Tulay ZENGİNKİNET, Erhan OKAY, Aykut ÇELİK, Ayşe Nur TOKSÖZ YILDIRIM, Muhammed Beşir ÖZTÜRK

İğsi Hücreli Lipomların Cerrahi Tedavisi Sonrası Klinik Sonuçlar

Amaç: İğsi hücreli lipom nadir görülen bir tümördür. Cilt altı yerleşimli olmakla birlikte arka boyun, omuz ve bel bölgesinde de yerleşim göstermektedirler. Radyolojik olarak liposarkomu taklit edebilmektedir. İğsi hücreli lipomanın atipik lipomatöz tümörlerden ayırımı önemlidir. Bu çalışmada, histopatolojik ve klinik bulguları olan iğsi hücreli lipomlu hastalarımıza ilişkin çalışmalarımızı sunmayı ve bu nadir gözlenen lipomatöz lezyonun ayırıcı tanıları hakkında kısaca bilgi vermeyi amaçladık. Gereç ve Yöntemler: Bu geriye dönük çalışmaya Ocak 2015 ve Aralık 2020 tarihleri arasında iğsi hücreli lipom nedeniyle cerrahi tedavi uygulanmış olan toplam 29 hasta (27 erkek, 2 kadın) dahil edildi. Tüm hastalar kitle lezyonu ile başvurdular ve düşük yağ içerikli kitle lezyonu olan olgularda ameliyat öncesi biyopsi uygulandı. Bulgular: Hastaların ortalama yaşı 57,0±14,6 (aralık, 25-79) yıl ve ortalama takip süresi ise 25,0±8,6 (aralık, 6-47) ay idi. Hastalarda başka herhangi bir ek hastalık saptanmadı. Nörovasküler yapılara yakın lezyonu olan 5 (%17,2) hastada marjinal rezeksiyon tercih edildi. Diğer 24 (%82,8) hastaya ise geniş rezeksiyon uygulandı. CD34 tüm lezyonlarda pozitifti. Bir hastada CDK4 pozitifti ve bu hastaya atipik iğsi hücreli lipom tanısı konuldu. Son kontrollerinde hiçbir vakada komplikasyon veya nüks saptanmadı. Sonuç: Lipomatöz tümörlerin ayırıcı tanısında iğsi hücreli lipomlar düşünülmelidir. Negatif sınırlar ile lokal eksizyon nüksü önleyebilir. Uygun tedavi için liposarkomdan doğru histopatolojik ayrım oldukça önemlidir.

Anahtar Kelimeler:

iğsi, lipom, sırt, omuz, ense

Clinical Results after Surgical Treatment of Spindle Cell Lipomas

Aim: Spindle cell lipoma is a rare tumor. Although located subcutaneously, they are localized in the posterior neck, shoulder, and lumbar regions. It can radiologically mimic liposarcoma. It is important to differentiate spindle cell lipoma from atypical lipomatous tumors. In this study, we aimed to present our studies on our patients with spindle cell lipoma with histopathological and clinical findings and give brief information about the differential diagnosis of this rare lipomatous lesion. Material and Methods: A total of 29 patients (27 male, 2 female) who underwent surgical treatment for spindle cell lipoma between January 2015 and December 2020 were included in this retrospective study. All patients were presented with mass lesions, and preoperative biopsy was performed in cases with low-fat content mass lesions. Results: The mean age of the patients was 57.0±14.6 (range, 25-79) years and the mean follow-up period was 25.0±8.6 (range, 6-47) months. No additional disease was detected in the patients. Marginal resection was preferred in 5 (17.2%) patients with lesions close to neurovascular structures. Wide resection was performed in the other 24 (82.8%) patients. CD34 was positive in all lesions. In one patient, CDK4 was positive, and the diagnosis was made as atypical spindle cell lipoma. At the last follow-up, there was no complication and recurrence in any of the cases. Conclusion: Spindle cell lipomas should be regarded in the differential diagnosis of lipomatous tumors. Local excision with negative margins may prevent a recurrence. Correct histopathologic differentiation from liposarcoma is of paramount importance for appropriate treatment.

Keywords:

spindle, lipoma, upper back, shoulder, neck,

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