Pleomorphic lipoma. Case report and discussion of ‘atypical’ lipomatous tumors

Department of Dermatology, University of Pennsylvania, Philadelphia.
Journal of Cutaneous Pathology (Impact Factor: 1.58). 09/1992; 19(4):330-3. DOI: 10.1111/j.1600-0560.1992.tb01370.x
Source: PubMed


A case of pleomorphic lipoma is described. Pleomorphic lipoma is included in the "atypical" lipoma classification. Because of its atypical microscopic appearance, it must be differentiated from liposarcoma. We will discuss pleomorphic lipoma and its position in the classification of atypical fatty tumors.

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    ABSTRACT: The authors report an example of an unusual subcuticular spindle cell tumor with histologic features which were most like those of "pleomorphic fibroma." However, the tumor cells exhibited bifid differentiation immunohistologically, with conjoint reactivity for vimentin, S-100 protein, Leu-7 antigen (CD57), myelin basic protein, and desmin. A hamartomatous origin was favored for this lesion, given its overall morphologic features, circumscription, and apparently heterogeneous cellular lineages. Although speculative, it is thought that this unusual cutaneous mass may represent a subcuticular analogue of the benign Triton tumor (neuromuscular choristoma) of deep soft tissues.
    No preview · Article · Jul 1995 · Journal of Cutaneous Pathology
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    ABSTRACT: We reviewed 37 referred, atypical, subcutaneous fatty tumors. There was a male preponderance (28:9). The median age was 51.5 years (26-83); the median duration of symptoms was 18 months (three weeks to 35 years); the median size was 5.5 cm (1.5-20) and the posterior cervico-dorsal areas (17 cases) was the commonest location. We divided tumors into five histological categories: (1) subcutaneous fibrolipomas with slight fibroblastic atypia (five cases); (2) subcutaneous spindle cell lipomas with atypia (mixed spindle cell/pleomorphic lipomas) without lipoblasts (three cases); (3) subcutaneous atypical well-differentiated fatty tumors (pure pleomorphic lipomas) without lipoblasts (nine cases); (4) subcutaneous atypical well-differentiated fatty tumors (pleomorphic lipomas) with lipoblasts (17 cases); (5) subcutaneous atypical fatty tumors with poorly differentiated or de-differentiated areas (three cases). Follow-up information was obtained in 25 cases (68%). The follow-up times were from three to 192 months (median 31). Five tumors (20%) recurred, two as the same and three as a higher histological category. Two were originally referred because of a recurrence. Four recurred once and one, initially a category 4 tumor, recurred twice as a category 5 tumor. Two category 1 and three category 4 tumors recurred. There were no recurrences in the other three groups. All recurrent tumors were located outside the cervico-dorsal areas. The sizes of two tumors that recurred were 2.8 and 3 cm and the time to first recurrence was from one to 85 months. Two recurrent tumors of high histological category were controlled by re-excision and either radiotherapy or combined chemotherapy and radiotherapy. This series suggests that atypical subcutaneous fatty tumors comprise a continuous and potentially transforming histological spectrum, which ranges from mildly atypical fibrolipomas through various mixed spindle cell and pleomorphic lipoma patterns to tumors indistinguishable from de-differentiated liposarcomas. Despite a sometimes alarming histological appearance, none in the present series metastasized.
    No preview · Article · Jun 1998 · Pathology
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    ABSTRACT: Background. Pleomorphic lipoma is a rare, benign, pseudosarcomatous, soft tissue neoplasm typically involving the subcutis of the neck and shoulder in middle-aged to elderly men. It is characterized histologically by atypical, multinucleated giant cells and grossly as a well-circumscribed mass. Since this neoplasm can resemble a sarcoma, histopathologic diagnosis is critical in preventing unnecessary surgery.Objective. To describe a case of pleomorphic lipoma in the neck and to review the clinical and histopathologic characteristics of this neoplasm.Methods. We present a case report and review of the literature.Results. Local excision to completely extirpate this neoplasm has proven curative at 10 months of follow-up.Conclusion. Pleomorphic lipoma is superficially located and may be encountered in a dermatologic setting. Thus the dermatologist should become familiar with its clinical presentation and microscopic appearance.
    No preview · Article · Mar 2000 · Dermatologic Surgery
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