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| Year : 2016 | Volume
: 59
| Issue : 2 | Page : 250-251 |
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| Dendritic fibromyxolipoma of left inguinal region |
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Sinem Ciloglu, Alpay Duran, Ekrem Keskin, Ahmet Yigit
Department of Plastic, Reconstructive and Aesthetic Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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| Date of Web Publication | 9-May-2016 |
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How to cite this article:
Ciloglu S, Duran A, Keskin E, Yigit A. Dendritic fibromyxolipoma of left inguinal region. Indian J Pathol Microbiol 2016;59:250-1 |
Editor,
The dendritic fibromyxolipoma (DFML) is an unusual, newly described benign soft-tissue tumor. The neoplasm characteristically shows positive immune reactivity for CD-34, Bcl-2, and vimentin.[1] Here, we report a 59-year-old woman with a DFML in the left inguinal region.
A 59-year-old woman was first seen in our clinic, 10 years after becoming aware of a painless subcutaneous mass in her left inguinal region [Figure 1]a. On her physical examination, there was a mobile, rubbery mass 17 cm × 13 cm × 10 cm in size. Magnetic resonance imaging revealed that the mass was localized in subcutaneous tissue, had well-demarcated margins, and mixed signal intensity consistent with adipose tissue. Excision of the mass and primer closure was performed [Figure 1]b. Histologically, the tumor was mainly composed by a proliferation of small spindle and stellate cells variably admixed with mature adipose tissue embedded within an abundant myxoid and collagenized stroma [Figure 1]c. Further immunohistochemical staining indicated that the spindle and stellate cells were reactive with CD 34, vimentin, and Bcl-2 but not with smooth muscle actin and desmin [Figure 1]d. No evidence of the local recurrence or metastasis has been seen in the 3 years follow-up since excision. | Figure 1: (a) Preoperative view of the case (b) preoperative view of the mass (c) higher magnification showing spindle and stellate cells with thin, dendritic cytoplasmic prolongations (H and E, ×400) (d) immunohistochemical staining with CD-34 (CD34, ×200)
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Suster et al. emphasized the dendritic nature of the spindle cells, the plexiform vascular pattern, and the abundance of keloidal collagen as the three essential features in DFML, which were not commonly presented in spindle cell lipoma (SCL).[1] With further study, these features of DFML have also been observed in certain cases of SCL. Karim et al. hypothesized that DFML possibly represented an atypical variant of myxoid SCL, due to the similarities in their clinical and pathological aspects.[2] By contrast, Tan and Wen concluded that DFML occurred on a morphologic continuum and represented a transitional form between SCL and solitary fibrous tumor (SFT).[3]
To date, 25 cases of DFML have been reported in the literature. In total, 20 of the reported cases were male, and 5 of them were female. Clinical follow-up of the cases ranged from 8 months to 13 years and showed no evidence of recurrence and metastasis after surgical treatment. Among the cases, DFML develops more frequently in male and elderly population. Only five cases were reported in females. The highest incidence is observed in DFML of the upper extremity, followed by the neck, trunk, and head. Immunohistochemically, all reported cases shared CD 34 and Bcl-2 expression.
DFML should be considered in the differential diagnosis of lesions with SCL, solitary fibrous tumor, lipoblastoma, lipoblastomatosis, nodular fasciitis, and myxoid liposarcoma.[4] Definitive diagnosis of dendritic DFML depends on the accurate correlation between the radiologic imaging, the histological and the clinical features, and it is crucial to recognize that this is a benign tumor and avoid the potential hazard of misdiagnosing the lesion as a myxoid liposarcoma with very differing prognostic implications. The treatment of option for dendritic fibromixolipoma is a complete local excision.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Suster S, Fisher C, Moran CA. Dendritic fibromyxolipoma: Clinicopathologic study of a distinctive benign soft tissue lesion that may be mistaken for a sarcoma. Ann Diagn Pathol 1998;2:111-20.  |
| 2. | Karim RZ, McCarthy SW, Palmer AA, Bonar SF, Scolyer RA. Intramuscular dendritic fibromyxolipoma: Myxoid variant of spindle cell lipoma? Pathol Int 2003;53:252-8. |
| 3. | Tan GM, Wen P. Clinicopathologic features of dendritic fibromyxolipoma. Zhonghua Bing Li Xue Za Zhi 2003;32:404-8. |
| 4. | Zhang XJ, Zhou S, Nie K, Chen da F, Kui GJ, Zhang XH. Dendritic fibromyxolipoma in the right inguinal and perineum regions: A case report and review of the literature. Diagn Pathol 2013;8:157. |
Correspondence Address:
Alpay Duran
Department of Plastic and Reconstructive Surgery, Haydarpasa Numune Training and Research Hospital, 34688 Istanbul
Turkey
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0377-4929.182045
[Figure 1] |
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