scholarly journals Primary Cutaneous Atypical Spindle Cell Lipomatous Tumor

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Madeline S. Tchack ◽  
Michael Broscius ◽  
Martin Reichel

This report documents an exophytic, pedunculated nodule in a 74-year-old man that upon histopathological examination revealed an atypical spindle cell/pleomorphic lipomatous tumor (ASPLT) confined to the papillary and reticular dermis, representing the fourth documented case within the skin. Despite the overt pleomorphic changes present histologically, the patient is free of metastasis or recurrence five years after surgery.

2001 ◽  
Vol 80 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Ingo Baumann ◽  
Florian Dammann ◽  
Hans Peter Horny ◽  
Peter Karl Plinkert

Spindle cell lipomas are usually located in the subcutaneous tissue of the back, shoulders, and neck. To our knowledge, the presence of such a tumor in the parapharyngeal space has not yet been described. We evaluated a 45-year-old man with a tender swelling of the right parotid area that had reached the submandibular area. Clinical examination and magnetic resonance imaging revealed the presence of a tumor that coated the parotid area laterally and extended into the center of the parapharyngeal space, thus causing a dislocation of the pharyngeal muscles and mucosa. We performed a total parotidectomy and submandibulectomy on the right side and extirpated the parapharyngeal tumor. We were able to spare the facial nerve, and no facial paralysis occurred. Histologic examination revealed an atypical lipomatous tumor with a remarkably large portion of spindles.


Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Khin Thway ◽  
Jayson Wang ◽  
John Swansbury ◽  
Toon Min ◽  
Cyril Fisher

Background. The assessment ofMDM2gene amplification by fluorescencein situhybridization (FISH) has become a routine ancillary tool for diagnosing atypical lipomatous tumor (ALT)/well-differentiated liposarcoma and dedifferentiated liposarcoma (WDL/DDL) in specialist sarcoma units. We describe our experience of its utility at our tertiary institute.Methods. All routine histology samples in whichMDM2amplification was assessed with FISH over a 2-year period were included, and FISH results were correlated with clinical and histologic findings.Results. 365 samples from 347 patients had FISH forMDM2gene amplification. 170 were positive (i.e., showedMDM2gene amplification), 192 were negative, and 3 were technically unsatisfactory. There were 122 histologically benign cases showing a histology:FISH concordance rate of 92.6%, 142 WDL/DDL (concordance 96.5%), and 34 cases histologically equivocal for WDL (concordance 50%). Of 64 spindle cell/pleomorphic neoplasms (in which DDL was a differential diagnosis), 21.9% showedMDM2amplification. Of the cases with discrepant histology and FISH, all but 3 had diagnoses amended following FISH results. For discrepancies of benign histology but positive FISH, lesions were on average larger, more frequently in “classical” (intra-abdominal or inguinal) sites for WDL/DDL and more frequently core biopsies. Discrepancies of malignant histology but negative FISH were smaller, less frequently in “classical” sites but again more frequently core biopsies.Conclusions. FISH has a high correlation rate with histology for cases with firm histologic diagnoses of lipoma or WDL/DDL. It is a useful ancillary diagnostic tool in histologically equivocal cases, particularly in WDL lacking significant histologic atypia or DDL without corresponding WDL component, especially in larger tumors, those from intra-abdominal or inguinal sites or core biopsies. There is a significant group of well-differentiated adipocytic neoplasms which are difficult to diagnose on morphology alone, in which FISH forMDM2amplification is diagnostically contributory.


2019 ◽  
Vol 131 (2) ◽  
pp. 517-525 ◽  
Author(s):  
Alexandra M. Giantini Larsen ◽  
David J. Cote ◽  
Hasan A. Zaidi ◽  
Wenya Linda Bi ◽  
Paul J. Schmitt ◽  
...  

OBJECTIVEThe authors report the diagnosis, management, and outcomes of 6 cases of spindle cell oncocytoma (SCO) in an effort to guide clinical diagnosis and management of these uncommon lesions.METHODSThis study is a retrospective review of cases involving adult patients who underwent resection of pituitary lesions at the authors’ institutions between January 2000 and October 2017. The authors identified patients with histopathological confirmation of SCO and collected clinical data, including preoperative, perioperative, and postoperative management, complications, and outcomes.RESULTSSix patients with SCO were identified. Clinical findings at initial presentation included visual disturbances, dizziness, and headache. All patients underwent resection. Four resections were initially performed by the transsphenoidal approach, and 2 resections were performed by craniotomy at an outside institution with subsequent transsphenoidal reoperations. Neither necrosis nor increased mitotic activity was seen in the tumor samples. All samples stained positive for S100 protein and thyroid transcription factor 1 and negative for glial fibrillary acidic protein and pituitary hormones. Five of the samples stained positive for epithelial membrane antigen. The average MIB-1 index was 8.3% (range 2–17). Postoperatively, 3 of the 6 patients received further treatment for progression of residual tumor or for recurrence, 2 have stable residual tumor, and 1 has had no recurrence after gross-total resection. Two patients developed postoperative complications of transient sixth cranial nerve palsy and diplopia. There were no other complications.CONCLUSIONSSCO poses both a diagnostic and therapeutic challenge. These tumors are often initially misdiagnosed as nonfunctional pituitary adenomas because of their sellar location and nonspecific symptomatology. Postoperatively, SCO must also be distinguished from other neoplasms of the posterior pituitary gland through histopathological examination. Resection of SCO can be challenging, given its highly vascular and adherent nature. Long-term follow-up is critical, as the tumor is associated with higher recurrence and progression rates compared to other benign neoplasms of the sella.


