ASOPRSFall Scientific SymposiumSyllabus
173
T20
SpindleCell Lipomaof theOrbit
AminaMalik
1
, JeffreyNerad
2
.
1
Cincinnati Eye Institute, Cincinnati, OH, UnitedStates,
2
Ophthalmology, University of Cincinnati,
Cincinnati, OH, UnitedStates
Introduction:
Lipomas are one of themost commonmesenchymal neoplasms and can arise in any location inwhich fat is present.
In 1975, a specific variant of lipoma termed “spindle cell lipoma,”was first described. Cases of these unusual spindle cell lipomas
of the orbit are rarely seen, despite the abundance of fat in the orbit,with only four previous case reports described in the literature.
Herewe describe a case of a recurrent spindle cell lipoma of the orbit,which to our knowledge, has not been previously described.
Methods:
The clinical presentation,management, and outcome of a case of a recurrent spindle cell lipoma of the orbit is reported.
A literature searchwas performed on spindle cell lipoma of the orbit and is described.
Results:
A60 year oldCaucasianmale presentedwith complaints of worsening diplopia and protrusion of his left eye. His past
medical historywas significant for Hepatitis C and squamous cell carcinoma of the tonsils, for which hewas treatedwith radiation
threemonths prior to presentation. On examination hewas noted to have 4mm of left proptosiswith ptosis (Figure 1) and limitation
of abduction and infraduction. Imaging disclosed a large, homogenous,well circumscribedmass in the left inferomedial orbit (Figures
2, 3). Surgical excisionwas performed and pathologywas positive for spindle cell lipoma (Figure 3).Two years postoperatively, patient
presentedwith recurrence of symptoms, and on imagingwas found to have a large orbital mass again in the left inferomedial orbit.
Repeat excisional biopsywas performed,with pathology positive for spindle cell lipoma. Postoperatively patient’s symptoms resolved,
and he remained stable over a two year follow up period.
Conclusions:
Spindle cell lipoma of the orbit, though rare, should be considered in the differential diagnosis for an orbital
mass.Treatment is primarily via surgical excision, but patients should have long-term follow-up to check for development of
tumor recurrence.
References:
1. Enzinger FM, Harvey DA. Spindle cell lipoma. Cancer 197; 36:1852.
Shields JA, Shields CL, Scartozzi R. Survey of 1264 patientswith orbital tumors and simulating lesions:The 2002Montgomery
Lecture, Part 1. Ophthalmol May 2004; 111(5):997-1008.
2. Johnson BL, Linn JG. Spindle cell lipoma of the orbit.ArchOphthalmol Jan 1979; 97:133-134.
3. Bartley GB,Yeatts RP, Garrity JA, et al. Spindle cell lipoma of the orbit.Am JOphthalmol Oct 1985; 100:605-609.
4. Uliveri S, Olieri G,Motolese PA, et al. Spindle cell lipoma of the orbit: a case report of an unusual orbital pathology.
Neurologia I Neurochirugia Polska 2010; 44:419-423.
5. PardheN, SinghN, Bharadwaj G, et al. Spindle cell lipoma. BMJ Case RepAug 2013; 2013.
6.Mawn LA, JordanDR, Olberg B. Spindle cell lipoma. Ophthal Plastic Recons SurgMay 1998; 14(3):174-177.
DetailedProgram
—Thursday,October 16, 2014
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