Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2022; 10(8): 2584-2590
Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2584
Large retroperitoneal atypical spindle cell lipomatous tumor, an extremely rare neoplasm: A case report
Jung-Min Bae, Chang-Yeon Jung, Woo-Sung Yun, Joon Hyuk Choi
Jung-Min Bae, Chang-Yeon Jung, Department of Surgery, Yeungnam University College of Medicine, Daegu 42415, South Korea
Woo-Sung Yun, Kyungpook National University School of Medicine, Jung-gu, Daegu 41944, Korea
Joon Hyuk Choi, Department of Pathology, Yeungnam University College of Medicine Nam-gu, Daegu 42415, Korea
Author contributions: Jung CY, Yun WS, and Bae JM performed the surgery; Jung CY, Yun WS, Choi JH, and Bae JM wrote the manuscript; Choi JH performed the histopathologic diagnosis; Bae JM was the patient’s doctor, who revised the manuscript; all authors have read and approved the final manuscript.
Supported by the 2016 Yeungnam University Research Grant.
Informed consent statement: Written Informed consent was obtained from the patient for publication at admission.
Conflict-of-interest statement: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
CARE Checklist (2016) statement: The authors have read the CARE checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jung-Min Bae, MD, Associate Professor, Department of Surgery, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, South Korea. netetern@naver.com
Received: September 13, 2021
Peer-review started: September 13, 2021
First decision: November 22, 2021
Revised: November 25, 2021
Accepted: February 10, 2022
Article in press: February 10, 2022
Published online: March 16, 2022
Processing time: 178 Days and 19.7 Hours
Abstract
BACKGROUND

Atypical spindle cell lipomatous tumor (ASLT) is a rare soft tissue neoplasm with a low potential for malignancy. ASLT frequently occurs in the limb and limb girdles. However, large retroperitoneal ASLTs are extremely rare. There was no concrete case report of retroperitoneal ASLTs.

CASE SUMMARY

An 18-year-old woman presented with abdominal pain and a palpable mass. Abdominal computed tomography revealed a large fatty mass that was approximately 30 cm in size and filled the entire abdominal cavity. Surgical excision was indicated. The tumor did not invade the adjacent organs. The pelvic cavity was then too narrow to dissect smoothly. The mass was successfully excised without tumor rupture or adjacent organ injury. Microscopically, the neoplasm was a well-differentiated adipocytic neoplasm. Immunohistochemical staining showed that the spindle cells were positive for CD34 and desmin, in addition to multifocal positivity for S100 protein. These histological features were consistent with an ASLT. The patient’s postoperative course was uneventful. At the 12-mo follow-up, no evidence of recurrence or metastasis was observed.

CONCLUSION

To the best of our knowledge, our study is the first concrete report of a large retroperitoneal ASLT in the English literature. In the large retroperitoneal ASLT located in the pelvic cavity, which made it too narrow and tight to dissect, complete excision is difficult but very important because of recurrence risk. Although large retroperitoneal ASLTs are considered extremely rare, their detection is important for accurate evaluation and management. Owing to their significant rarity, retrospective multicenter case studies are required to determine the clinicopathologic characteristics.

Keywords: Neoplasms; Retroperitoneal space; Spindle cell; Case report

Core Tip: To the best of our knowledge, our study is the first concrete report of a large retroperitoneal atypical spindle cell lipomatous tumor (ASLT) in the English literature. ASLT is a rare soft tissue neoplasm. Additionally, retroperitoneal ASLT is extremely rare. In the large retroperitoneal ASLT located in the pelvic cavity, which made it too narrow and tight to dissect, complete excision is difficult but very important because of recurrence risk.