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Updated: Oct 26, 2025
Intravital Microscopy of the Inguinal Lymph Node
Published on: April 4, 2011
[A CASE OF SPINDLE CELL LIPOMA ARISING IN THE INGUINAL SUBCUTIS: A CASE REPORT]
Kenichi Sasaki1, Masaki Kimura1, Akihiko Sakamoto1
1Department of Urology, Teikyo University School of Medicine.
Insights
A rare spindle cell lipoma presented as an inguinal mass, initially suspected as an atypical lipomatous tumor. Surgical removal confirmed the benign diagnosis, highlighting the importance of considering tumor location in differentiating these lipomatous tumors.
Area of Science:
- Oncology
- Pathology
- Radiology
Context:
- A 39-year-old male presented with a right inguinal mass.
- Initial imaging (PET/CT, MRI) suggested an atypical lipomatous tumor (well-differentiated liposarcoma).
- The mass was adjacent to the spermatic cord and corpora cavernosa.
Purpose:
- To report a rare case of spindle cell lipoma in the groin.
- To discuss the differential diagnosis between spindle cell lipoma and atypical lipomatous tumor.
- To highlight the diagnostic challenges posed by similar radiological findings.
Summary:
- A 7cm heterogeneously enhanced adipose tumor was surgically excised.
- Histopathological examination revealed a spindle cell lipoma, a benign tumor.
- The surgery successfully spared the right spermatic cord and corpora cavernosa.
Impact:
- This case underscores the rarity of spindle cell lipomas in the groin.
- It emphasizes the diagnostic difficulties in differentiating benign lipomatous tumors from malignant ones based on imaging alone.
- Understanding the typical subcutaneous presentation of spindle cell lipomas versus deep-seated atypical lipomatous tumors can aid pre-operative diagnosis.
Abstract:
A 39-year-old man was referred to us for further examination of a right inguinal mass. He had noticed the mass several months prior and had undergone positron emission tomography/computed tomography, which revealed a mass with an SUVmax of 1.48 at the right inguinal subcutis. Magnetic resonance imaging (MRI) showed a well-circumscribed, heterogeneously enhanced adipose tumor 7cm in length, adjacent to the right spermatic cord and corpora cavernosa with clear boundaries. The tumor was a suspected atypical lipomatous tumor (well-differentiated liposarcoma), and he underwent tumor extirpation surgery. At surgery, the right inguinal canal was not opened, and the right spermatic cord and corpora cavernosa were safely spared. The excised specimen was composed of lipomatous tissue macroscopically. Histopathological diagnosis was of a spindle cell lipoma. Spindle cell lipomas are relatively rare, benign tumors, comprising only 1.5% of all lipomatous tumors. They arise most commonly in the shoulder and posterior region of the neck, and rarely develop in the groin. Differential diagnosis includes atypical lipomatous tumors, but radiological diagnosis is often difficult because of similar findings on MRI. Spindle cell lipomas typically present as a subcutaneous tumor, while atypical lipomatous tumors arise in the deep layers of connective tissue. This difference in the site of the tumor may contribute to their differential diagnosis before surgery.
