Spindle Cell Lipoma of the Oral Cavity

Abstract

Spindle cell lipoma is typically seen in the neck/trunk region of middle-aged and older men. Rare cases of oral spindle cell lipoma have been reported. An entity described as myxoid lipoma of the oral cavity has rarely been reported but appears to be more properly classified as spindle cell lipoma. We describe the largest series yet of oral spindle cell lipoma involving the tongue (4), buccal mucosa (1), floor of mouth (1), and lip (1). The patients (3M; 4F) ranged from 31 to 88 years old. All presented with mass lesions. All were circumscribed and composed of mature adipocytes admixed with bland spindled cells. In two cases the adipocytes appeared atrophic, imparting a pseudo-lipoblastic appearance. No true lipoblasts were seen and none had the characteristic vasculature of a myxoid liposarcoma or the characteristic hyperchromatic cells of well-differentiated liposarcoma. The stromal background of all cases contained characteristic wiry collagen and myxoid ground substance. The myxoid ground substance was prominent in four cases. Immunohistochemical stains for CD34 highlighted the bland spindle cells in all cases. The combination of the histologic features and the immunoreactivity for CD34 confirmed the diagnosis. Spindle cell lipoma should be considered in the differential diagnosis of oral cavity mesenchymal tumors.

Spindle Cell Lipoma of the Tongue: A Clinicopathologic Study of 8 Cases and Review of the Literature

“…Lingual spindle cell lipomas are benign neoplasms managed adequately by local excision. The present series along with prior reports with known follow up information have shown no instances of tumor recurrence or aggressive biologic behavior [3,11,14,16,18,19,21]. On gross examination, spindle cell lipomas are well circumscribed neoplasms with a firmer consistency than ordinary lipomas.…”

“…Spindle cell lipomas are infrequently encountered in the oral region, with lingual examples of this entity in particular being distinctly rare. To our knowledge, only 24 cases of spindle cell lipoma involving the tongue have been reported in the English literature [3,5,[9][10][11][12][13][14][15][16][17][18][19][20][21]. The clinical and pathologic features of lingual spindle cell lipoma based on findings from the present series combined with previously published data are summarized in Table 3.…”

“…Rare lipoblasts may occur in spindle cell lipoma but are never a prominent finding. Pseudo-lipoblastic changes attributed to atrophy resulting in adipocytes with decreased cytoplasmic lipid and more prominent nuclei are not uncommon in oral cavity spindle cell lipomas [13,16] and should be distinguished from true lipoblasts that exhibit enlarged, hyperchromatic, irregularly shaped nuclei.…”

“…While most ordinary lipomas of the oral cavity involve the buccal mucosa, tongue or lip [1][2][3][4][5][6][7][8], lingual examples of spindle cell lipoma remain rare. The reported literature pertaining to spindle cell lipoma of the tongue is relatively sparse and comprised predominantly of single case reports and limited descriptions of small numbers of cases among larger series of lipomas of the oral cavity [3,5,[9][10][11][12][13][14][15][16][17][18][19][20][21]. In this study, we analyzed eight new cases of lingual spindle cell lipoma in order to further characterize the clinicopathologic features of this uncommon type of intraoral lipomatous tumor.…”

Lipomas of the oral cavity: clinical and histopathologic study of 41 cases in a Brazilian population

“…Histologically, these lipomas are characterized by the proliferation of mature adipocytes and CD34-positive spindle-shaped cells, the latter embedded either among short collagen Wber bundles or in a myxoid matrix [40,41]. One characteristic is that the spindle-shaped cells are immunopositive for CD34 and negative for S-100 protein, smooth muscle alpha-actin, desmin, and factor VIII [13,40,42]. The proportion of adipocytes and spindle-shaped cells is variable [1,40,43].…”