Chondroid lipoma. A newly described lesion that may be mistaken for malignancy

Chondroid lipoma: multimodality imaging in a 9-year-old female

Chondroid lipomas are rare, benign lipomatous tumors that occur most frequently in adults during the fourth decade of life. While a female predominance was observed in the initial series of 20 cases described in 1993, the subsequent 49 reported cases do not support a strong gender predilection. We report a case of a chondroid lipoma presenting in a 9-year-old female as a painless, enlarging, left gluteal mass. This is the second case to be reported in the first decade of life and the fourth pediatric case reported in the literature (age < 21). We review the imaging and pathology findings as well as present a comprehensive review of the current literature.

Characteristics of chondroid lipoma: A case report and literature review

RATIONALE

Chondroid lipoma (CL) is a rare benign tumor. No relevant epidemiological reports have been published on CL, and there is a lack of uniform diagnostic and treatment criteria for the tumor.

PATIENT CONCERNS

Here, we report a case of CL with a mass on the left buttock for 2 weeks, and further illuminate its diagnosis and treatment.

DIAGNOSIS

The diagnosis of CL was rendered according to the pathological indices.

INTERVENTIONS

The tumor was resected completely under spinal anesthesia.

OUTCOMES

The patient was followed-up for 6 months and showed no tumor recurrence or metastasis and there was resolution of the patient's lower-limb numbness and pain.

LESSONS

The case study presented here provides evidence that CL could be effectively diagnosed by using ultrasound, puncture or biopsy, and/or magnetic resonance imaging. Furthermore, the patient recovered without any complications after completely resecting the tumor.

Chondroid lipoma of the tongue: a report of two cases

BACKGROUND

Chondroid lipoma affecting the oral cavity is rare and usually presents as a polyp of benign clinical appearance which is easily excised. However, the histopathological features of chondroid lipoma resemble liposarcoma due to the presence of lipoblasts and lack of mature cartilage.

CASE REPORTS

The clinicopathological features of two cases of chondroid lipoma of the dorsum of the tongue, one in a 66-year-old woman and the other in a 43-year-old man, are described.

CONCLUSION

Once the diagnosis had been established, no treatment other than surgical excision was necessary and in neither case has there been recurrence in two years of follow-up.

Diode laser excision of chondroid lipoma of the tongue with microscopic (conventional and confocal laser scanning) analysis

OBJECTIVE

We describe a case of chondroid lipoma of the oral mucosa, which represents an unusual histological type of oral lipoma. Though its use is still debated, we used a diode laser to perform complete excision of the lesion, and histologically analyzed the specimen.

BACKGROUND DATA

Lipomas represent 0.1-5% of all benign oral neoplasms. Chondroid lipoma is a rare histological type first described in 1993; only a few cases have been described in the literature. Its clinical diagnosis is difficult because the clinical appearance is not specific.

METHODS

The lesion was excised by diode laser and the specimen was histologically evaluated using both conventional and confocal laser scanning microscopy.

RESULTS

The final diagnosis was lipoma (chondroid variant). Diode laser had several benefits in the clinical application and in the histological evaluation due to the lack of morphological and structural alterations of the surgical specimen.

CONCLUSION

We maintain that the diode laser is a useful electromedical device for surgery on both benign and malignant oral lesions, though good practice is mandatory in order to apply the best parameters to the clinical situation. When the preoperative biopsy is not performable because of small dimension, as in the reported case, surgical excision of all nodular lesions of the oral mucosa should be performed with lateral and deep margins distant from the central lesion. This prevents possible complications related to a possible final diagnosis of malignant neoplasm; in fact, the differential diagnosis in the reported case also included liposarcoma.

Ossifying chondroid lipoma

Chondroid lipoma is a rare variant of lipoma that pathologically can mimic liposarcoma or possibly other sarcomas. Variants of lipoma, including chondroid lipoma, may demonstrate radiological evidence of fat within the tumor, but often display heterogeneous features on imaging studies, making a clinical diagnosis difficult. A large collective experience with the imaging characteristics of chondroid lipoma is lacking due to the rarity of this tumor. We present a case of chondroid lipoma of the upper thigh in a 37-year-old woman who had regions of metaplastic bone formation within the tumor. Radiologically, the tumor presented as a large soft tissue mass with calcification and ossification. Although metaplastic bone formation in conventional lipoma is well described, it has been rarely reported to occur in chondroid lipoma and has not been pathologically documented or illustrated. The imaging findings and histopathology of this unusual tumor are presented, along with a review of the literature.

Intraoral chondroid lipoma: A case report and immunohistochemical investigation

Lipomas are common neoplasms of fat in the oral cavity. However, the diagnosis may be difficult for lesions exhibiting unusual histological features. This paper documents the first intraoral report of a chondroid lipoma. The differential diagnosis is discussed. It is important for practicing oral pathologists to recognize rare variants to ensure accurate diagnosis and appropriate treatment for the patient.

Lipoma of the oral and maxillofacial region: Site and subclassification of 125 cases

OBJECTIVE

Lipomas and lipoma variants are common soft tissue tumors, but occur infrequently in the oral and maxillofacial region. In this study, we reviewed 125 lipomas in specific oral and maxillofacial locations. We wanted to examine and compare the clinicopathologic features of these tumors. Study design The records from the Oral and Maxillofacial Pathology Registry of the Armed Forces Institute of Pathology from 1970 to the present were searched for cases coded as "lipoma." This study included 125 cases based on location within the oral and maxillofacial region, benign histology, and available clinical information. Subcutaneous and intraosseous lipomas were excluded. The tumors were classified according to the most recent World Heath Organization classification for soft tissue tumors.

