A SPECULATED PLEOMORPHIC ADENOMA OF PAROTID TURNS OUT TO BE A SPINDLE CELL LIPOMA

Abstract

Spindle cell lipoma is a rare benign adipocytic tumour which compromises about 1.5 % of the lipomatous tumour.It is a slow growing tumour most frequently located in upper back and neck with male predominance. Less frequently the tumour may occur in unexpected sites.A 43 year old male patient with history of right sided ,painless, indolent cheek mass. Clinical examination revealed a soft,non tender mass in the parotid region on right side. MRI scan shows lesion arising from tail of right parotid abutting right masseter muscle probably warthin tumor.Fine needle aspiration showed occasional epithelial cells with spindle cells. Case was proceeded with superficial parotidectomy. Grossly there was a well encapsulated mass of size 3.5 cm adherent to the adjacent parotid gland.Histopathology showed mature adipocytes in fibromyxoid stroma with spindle cell suggesting spindle cell lipoma.Spindle cell lipoma,a benign lipomatous tumour usually arises from the shoulder, upper back. These lesions can also arise from atypical sites causing diagnostic challenges. These tumours have to be differentiated from malignant tumours which may require aggressive surgery, while spindle cell lipoma itself is curative by a simple excision.This requires awareness of this entity by both surgeons and pathologists to aim for a proper management .