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IJD® QUIZ |
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| Year : 2014 | Volume
: 59
| Issue : 2 | Page : 205-206 |
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| Solitary pedunculated growth on a thigh |
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Rajesh Verma1, Biju Vasudevan1, Vijendran Pragasam1, Nikhil Moorchung2, Shekar Neema1, Manoj Gopal2
1 Department of Dermatology, Command Hospital and Armed Forces Medical College, Pune, India
2 Department of Pathology, Command Hospital and Armed Forces Medical College, Pune, India
| Date of Web Publication | 21-Feb-2014 |
Correspondence Address:
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0019-5154.127701
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How to cite this article:
Verma R, Vasudevan B, Pragasam V, Moorchung N, Neema S, Gopal M. Solitary pedunculated growth on a thigh. Indian J Dermatol 2014;59:205-6 |
How to cite this URL:
Verma R, Vasudevan B, Pragasam V, Moorchung N, Neema S, Gopal M. Solitary pedunculated growth on a thigh. Indian J Dermatol [serial online] 2014 [cited 2021 Mar 8];59:205-6. Available from: https://www.e-ijd.org/text.asp?2014/59/2/205/127701 |
A 21-year-old female presented with complaints of insidious onset, gradually progressive asymptomatic swelling over the back of the left thigh for past five years. She first noticed a pea-sized swelling when she was 16 years old. The swelling gradually increased in size over 3 years to the present size and has remained static since then. General physical and systemic examination was unremarkable. Dermatological examination revealed a solitary well-defined dome-shaped pedunculated growth measuring 5 × 5 cm over the posterior aspect of the left upper thigh [Figure 1]. The lesion was firm in consistency, nontender, and there was no noticeable surface change.
Excisional biopsy of the lesion was done. Histopathology revealed keratinized stratified squamous epithelium. Subepithelium showed fibrocollagenous tissue along with scattered adipose tissue within reticular dermis [Figure 2] and [Figure 3]. Scant mononuclear inflammatory infiltrate was also seen. No hyperpigmentation of basal layer, foamy histiocytes, giant cells, or grenz zone was seen. No atypical cells or evidence of malignancy was noted. | Figure 2: Histopathology of growth revealing keratinized stratified squamous epithelium with dermis showing fibrocollagenous tissue along with pockets of adipose tissue (H and E, ×10)
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| Answer | | |
Nevus lipomatosus cutaneous superficialis | Discussion | | |
Nevus lipomatosus cutaneous superficialis is a rare disorder characterized by multiple, variable-sized, flesh-colored to yellowish sessile plaques or small solitary nodules due to mature adipocytes present ectopically within the dermis. [1] There are two clinical types. The first type is the classical type, which is characterized by multiple flesh-colored or yellowish sessile lesions with a tendency to coalesce into plaques. They usually have a smooth or corrugated surface and zonal distribution following natural cleavage lines of the skin has been reported. They have a predilection for the pelvic girdle, lumbar, and sacral regions, including posterior upper thighs. They can be sessile or pedunculated. The second type comprises a solitary, domed, or sessile lesion and has been reported at sites other than the lower trunk such as the knee, axilla, arm, and ear. [2] Our case belonged to the second type. It can also be referred to as a a pedunculated lipofibroma as described by Mehregan. The lesions generally appear at birth but may appear at first time during childhood or adolescence, as in our case. [3] Histopathological examination reveals the presence of ectopic mature adipocytes in the dermis, intermingled with collagen bundles and perivascular infiltration of dermis and subcutis with chronic inflammatory cells. Plexiform neurofibroma, connective tissue nevus, vascular malformation, and lipomatosis can be considered as differential diagnosis. The treatment of choice is surgical excision. [4] If patients are unwilling for surgery, cryotherapy remains a viable option. [5]The names of the winners(first three correct entries) are: - Himanshu Gupta, ESIC-PGIMSR, Basaidarapur, New Delhi
- Shikha Arora, ESI- PGIMSR, Basaidarapur, New Delhi
- Keshavmurthy Adya, SBMP Medical College Hospital and Research Center, Karnataka
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| References | | |
| 1. | Abel R, Dougherty JW. Nevus lipomatosus cutaneous superficialis (Hoffman-Zurhelle); report of two cases. Arch Dermatol 1962;85:524-6. 
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| 2. | Jones EW, Marks R, Pongsehirun D. Naevus superficialis lipomatosus. A clinicopathological report of twenty cases. Br J Dermatol 1975;93:121-33.
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| 3. | Finley AG, Musso LA. Naevus lipomatosus cutaneus superficialis (Hoffman-Zurhelle). Br J Dermatol 1972;87:557-64.
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| 4. | Lane JE, Clark E, Marzec T. Nevus lipomatosus cutaneous superficialis. Pediatr Dermatol 2003;20:313-4.
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| 5. | Al-Mutairi N, Joshi A, Nour-Eldin O. Naevus lipomatosus cutaneous superficialis of Hoffmann-Zurhelle with angiokeratoma of Fordyce. Acta DermVenereol 2006;86:92-3.
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[Figure 1], [Figure 2], [Figure 3] |
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