In this following blog let’s look at the details of what pleomorphic lipoma are, it’s definition, diagnosis, treatment and its quick comparison to other lipomas. 

Pleomorphic Lipoma

An extremely rare or uncommon form of the bulge, a rarely found neoplasm, a bulge that does not decrease or goes away naturally. It is generally located under the skin area, the most common location it may develop are the upper back, neck, or shoulders. It is composed of a mix of mature adipose tissue, spindle cells, and multinucleated giant cells.

Further,  it is a well-circumscribed and slowly growing bulge that remains firmly in its location without causing any movement, or in other terms, it is a benign tumor but is often confused for malignant soft tissue or sarcoma. These account for less than 1% of all lipomas. This type of lipoma typically occurs in adults aged 45 to 65 years and is more common in males than females.

A detailed diagnosis to understand Pleomorphic lipoma 

A combination of clinical, radiological, and histopathological features helps in the diagnosis of pleomorphic lipoma. 

The physicians diagnose the extent of the tumor and its relationship to adjacent structures using various imaging studies such as ultrasound, CT scan, and MRI.

To obtain a sample for histological examination, physicians recommend FNAC ( Fine-needle aspiration cytology). This method is not the diagnostic test but excisional biopsy is done is the gold standard for diagnosis.

Pleomorphic lipoma treatment 

Pleomorphic lipoma is a benign tumor and can be cured by complete surgical excision. The tumor is usually encapsulated, and enucleation or marginal excision is usually sufficient. In cases where the tumor is infiltrative, wide excision with a margin of normal tissue is recommended to prevent a recurrence. The prognosis is excellent, with a low recurrence rate.

Difference between Pleomorphic lipoma and another lipoma

It is very important to differentiate a pleomorphic lipoma from other benign and malignant lipomatous tumors. Various types of lipoma look similar but differ substantially from one another like liposarcoma, myxoid liposarcoma, and atypical lipomatous tumor. 

The key histological features that differentiate a pleomorphic lipoma from these tumors are the presence of spindle cells and multinucleated giant cells in the background of mature adipocytes. These are differentiated by appropriate tests as recommended by the physicians. 

Frequently Asked Questions

What is pleomorphic lipoma?

Pleomorphic lipoma usually presents as a slow-growing, painless, and soft-tissue mass. The most common location is the subcutaneous tissue of the neck, upper back, and shoulders.

How big is a spindle cell lipoma?

Spindle cell lipomas are typically benign (non-cancerous) growths composed of fat cells and spindle-shaped cells that can occur in subcutaneous tissues, especially in the neck, back, and shoulders. The size of a spindle cell lipoma can vary widely and depends on several factors, such as the duration of growth, location, and genetic predisposition.

What is atypical spindle cell pleomorphic lipomatous tumor histology?

Atypical spindle cell pleomorphic lipomatous tumor (ASPLT) is a rare and newly recognized subtype of liposarcoma, a cancer of fat cells. They have a chaotic appearance, with a mixture of mature and immature fat cells. 

What is the treatment for pleomorphic lipoma?

The treatment for pleomorphic lipoma is typically surgical excision, which involves removing the lipoma and its capsule to ensure that all of the abnormal tissue has been removed.

Is pleomorphic benign or malignant?

Pleomorphic are benign that may occur around the upper back neck or shoulders and are seen developing underneath the skin. These are not cancerous. 

What size lipoma should be removed?

Lipoma removal depends on several factors, including its size, location, symptoms, and any concerns about its potential for growth or transformation into a more aggressive tumor. larger lipomas, those that are causing discomfort or interfering with daily activities, or those located in sensitive areas such as the face, neck, or hands, may be candidates for removal.

Do all lipomas need a biopsy?

Most lipomas are common benign lipomas, are harmless, and form underneath the skin. But, it is essential to make a clear identification of its masses for which core needle biopsy is necessary and recommended. 

Can a lipoma turn into a tumor?

In most cases, lipomas are safe and do not turn into tumors. But, in case of any uneasiness, experiencing anything odd or lipoma becoming painful, it simply needs to be medically checked.

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