{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T13:47:36Z","timestamp":1762264056208,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatopathology"],"abstract":"<jats:p>We report the case of a 16-year-old girl presenting with a painless, clinically stable subcutaneous swelling of the nasal dorsum with a three-year history. Despite an extensive multidisciplinary diagnostic work-up\u2014including dermatological, otorhinolaryngological, and radiological evaluations (ultrasound, CT, and MRI)\u2014the nature of the lesion remained indeterminate. In order to achieve a definitive diagnosis while preserving the nasal profile aesthetics, the mass was entirely excised via an endoscope-assisted closed rhinoseptoplasty approach. Histopathological analysis revealed a spindle cell lipoma characterized by CD34 positivity and a Ki-67 proliferation index of less than 1%. This finding is extremely rare in terms of both anatomical location and patient age. The present case highlights the crucial role of histopathological examination in establishing the correct diagnosis, supported by a multidisciplinary assessment.<\/jats:p>","DOI":"10.3390\/dermatopathology12040040","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T12:13:08Z","timestamp":1762258388000},"page":"40","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Indeterminate Subcutaneous Lesion of the Nasal Dorsum in an Adolescent: A Multidisciplinary Approach to a Rare Case of Spindle Cell Lipoma"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1278-6125","authenticated-orcid":false,"given":"Alessandro","family":"Serrone","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, University of Turin, \u201cSan Luigi Gonzaga\u201d Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy"},{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2764-3499","authenticated-orcid":false,"given":"Chiara","family":"Rustichelli","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, University of Turin, \u201cSan Luigi Gonzaga\u201d Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy"},{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8111-7291","authenticated-orcid":false,"given":"Gian Luca","family":"Fadda","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, University of Turin, \u201cSan Luigi Gonzaga\u201d Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1825-7635","authenticated-orcid":false,"given":"Giuseppe","family":"Riva","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Rizzo","sequence":"additional","affiliation":[{"name":"General Surgery Unit, Department of General Surgery, University of Turin, University Hospital \u201cSan Luigi Gonzaga\u201d, Orbassano, 10043 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, University of Turin, \u201cSan Luigi Gonzaga\u201d Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy"},{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/jon.12942","article-title":"Imaging of pediatric nasal masses: A review","volume":"32","author":"Cunha","year":"2022","journal-title":"J. Neuroimaging"},{"key":"ref_2","first-page":"816409","article-title":"Uncommon presentation of a benign nasopharyngeal mass in an adolescent: Comprehensive review of pediatric nasopharyngeal masses","volume":"2013","author":"Duarte","year":"2013","journal-title":"Case Rep. Pediatr."},{"key":"ref_3","first-page":"133","article-title":"Nasal masses in children","volume":"5","author":"Clarke","year":"2012","journal-title":"Otorhinolaryngologist"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Kotowski, M. (2023). The differential diagnosis of congenital developmental midline nasal masses: Histopathological, clinical, and radiological aspects. Diagnostics, 13.","DOI":"10.3390\/diagnostics13172796"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1097\/DAD.0b013e31813735df","article-title":"Diagnostically challenging spindle cell lipomas: A report of 34 \u201clow-fat\u201d and \u201cfat-free\u201d variants","volume":"29","author":"Billings","year":"2007","journal-title":"Am. J. Dermatopathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"282","DOI":"10.21873\/cdp.10213","article-title":"Spindle cell lipoma and pleomorphic lipoma: An update and review","volume":"3","author":"Ohshima","year":"2023","journal-title":"Cancer Diagn. Progn."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/cup.13961","article-title":"A fat tumor goes on a diet: Rare case of low-fat spindle cell lipoma","volume":"49","author":"Zhu","year":"2021","journal-title":"J. Cutan. Pathol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1111\/his.12548","article-title":"Spindle cell\/pleomorphic lipomas of the face: An under-recognized diagnosis","volume":"66","author":"Cheah","year":"2015","journal-title":"Histopathology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"301","DOI":"10.4103\/IJPM.IJPM_475_19","article-title":"Spindle cell lipoma, dorsum of hand in a 4 year old child: A rare entity","volume":"63","author":"Kumar","year":"2020","journal-title":"Indian J. Pathol. