Robotic Oesophageal Spindle Cell Lipoma Excision

Oesophageal lipoma is a benign oesophageal tumour accounting for less than 1% of all the gastrointestinal lipomas. The spindle cell variant of oesophageal lipoma is an even rarer entity. Histologically it is characterized by the presence of varying amounts of mature fat, uniform spindle cells and collagen. To the best of our knowledge, only two cases of spindle cell lipoma (SCL) of the oesophagus have been reported so far. Herein, we present a case of a 52-year-old lady who was evaluated for dysphagia. Oesophago-gastroscopy showed a submucosal mass on the posterolateral wall of the oesophagus on the right side arising at 18-20 cm from incisors. Biopsy was suggestive of squamous hyperplasia with no evidence of dysplasia or malignancy. On computerized tomography (CT) scan of the chest, the mass measured 11.2x3.2x3.3 cm and was seen to extend from the post-cricoid to the infra-carinal region. In view of the major intrathoracic extent, she underwent robotic trans-thoracic excision of the oesophageal lesion. The final histopathology report confirmed SCL of the oesophagus. Immunohistochemical examination was positive for CD 34 and negative for desmin and MDM2. Complete excision of the lesion remains the standard treatment. It is essential to establish a precise diagnosis of SCL of the oesophagus and rule out malignancy.