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Unusual lipid poor spindle cell lipoma
  1. Benjamin R Schwartz1,
  2. Ty Subhawong1,
  3. Andrea Proctor Subhawong2,
  4. Felipe Ferreira de Souza1 and
  5. Juan Pretell-Mazzini2
  1. 1Diagnostic Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA
  2. 2Orthopedic Oncology, Baptist Health South Florida Inc, Plantation, Florida, USA
  1. Correspondence to Dr Benjamin R Schwartz; benjamin.schwartz{at}


Spindle cell lipomas (SCLs) containing minimal fat are rare and can be diagnostically challenging due to their similar radiographic appearance to other benign and malignant tumours. SCLs are benign lipomatous tumours that typically occur in middle aged to elderly men as slow-growing, painless masses in the subcutaneous tissue of the posterior neck, shoulders or back. However, rarely these tumours can arise in unusual locations such as the lower extremities. We present an unusual case of a lipid poor SCL occurring in the lower extremity. Initial clinical and radiographic findings were suspicious for a malignancy. Two core biopsies demonstrated benign fibro collagenous tissue, so a marginal excision was performed. Final histopathological and immunohistochemical stains confirmed the diagnosis of an SCL. Radiologists, pathologists and oncologic surgeons should be aware of this lipomatous tumour’s potential to present in unusual locations with minimal fatty components to increase confidence in radiologic-pathological concordance.

  • Orthopaedics
  • Pathology
  • Radiology
  • Surgical oncology

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: TS, AS, FFdS, JP-M and BRS. The following authors gave final approval of the manuscript: TS, AS, FFdS, JP-M and BRS.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.