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Case report
Exceptionally large, atypically located spindle cell lipoma
  1. Mitchell John II1,
  2. Shaan Patel1 and
  3. George Joseph1,2
  1. 1 Department of Orthopaedic Surgery, University of South Florida, Tampa, Florida, USA
  2. 2 Department of Orthopaedic Surgery, James A Haley Veterans Hospital, Tampa, Florida, USA
  1. Correspondence to Dr Mitchell John II, mitchellpjohn{at}, mpjohn{at}


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.

  • orthopaedics
  • oncology

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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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