SCLEROTIC LIPOMA - LIPOMAS SIMULATING SCLEROTIC FIBROMA

Aims: We report a series of five unusual subcutaneous lipomas characte rized by prominent stromal sclerosis in a storiform arrangement, Metho ds and results: All lesions occurred in young male adults (23.0 +/- 9. 5 years), three lesions were on the scalp and two on the hands, Clinic ally, lipoma, chondroma or some form of cyst were suspected, In contra st to sclerotic fibroma ('circumscribed storiform collagenoma') a vari able number of adipocytes were interspersed within the fibrosclerotic background, These cells also showed immunoreactivity for S100 protein as well as intracytoplasmic lipid deposits ultrastructurally. None of the lesions recurred within a follow-up period of between 0.5 and 9 ye ars. Conclusions: Our series suggests that sclerotic lipomas should be classified with fibro-and myxolipomas, angiolipomas, spindle cell and pleomorphic lipomas, as an additional characteristic subtype of lipom a, Sclerotic lipomas are often misdiagnosed as a sclerotic fibroma, bu t are essentially fatty tumours and are, at least in our small series, not associated with Cowden's disease.