Spindle cell lipomas are a rare subtype of lipoma typically occurring in the shawl region of middle-aged men with a characteristic histological appearance consisting of mature adipocytes, ropey collagen and spindle cells. Those of extraordinary size or atypical anatomic location require a proper immunohistological workup to rule out more ominous malignancy. The authors report the rare presentation of a 54-year-old man with a large mass of the left palm causing discomfort and paresthesia for 6 months. Radiographs showed a radiolucent mass without mineralisation or bony involvement. MRI demonstrated a non-contrast-enhancing homogeneous lipomatous mass encompassing flexor tendons of the palm. Elective excisional biopsy and immunohistological analysis were consistent with spindle cell lipoma measuring 11 cm × 7 cm × 4 cm. This case is the largest spindle cell lipoma of the hand reported in the literature and appears to be the largest described in the upper extremity.
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Contributors Planning, concept and design: MJ and GJ. Creation and editing of manuscript: MJ and SP. Reporting, data acquisition, analysis and interpretation of data: MJ, SP and GJ.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Obtained.
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