Spindle Cell Lipoma of the Fourth Metatarsal: A Case Report

Spindle cell lipoma (SCL) is a rare subtype of lipoma that typically arises in the subcutaneous tissue of the posterior neck and shoulders, most commonly in middle-aged men, and only rarely occurs in the extremities. SCL typically presents as a well-circumscribed, firm mass composed of CD34-positive adipocytes mixed with bland spindle cells and ropy collagen fibers. We present the case of a 46-year-old man who came to the hospital for routine hemodialysis treatment, during which his physician discovered a mass on his left fourth metatarsal that had been slowly growing for the past five years. A subdermal soft tissue lesion (5.6 cm x 3.8 cm x 4.5 cm) was excised, and histological findings confirmed the diagnosis of SCL. This case reports a rare occurrence of SCL in the metatarsal and emphasizes the importance of distinguishing SCL from its malignant equivalents, particularly when it occurs in rare and unusual locations.