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1136\/jclinpath-2017-204975","article-title":"Tumours composed of fat are no longer a simple diagnosis: An overview of fatty tumours with a spindle cell component","volume":"71","author":"McCarthy","year":"2018","journal-title":"J. Clin. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1097\/DAD.0b013e3181d0c587","article-title":"Cutaneous CD34+ spindle cell neoplasms: Histopathologic features distinguish spindle cell lipoma, solitary fibrous tumor, and dermatofibrosarcoma protuberans","volume":"32","author":"Wood","year":"2010","journal-title":"Am. J. Dermatopathol."},{"key":"ref_12","first-page":"28","article-title":"Lipoma with osteocartilaginous metaplasia: Case report and literature review","volume":"102","author":"Vecchio","year":"2010","journal-title":"Pathologica"},{"key":"ref_13","first-page":"30","article-title":"Use of Calretinin, CD56, and CD34 for Differential Diagnosis of Schwannoma and Neurofibroma","volume":"45","author":"Park","year":"2011","journal-title":"J. Pathol. Transl. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1038\/modpathol.2013.164","article-title":"Nuclear expression of STAT6 distinguishes solitary fibrous tumor from histologic mimics","volume":"27","author":"Doyle","year":"2014","journal-title":"Mod. Pathol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"adv00571","DOI":"10.2340\/actadv.v101.268","article-title":"A rare, recurrent spindle cell lipoma of the nose","volume":"101","author":"Kubin","year":"2021","journal-title":"Acta Derm. Venereol."},{"key":"ref_16","first-page":"41","article-title":"Role of fine needle aspiration cytology in the diagnosis of cutaneous and subcutaneous swellings","volume":"8","author":"Gupta","year":"2023","journal-title":"IP Arch. Cytol. Histopathol. Res."},{"key":"ref_17","first-page":"200","article-title":"Role of Fine Needle Aspiration Cytology in the Diagnosis of Skin and Superficial Soft Tissue Lesions: A Study of 510 Cases","volume":"31","author":"Bhowmik","year":"2015","journal-title":"Turk. Patoloji Derg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1055\/s-0042-1756315","article-title":"Outcomes of closed versus open rhinoplasty: A systematic review","volume":"49","author":"Gupta","year":"2022","journal-title":"Arch. Plast. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2651","DOI":"10.1007\/s00266-023-03459-z","article-title":"Video-assisted septorhinoplasty, the future of endonasal rhinoplasty\u2014A technical note","volume":"47","author":"Radulesco","year":"2023","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"258","DOI":"10.18678\/dtfd.954752","article-title":"Clinical results after surgical treatment of spindle cell lipomas","volume":"23","author":"Zenginkinet","year":"2021","journal-title":"Duzce Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1055\/s-0038-1676379","article-title":"Postoperative care in aesthetic rhinoplasty patients","volume":"34","author":"Apaydin","year":"2018","journal-title":"Facial Plast. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1007\/s00266-010-9489-7","article-title":"Adolescent rhinoplasty: Challenges and psychosocial and clinical outcomes","volume":"34","author":"Chauhan","year":"2010","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"110","DOI":"10.4103\/2006-8808.110250","article-title":"A rare case of spindle cell lipoma of nose","volume":"4","author":"Tanthry","year":"2012","journal-title":"J. Surg. Technol. Case Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1097\/DSS.0000000000000533","article-title":"Management of a nasal spindle cell lipoma: Diagnostic and therapeutic considerations","volume":"41","author":"Hellingman","year":"2015","journal-title":"Dermatol. Surg."}],"container-title":["Dermatopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2296-3529\/12\/4\/40\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T13:40:29Z","timestamp":1762263629000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2296-3529\/12\/4\/40"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["dermatopathology12040040"],"URL":"https:\/\/doi.org\/10.3390\/dermatopathology12040040","relation":{},"ISSN":["2296-3529"],"issn-type":[{"type":"electronic","value":"2296-3529"}],"subject":[],"published":{"date-parts":[[2025,11,4]]}}}