Case Example Parotid Lipoma-like Liposarcoma
Preop CT: Well circumscribed fatty dense lesion in the left parotid gland.
This could represent lipomatous tumor such as lipoma.
Preop MRI: Left parotid lipomatous tumor, containing small enhancing lesion
with differential of vascular structure versus solid lesion. Repeat
ultrasound to further define the possible vasculature is recommended.
Atypical lipomatous neoplasm, favor well differentiated, lipoma-like
liposarcoma, 2.3 cm in greatest dimension, abutting the lateral
surgical resection margin.
Comment: This lipomatous tumor shows nuclear pleomorphism and irregularity, and
given the sub-fascial location, the tumor is best interpreted as
lipoma-like liposarcoma. This low-grade tumor may have a small risk of
local reoccurrence given the close lateral margin. Spindle cell lipoma was
also a consideration, however the CD34 stain is negative.
Second resection 7 days later:
no residual neoplasm, all margins clear.