Spindle cell lipoma is a subtype of lipoma, and is a relatively rare tumor of the head and neck region. In this report, we describe a case in which the tumor was initially suspected as a schwannoma, because aspiration cytology revealed spindle-shaped cells and MRI revealed no evidence of a lipoma.
Case: 32-year-old, male. Main complaint: Tumor on the right side of the neck. Current medical history: The patient presented to us for the first time with an 8-year history of discomfort on the right side of the neck. Thorough examination by a local doctor performed 5 years before his first visit had revealed no evidence of malignancy, and the patient was kept only under observation. Due to gradual increase in size of the tumor, 2 months prior to his visit to our hospital, the patient visited the same doctor; an imaging study ordered by the doctor revealed signs of a schwannoma. A subsequent fine-needle aspiration cytology also detected spindle-shaped cells, which led to the diagnosis of schwannoma. The patient was then referred to our department for surgery. Although we suspected schwannoma based on the shape of the tumor on the MRI findings, we also considered the possibility of solitary fibrous tumor or Castleman’s disease in the differential diagnosis, and scheduled the patient for surgery with informed consent. If it was a schwannoma, we thought it would be of sympathetic origin, but there was no intraoperative continuity with the nerve, and the entire tumor could be removed intact, with no postoperative neurological deficits occurred. The postoperative histopathological findings indicated that the tumor was a spindle cell lipoma.
Spindle cell lipoma in the neck is relatively rare, and there are reports of cases in which the rare tumor is initially suspected as a schwannoma. We report this case with a review of the literature.
