistochemical staining with MDM2, CDK4 and p16 were all negative. Therefore, we diagnosed intramuscular SCL of the left shoulder.Figure 2


Intramuscular spindle cell lipoma of the deltoid: a case report.

Mizoshiri N, Shirai T, Terauchi R, Arai Y, Fujiwara H, Konishi E, Tsuchiya H, Kubo T - J Med Case Rep (2015)

Intra-operative photograph of the tumor. During surgery, it was confirmed that the whole lesion was localized underneath the fascia and embedded within the deltoid.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4340779&req=5

Fig2: Intra-operative photograph of the tumor. During surgery, it was confirmed that the whole lesion was localized underneath the fascia and embedded within the deltoid.
Mentions: On the basis of the pre-operative diagnosis of intramuscular lipoma, we removed the tumor with the patient under general anesthesia. During surgery, it was confirmed that the whole lesion was localized underneath the fascia and embedded within the deltoid. There was no adhesion to the surrounding tissues (Figure 2). The tumor was removed with surrounding musculature and fascia. The excised tumor was 5cm×4cm×3cm in size and had a yellowish color like that of a lipoma (Figure 3). However, it was slightly harder than a typical lipoma. The bisected surface was whiter than a typical lipoma (Figure 4a and b). To make a pathological diagnosis, formalin-fixed, paraffin-embedded specimens were stained with hematoxylin and eosin. The tumor consisted of spindle cells, collagen fibers and lipocytes (Figure 5a and b). The striated muscle fibers were infiltrated and entrapped by mature lipocytes in a diffuse manner. There were no lipoblasts or atypical cells. The results of immunohistochemical staining with MDM2, CDK4 and p16 were all negative. Therefore, we diagnosed intramuscular SCL of the left shoulder.Figure 2

Bottom Line: There are several kinds of lipomas.There are only five other reported cases of intramuscular spindle cell lipoma in the literature, to our knowledge.The case of our patient is very interesting, as to date there have been few reported patients with a diagnosis of an intramuscular spindle cell lipoma in a deltoid.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, 602-8566, Japan. mizo715@koto.kpu-m.ac.jp.

ABSTRACT

Introduction: Spindle cell lipoma is an uncommon adipocytic tumor. Intramuscular lesions of this tumor are very rare. In this report, we describe a case of a patient with intramuscular spindle cell lipoma localized in a deltoid.

Case presentation: A 58-year-old Japanese man visited us because of a soft tissue mass on the lateral aspect of the left shoulder that had been noticed 2 years prior. The spherical tumor, which measured 5 cm × 4 cm, was elastic and firm on palpation and immobile. Magnetic resonance imaging revealed that the lesion was localized in the left deltoid muscle. A needle biopsy was performed to make a histological diagnosis. With a pre-operative diagnosis of intramuscular lipoma, we removed the tumor with the patient under general anesthesia. The tumor was removed with surrounding musculature and fascia. The pathological diagnosis was intramuscular spindle cell lipoma in the left deltoid muscle.

Conclusions: There are several kinds of lipomas. Spindle cell lipoma is a relatively rare variant (1.5% of all adipocytic neoplasms) that is histologically distinct and characterized by the replacement of mature fat by a mixture of mature adipocytes and undifferentiated spindle cells. There are only five other reported cases of intramuscular spindle cell lipoma in the literature, to our knowledge. The case of our patient is very interesting, as to date there have been few reported patients with a diagnosis of an intramuscular spindle cell lipoma in a deltoid.

Show MeSH
Related in: MedlinePlus