Track: Case Reports

Topic: Neoplasia,Carcinogensis,Tumor Biology

Abstract:

Spindle cell lipoma is a benign adipocytic tumor, which commonly arises in the posterior neck, upper back, and shoulders of middle-aged to older males. Its occurrence in the oral cavity is notably rare, with only four previously reported cases arising in the lip. Here, we present a case of spindle cell lipoma diagnosed in the lip of a 54-year-old male who initially presented for evaluation of a painless, slow-growing nodule on the buccal surface of the left lower lip, which arose following an accidental self-inflicted bite two years earlier. The mass hindered eating and was frequently traumatized by accidental biting. The patient's comorbidities included a thirty-year history of chewing tobacco use. Physical examination revealed a pedunculated, non-tender, firm mass on the left lower lip. After surgical excision, histological analysis demonstrated mature adipose tissue interspersed with bland spindle cells, ropey eosinophilic collagen bundles with an interspersed myxoid background, and scattered mast cells. No lipoblasts were identified. Immunohistochemical staining revealed the spindle cells to be diffusely positive for CD34 with multifocal loss of nuclear RB protein expression, consistent with a diagnosis of spindle cell lipoma. The patient experienced no postoperative complications and no recurrence at a follow-up six months later. This case marks the fifth reported case of spindle cell lipoma in the lip, emphasizing the importance of recognizing this type of neoplasm in such a rare location. Further investigation is necessary to ascertain its pathogenesis and predisposing risk factors, particularly the possible impact of chronic irritation and tobacco use.

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Dinh Quoc Duong, Medical doctor