Intradermal spindle cell/pleomorphic lipoma of the vulva: case report and review of the literature.
BACKGROUND
Spindle cell/pleomorphic lipoma (SC/PL) is a benign adipose tissue tumor that usually affects the subcutaneous tissues of shoulders, backs, and neck region of middle-aged male patients. Histologically, it is characterized by the presence of primitive CD34-positive spindle cells arranged in short fascicles, bizarre floret-like multinucleated giant cells, mature adipocytes, and a small number of lipoblasts. Recently, an intradermal subset has been described, which mainly affects female patients and presents a wider antomical distribution when compared to the classical variant of SC/PL.


METHODS
We report a case of intradermal SC/PL affecting the labium majus of a 56-year-old female patient.


RESULTS
The histological examination disclosed the typical histological features, however the lesion showed poorly demarcated and infiltrative borders, as well as involvement of dermal nerves. The immunohistochemical analysis according to streptovidin-biotin-peroxidase technique showed immunoreactivity for CD34 and vimentin in the spindle cells, as well as S100 protein and vimentin in the adipocytic cells.


CONCLUSIONS
To the best of our knowledge, this is the first case of intradermal SC/PL affecting the vulvar region. Care must be taken not to misdiagnosis this rare tumor as well-differentiated liposarcoma, cellular angiofibroma, solitary fibrous tumor, and cutaneous neurofibroma.
Reis-Filho
Jorge S
JS
Institute of Molecular Pathology and Immunology (IPATIMUP), University of Porto, Porto, Portugal. jreis@ipatimup.pt
Milanezi
Fernanda
F
Soares
Maria F
MF
Fillus-Neto
José
J
Schmitt
Fernando C
FC
D017667:Adipocytes / Q000737:chemistry / Q000473:pathology; D018322:Angiofibroma / Q000473:pathology; D018952:Antigens, CD34 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008067:Lipoma / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D008080:Liposarcoma / Q000473:pathology; D008875:Middle Aged; D018218:Neoplasms, Fibrous Tissue / Q000473:pathology; D009455:Neurofibroma / Q000473:pathology; D009418:S100 Proteins / Q000032:analysis; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D014746:Vimentin / Q000032:analysis; D014846:Vulvar Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery
D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D009418:S100 Proteins; D014746:Vimentin