Mizoshiri Naoki, Shirai Toshiharu, Terauchi Ryu, Arai Yuji, Fujiwara Hiroyoshi, Konishi Eiichi, Tsuchiya Hiroyuki, Kubo Toshikazu
Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, 602-8566, Japan.
Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
J Med Case Rep. 2015 Feb 19;9:38. doi: 10.1186/s13256-014-0509-0.
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.
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.
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.
梭形细胞脂肪瘤是一种罕见的脂肪细胞肿瘤。该肿瘤的肌内病变非常罕见。在本报告中,我们描述了一例位于三角肌的肌内梭形细胞脂肪瘤患者。
一名58岁的日本男性因2年前发现左肩部外侧的软组织肿块前来就诊。该球形肿瘤大小为5厘米×4厘米,触诊时质地有弹性且坚硬,活动度差。磁共振成像显示病变位于左三角肌。进行了针吸活检以做出组织学诊断。术前诊断为肌内脂肪瘤,我们在全身麻醉下为患者切除了肿瘤。肿瘤连同周围肌肉组织和筋膜一并切除。病理诊断为左三角肌肌内梭形细胞脂肪瘤。
脂肪瘤有多种类型。梭形细胞脂肪瘤是一种相对罕见的变体(占所有脂肪细胞肿瘤的1.5%),在组织学上具有独特性,其特征是成熟脂肪细胞被成熟脂肪细胞和未分化梭形细胞的混合物所取代。据我们所知,文献中仅另有5例肌内梭形细胞脂肪瘤的报道。我们患者的病例非常有趣,因为迄今为止,很少有报道称患者被诊断为三角肌肌内梭形细胞脂肪瘤。