Spindle Cell Lipoma of the Posterior Nasal Floor: A Case Report and Review

A spindle cell lipoma is a benign, lipomatous neoplasm that typically arises within the subcutaneous tissue on the posterior neck or shoulder of older men. We report a case of a highly unusual presentation of a spindle cell lipoma in a female initially presenting with chronic nasal congestion non-responsive to pharmacological therapy. Computed tomography of the sinuses revealed bilateral pansinus mild to moderate mucosal thickening, right septal deviation and a large polypoid mass arising from the left posterior nasal cavity and filling the nasopharynx and much of the bilateral posterior nasal cavity. Final pathology of the excised mass obtained during endoscopic sinus surgery demonstrated a spindle cell lipoma. To date, there is generally limited literature documenting spindle cell lipomas involving the nasal or nasopharyngeal mucosa, and this is the first reported case of such a tumor arising from the posterior nasal floor.