Atypical Spindle Cell/Pleomorphic Lipomatous Tumor

Atypical spindle cell/pleomorphic lipomatous tumor (ASCPLT) is a rare soft tissue neoplasm, commonly arising in the subcutis (more common than deep soft tissue) of limbs and limb girdles during mid-adulthood. ASCPLT is histologically a lipogenic neoplasm with ill-defined margins composed of a variable amount of spindle to pleomorphic/multinucleated cells within a fibromyxoid stroma. ASCPLTs lack MDM2 amplification, but a large subset show RB1 deletion and variable expression of CD34. Though initially thought to be the malignant form of spindle cell lipoma, ASCPLTs are benign with local recurrences (∼10-15%) and no well-documented dedifferentiation or metastasis.