2019 ◽  
Vol 6 (6) ◽  
pp. 2204
Author(s):  
Vidhyachandra Gandhi ◽  
Swapnil Karnik ◽  
Nitin Pai ◽  
Sujai Hegde

Angiomyolipomas are benign mesenchymal tumors mostly arising from the kidney. Angiomyolipoma of the colon is extremely rare. Here we report the findings of a 72 years gentleman who presented with recurrent episodes of abdominal pain and fullness of one year duration. Colonoscopy was suggestive of polypoidal lesion in the descending colon. CECT abdomen revealed a colocolic intussusception in the descending colon with lipoma as a leading point. He underwent a standard left hemicolectomy. Histopathological examination showed that the tumor of 5.7 cm in diameter included smooth muscle (spindle cell type), mature adipose tissue, and vessels, and therefore a diagnosis of angiomyolipoma was made. We believe this is the second report of colonic angiomyolipoma presenting with colocolic intussusception. 


2013 ◽  
Vol 3 (5) ◽  
pp. 419-421
Author(s):  
S Neupane ◽  
T Pathak ◽  
S Bastola ◽  
S Shrestha ◽  
CB Pun

Primary carcinosarcoma of the lung is exceedingly rare. It is described as malignancy composed of a mixture of carcinoma and sarcoma elements. The sarcomatous element is usually spindle cell but may contain cartilage, bone or skeletal muscle. We report a case of pulmonary carcinosarcoma in a 66 years male who presented with cough, chest pain on exertion, anorexia and weight loss. Brush cytology revealed poorly differentiated non-small cell carcinoma. Histopathological examination showed proliferation of malignant spindle cells containing bone and malignant cartilage admixed with areas of keratinized squamous cells with few foci of ill-defined glandular structure. On immunohistochemistry, carcinomatous component of tumor showed positivity for cytokeratin AE1/AE3 and spindle cell component were positive for vimentin. These findings led to diagnosis of carcinosarcoma. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 419-421 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7873


2020 ◽  
Vol 86 (9) ◽  
pp. 1208-1211
Author(s):  
Chase J. Wehrle ◽  
J. Will Daigle ◽  
Asad Ullah ◽  
Suash Sharma ◽  
Edmond F. Ritter ◽  
...  

Atypical spindle cell lipomatous neoplasm, also known as well-differentiated spindle cell liposarcoma, represents a newly discovered entity of adipocytic tumors. Recent research has shown this tumor variant to be more related to spindle cell lipoma, rather than the originally hypothesized atypical lipomatous tumor spectrum. Here we present a case of a 58-year-old man with a history of chronic lymphocytic leukemia with an enlarging mass on the posterior left shoulder, initially hypothesized to be a benign lipoma. However, magnetic resonance imaging showed a large, multiseptated, heterogeneous mass concerning for soft tissue sarcoma. After resection, pathologic analysis showed cells closely resembling spindle cell lipoma, with additional cellular and fascicular zones containing lipoblasts and mitotic figures. Molecular analysis showed no MDM2 amplification. This lack of amplification indicates this tumor is distinctly different from an atypical lipomatous tumor, which characteristically displays MDM2 amplification. However, tumor expression of RB1 was normal. The majority of atypical spindle cell lipomatous neoplasms are associated with RB1 deletions. We conclude that we have a unique example of an atypical spindle cell lipomatous tumor.


2021 ◽  
Vol 20 (4) ◽  
pp. 923-925
Author(s):  
Ng CS ◽  
Mohd Razif M Y ◽  
Chew MX ◽  
Suria HMP

Introduction:Spindle cell carcinomas (SpCC) are a rare variant of squamous cell carcinoma which is rarely encountered in the head and neck. It is also known as“pseudocarcinoma”, “sarcomatoidcarcinoma,” and “carcinosarcoma”.It has an aggressive nature and has poor prognosis despite aggressive treatment. Case report: A 48-year-old lady presented to us with a right painless upper gum swelling which was progressively enlarging for 3 months after tooth extraction. Examination of the oral a fungating mass over the right upper alveolus extending to the right upper gingivolabial sulcus. She was subjected to a debulking palliative to reduce the tumour bulk. The intraoperative samples sent for histopathological examination was reported as SpCC, AJCC (8th edition) stage pT2pN3b. She recovered well after the surgery with quality of life after the surgery. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.923-925


2019 ◽  
Vol 28 (3) ◽  
pp. 336-340 ◽  
Author(s):  
Judith A. S. Jebastin ◽  
Kyle D. Perry ◽  
Dhananjay A. Chitale ◽  
Michael P. Mott ◽  
Jessica Sanchez ◽  
...  

Atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) and spindle cell lipoma are lipomatous tumors with distinct clinical, molecular, and prognostic features. Although histological and immunophenotypic features can overlap between ALT/WDL and spindle cell lipoma, the oncogenesis and clinical behavior are markedly different. In borderline cases, molecular analysis for MDM2 or CDK4 amplification can aid in distinguishing ALT/WDL from spindle cell lipoma. Although dedifferentiated liposarcoma has been reported to harbor both MDM2 amplification and loss of the RB1 region, we are not aware of a reported RB1 loss in well-differentiated ALT/WDL. In this article, we present a 69-year-old woman with a lipomatous tumor in the gluteal region that histologically, immunohistochemically, and molecularly mimicked spindle cell lipoma (with positive immunohistochemical staining for CD34 and loss of the RB1 gene region), yet harbored amplification of MDM2 and CDK4 confirmed by fluorescence in situ hybridization, supporting classification as ALT/WDL. This case strengthens the argument that in atypical clinical contexts, molecular studies for MDM2/CDK4 should be considered in tumors resembling spindle cell lipoma.


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