梭狀細胞脂肪瘤以腹股溝腫塊表現- 病例報告與文獻回顧

任駿逸、康智雄

高雄長庚紀念醫院泌尿科

Spindle Cell Lipoma Mimicking Inguinal Hernia: A Case Report and Literature Review

Chun-Yi Jen, Chih-Hsiung Kang

Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung

 University College of Medicine

Background: Spindle cell lipoma (SCL) is a rare benign adipocytic tumor, accounting for approximately 1.5% of all lipomatous tumors, and typically arises in the posterior neck, shoulder, and back of middle-aged men. Occurrence in the inguinal region is exceedingly uncommon and may pose a diagnostic challenge, often mimicking more common conditions such as inguinal hernia or even malignant lipomatous tumors.

Case presentation: We report a case of a middle-aged male presenting with a left inguinal mass, clinically suspected to be an inguinal hernia. The patient underwent open herniorrhaphy. Intraoperatively, no hernia sac was identified; instead, a well-defined soft tissue tumor was noted above the external oblique fascia. Complete wide excision of the mass was performed.

Histopathological examination revealed a spindle cell lipoma, characterized by mature adipocytes admixed with bland spindle cells embedded in a collagenous stroma, without atypia or mitotic activity.

Discussion: Inguinal masses are commonly attributed to hernia; however, various benign and malignant tumors—including lipoma, liposarcoma, leiomyoma, and other spindle cell neoplasms—can mimic this presentation. SCL in the inguinal region is particularly rare, with only limited cases reported. Radiological differentiation from atypical lipomatous tumor or well-differentiated liposarcoma is often difficult due to overlapping imaging features. Most SCLs arise in subcutaneous tissue and are benign with an excellent prognosis after complete excision. Recognition of this entity is important to avoid overtreatment and to guide appropriate surgical management.

Conclusions: Spindle cell lipoma should be considered in the differential diagnosis of inguinal masses, especially when intraoperative findings are inconsistent with hernia. Surgical excision remains both diagnostic and curative. Increased awareness of this rare entity can help prevent misdiagnosis and inappropriate management.

Keywords: Spindle cell lipoma; Inguinal mass; Inguinal hernia mimic; Soft tissue tumor; Case report