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      Eyelid Spindle Cell Lipoma: Case Report and Review of Three Patients in Literature

      case-study

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          ABSTRACT

          A 39‐year‐old woman presented a saucer‐shaped mass in the left upper eyelid and underwent the extirpation at local anesthesia. Pathologically, collagen fibers, capillaries, small vessels, and CD34‐positive spindle cells were dispersed among mature adipose tissues, indicative of spindle cell lipoma. Long‐lasting cyst‐like eyelid masses would be usually dermoid cysts, and spindle cell lipoma would be listed as a rare pathological diagnosis in differential diagnoses of cyst‐like lesions in the upper and lower eyelid.

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          Spindle cell lipoma: clinicopathologic characterization of 40 cases

          Shuai Chen, Haining Huang, Shujin He … (2019)
          Objective: In view of the existence of multifarious pathologic subtypes of spindle cell lipoma (SCL), which is easily misdiagnosed as other benign and malignant soft tissue tumors, we performed this study and aimed to better define the category of SCL. Methods: We collected and analyzed 40 cases of SCL with complete clinical and pathologic information from January 2010 to December 2018. Clinical and histopathologic analyses of SCL were performed, as well as immunohistochemical staining and fluorescence in situ hybridization (FISH) using probes for RB1 and MDM2 , and the related literature was reviewed. Results: In 40 cases, the male to female ratio was 3.4:1, and the mean age was 54 years old. SCL of our study included six pathologic subtypes: classic (25/40), fibrous (4/40), myxoid (4/40), low-fat (3/40), pseudoangiomatous (2/40), and fat-rich (2/40) changes. Microscopically, SCL showed distinctive morphology, with uniform spindle cells and a variably adipocytic component. The spindle cells were bland in morphology, without prominent atypia or pleomorphism, set in a myxoid or fibrous matrix. Immunohistochemically, CD34 and vimentin were positive in spindle cells, and spindle cells of 6 cases also expressed S-100 protein. FISH analysis of 10 cases revealed that heterozygous deletion of RB1 was in six samples with chromosome 13 aberrations and MDM2 gene amplification was not detected in any cases. Surgical resection is considered as the primary treatment for SCL, as there was no any recurrence or metastasis in our cases after 2-105 months of follow-up. Conclusions: SCL is a rare benign lipoma, and the proportion of spindle cells and adipocytic component varies, which may form various pathologic changes. The diagnosis needs to be combined with clinicopathologic features, immunophenotypes, and genetics. It has to be differentiated from mammary-type myofibroblastoma, cellular angiolipoma, solitary fibrous tumor, and myxoid liposarcoma.
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            Myolipoma of the eyelid.

            Alice W. Lee, C Weir, N Sharara (1998)
            This report describes the pathology of a myolipoma which occurred in the eyelid. Myolipoma is a benign hamartomatous tumour in which smooth muscle cells are interspersed with adipocytes. PATIENT DETAILS: An irregular yellowish tumour (30 x 25 mm) with illdefined borders had been present for 50 years in the medial part of the left lower eyelid of a 67-year-old woman. The tumour was excised and studied by conventional histology, immunohistochemistry and transmission electron microscopy. The tumour was formed by bundles of spindle-shaped cells with cigarshaped nuclei intermingled with multiloculated clear cells containing small eccentric nuclei. By immunohistochemistry, positive staining of the spindle cells was restricted to smooth muscle actin and desmin; the clear cells were non-reactive with the immunohistochemical panel, but fat was identified within the cytoplasm. The ultrastructural features of the spindle cells were those of a leiomyoma, while the clear cells were classified as adipocytes. This tumour was considered to originate from the media of blood vessels within the tumour.
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              Pleomorphic lipoma of the orbit: a case series and review of literature.

              Adam J. Heathcote, P Luthert, Michele Beaconsfield … (2002)
              Pleomorphic lipomas are rare benign tumors that can resemble a variety of malignant soft tissue tumors on histologic examination. Six cases of patients with orbital pleomorphic lipoma, one of which was proven to be bilateral, are presented. Retrospective, noncomparative, interventional case series with clinicopathologic correlation. Clinical and histologic review of 6 patients with pleomorphic lipomas of the orbit and histologic review of fat from 22 exenteration specimens and 20 other orbital procedures. Evidence of histologic abnormalities in histologic specimens. Pleomorphic spindle cells and multinucleated cells with nuclei arranged in a floret-like pattern were present in 7 specimens from 6 patients presenting with a clinical diagnosis of orbital fat prolapse, but there were no similar cell types present in the adipose tissue of 22 exenteration or 20 other orbital specimens. Pleomorphic lipoma may arise in the orbit, presenting as what was hitherto considered to be age-related epibulbar prolapse of orbital fat.
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                Author and article information

                Contributors
                Toshihiko Matsuo:
                ORCID: https://orcid.org/0000-0001-6570-0030
                matsuot@cc.okayama-u.ac.jp
                Journal
                Journal ID (nlm-ta): Clin Case Rep
                Journal ID (iso-abbrev): Clin Case Rep
                Journal ID (doi): 10.1002/(ISSN)2050-0904
                Journal ID (publisher-id): CCR3
                Title: Clinical Case Reports
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2050-0904
                Publication date (Electronic): 07 January 2025
                Publication date Collection: January 2025
                Volume: 13
                Issue: 1 ( doiID: 10.1002/ccr3.v13.1 )
                Electronic Location Identifier: e70097
                Affiliations
                [ 1 ] Graduate School of Interdisciplinary Science and Engineering in Health Systems Okayama University Okayama Japan
                [ 2 ] Department of Ophthalmology Okayama University Hospital Okayama Japan
                [ 3 ] Plastic and Reconstructive Surgery Kousei Hospital Okayama Japan
                [ 4 ] Department of Pathology General Medical Center, Kawasaki Medical School Okayama Japan
                [ 5 ] Okayama Medical Laboratories Inc. Kurashiki Japan
                [ 6 ] Department of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama University Okayama Japan
                Author notes
                [*] [* ] Correspondence:

                Toshihiko Matsuo ( matsuot@ 123456cc.okayama-u.ac.jp )

                Author information
                https://orcid.org/0000-0001-6570-0030
                Article
                Publisher ID: CCR370097 Other ID: CCR3-2024-08-2435.R1
                DOI: 10.1002/ccr3.70097
                PMC ID: 11706713
                PubMed ID: 39780903
                SO-VID: 473f946f-baf0-4bfc-b146-4257d62383a9
                Copyright © © 2025 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date revision received : 24 November 2024
                Date received : 10 August 2024
                Date accepted : 02 January 2025
                Page count
                Figures: 2, Tables: 1, Pages: 4, Words: 1900
                Categories
                Subject: Ophthalmology
                Subject: Case Report
                Subject: Case Report
                Custom metadata
                source-schema-version-number 2.0
                cover-date January 2025
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.5.2 mode:remove_FC converted:07.01.2025

                Keywords: cd34,eyelid,orbital bony edge,pathology,spindle cell lipoma
                Data availability:
                Keywords: cd34, eyelid, orbital bony edge, pathology, spindle cell lipoma

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