9 The most common locations are at the shoulder and neck.
Spindle cell lipoma (SCL), a benign lipomatous neoplasm that was first described by Enzinger and Harvey in 1975. The diagnosis of SCL of the gluteal region was concluded. The immune histochemical analysis, showed that the lesional spindle cells were strongly immunoreactive for CD34 and the results of MDM2 immunostaining were negative. Neither the lipomatous nor the spindle cell elements of the tumors showed evidence of necrosis or mitotic activity. A histopathological examination revealed a well circumscribed mass composed of a mixture of mature adipocytes and spindle cells in varying proportions surrounded by a clear fibrous capsule. The patient was operated on with a single-block excision of the mass without capsular break-in ( Figure 4-6). On the basis of these radiological findings, we suspected a desmoide tumor, or liposarcoma from which the surgical indication was put. It showed high signal on a T2-weighted image ( Figure 1), heterogeneous, iso-signal on a T1-weighted image ( Figure 2), and a gadolinium-enhanced image ( Figure 3), measuring 76-49-108 mm coming into contact with the internal shutter muscle outside, pushing back the anal canal into it without signs of invasion. Magnetic resonance imaging (MRI) revealed a large, well defined mass of the right ischio-rectal pit. The clinical examination objected a freely mobile large mass of the right gluteal region measuring 7cmx10cm, soft, non-painful and with no inflammatory signs. Keywords: spindle cell lipoma, gluteal region, geant lipoma IntroductionĪ 69-year-old male patient, consulted with complaints of swelling in the right gluteal region gradually increasing in size for 3 years, with no other associated signs. The large and deep seated lipomas represent a real diagnostic and therapeutic challenge as they can be confused with a well-differentiated low grade liposarcoma or other lipomatous neoplasms. Spindle cell lipoma (SCL) is a relatively rare adipocytic neoplasm that classically arise in the trunk, lower extremities, and distal upper extremities of older male patients. The pathological diagnosis was intramuscular spindle cell lipoma and immunohistochemical study revealed all spindle cells were strongly positive for CD34. The tumor was 10cmx7cm and was excised completely at surgery. Magnetic resonance imaging (MRI) revealed a lipomatous tumor within the right gluteal muscle.
A 69-year-old male patient consulted because of a soft tissue mass in the right gluteus gradually increasing in size over the past 3 years. In this article, we describe a case of a patient with geant spindle cell lipoma localized in atypical location. They rarely reach a size more than 2-3cms. Spindle cell lipoma is a histologically distinct variant of lipoma characteristically arising in the subcutis of the posterior neck, upper back, or shoulder.
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