Among the primary mesenchymal tumors of the hypopharynx and larynx, lipomas are rare. Macroscopically, they often resemble a retention cyst or laryngeal nodule. Spindle cell lipomas (SCLs) are an uncommon variant of lipoma. SCLs are extremely rare in the larynx; as far as we know, only 4 cases have been previously described in the literature. We present a new case of laryngeal SCL in a 65-year-old man who presented with a 1-year history of hoarseness, choking spells, stridor, and dyspnea. Examination revealed the presence of a large polyp on the left true vocal fold that had caused stenosis of the posterior glottis. The polyp was removed endoscopically, and the patient's stridor and dyspnea resolved. Histologically, the tumor was composed of bland, CD34-positive spindle cells with an abundant fibrous and myxoid stroma interspersed with mature fatty tissue. The patient was free of local recurrence at 2 years of follow-up.
Spindle cell lipomas (SCLs) represent a rare variant of lipoma. Microscopically, these tumors are composed of mature fat cells mixed with bland spindle cells, hyperchromatic round cells, and multinucleated giant cells.1 Most SCLs originate in the subcutaneous tissue of the posterior neck and upper back.1 In rare cases, these benign tumors arise in other head and neck mucosal sites, such as the buccal fat pad.2