RESULTS

Of 125 lipomas, 91 tumors occurred in males, 33 in female patients, and 1 of unknown gender. The mean age was 51.9 years, range 9-92 years. Four tumors occurred in pediatric patients (age <18 years). Specific anatomic sites within the oral and maxillofacial region included the parotid region (n=30); buccal mucosa (n=29); lip (n=21); submandibular region (n=17); tongue (n=15); palate (n=6); floor of mouth (n=5); and vestibule (n=2). The mean size of tumors was 2.2 centimeters, range 0.5 to 8.0 centimeters. The mean duration of the tumors prior to excision was 3.2 years, range 6 weeks to 15 years. Most patients presented with an asymptomatic, circumscribed mass. Grossly, most tumors were described as pink and smooth, occasionally mucoid. Histologically, the tumors were subclassified as classic lipomas (n=62); spindle cell/pleomorphic lipomas (n=59); fibrolipoma (n=2), and chondroid lipoma (n=2). Fourteen tumors exhibited secondary changes, such as fat necrosis, atrophy, and prominent hyalinization; 23 tumors were histologically confirmed to be intramuscular.

CONCLUSIONS

Lipomas of the oral and maxillofacial region occur most commonly in adult males in the parotid region, followed closely by the buccal mucosa. These tumors are uncommon in children. Interestingly, spindle cell lipomas are common in this region and comprise the majority of our parotid and lip tumors. Angiolipomas were absent in this anatomic region in this study. Secondary changes and atrophy should not be confused with the malignant histologic features of a liposarcoma.

Chondroid lipoma of the trunk: MRI appearance and pathologic correlation

Chondroid lipoma is a rare tumour of adipose tissue, bearing a strikingly close pathologic resemblance to myxoid liposarcoma and extraskeletal myxoid chondrosarcoma. Unlike these malignant tumours, chondroid lipoma has a non-aggressive behaviour and does not require radical treatment. Although repeatedly reported in the proximal extremities and limb girdles, this rare entity may less frequently be observed in the trunk. We describe the imaging findings of a chondroid lipoma in the trunk and provide a discussion on the radiologic-pathologic correlation and differential diagnosis.

Lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas): results of MRI evaluations of 126 consecutive fatty masses

OBJECTIVE

Our objectives were to evaluate the reliability of MRI in distinguishing simple lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas) and to identify various imaging mimics of well-differentiated liposarcoma.

MATERIALS AND METHODS

One hundred twenty-six consecutively imaged grossly fatty masses were retrospectively reviewed. MRI examinations, their prospective interpretations, and their corresponding pathology reports were compared to determine the reliability of MRI in distinguishing simple lipomas, lipoma variants, and well-differentiated liposarcomas.

RESULTS

The success of MRI in identifying well-differentiated liposarcomas among other fatty masses was as follows: sensitivity, 100%; specificity, 83%; accuracy, 84%; positive predictive value, 38%; and negative predictive value, 100%. MRI was 100% specific in the diagnosis of simple lipoma. Sixty-three percent of lesions considered suspicious for well-differentiated liposarcoma were actually simple lipomas (13%) and benign lipoma variants (50%), including chondroid lipoma (13%), osteolipoma (6%), hibernoma (6%), lipoleiomyoma (6%), angiolipoma (6%), and infarcted lipoma (13%).

CONCLUSION

Because of differences in treatment, prognosis, and long-term follow-up, it is important to preoperatively distinguish simple lipomas from well-differentiated liposarcomas. MRI is highly sensitive in the detection of well-differentiated liposarcomas and highly specific in the diagnosis of simple lipomas. However, when an extremity or body wall lesion is considered suspicious for well-differentiated liposarcoma, it is more likely (64%) to represent one of many benign lipoma variants.

Unique cytological features and chromosome aberrations in chondroid lipoma: a case report based on fine-needle aspiration cytology, histopathology, electron microscopy, chromosome banding, and molecular cytogenetics

Chondroid lipoma is a rare, benign tumor that may mimic soft-tissue sarcoma clinically. Its histopathologic features may resemble hibernoma, myxoid liposarcoma, myxoid chondrosarcoma, and other lipomatous or chondroid neoplasms. In this study, a chondroid lipoma was analyzed by fine-needle aspiration cytology, histopathology, electron microscopy, chromosome banding, and metaphase fluorescence in situ hybridization. The results demonstrate that chondroid lipoma exhibits a characteristic pattern by fine-needle aspiration cytology, including a mixture of benign adipose tissue with lipoblastlike cells, and chondroblastlike cells with a fibrochondroid matrix. Cytogenetically, a three-way rearrangement between chromosomes 1, 2, and 5 was found, together with an 11;16 translocation with a breakpoint in 11q13, approximately 1 Mb proximal to the MEN1 region shown to be rearranged frequently in hibernoma. The presence of a karyotype of low complexity, but without any of the genetic aberrations characteristic for other types of soft-tissue tumors, indicate that chondroid lipoma develops along a unique pathogenetic pathway.