PMC4012099_01
(a) Pedunculated, nonmobile growth with a smooth surface present on the midline of the hard palate. (b) Gross specimen of the excised tumor and cut section showing calcifications
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F1
The lesion measuring about 2 x 1.5 x 1.5 cm, was well circumscribed and pedunculated [Figure 1a]. Grossly, the dome shaped specimen appeared tan and cut surface has yellowish hue [Figure 1b].
(a) Mesenchymal tissue showing mature adipocytes, bony trabaculae in uniform spindle cells containing fibrillar stroma (H and E, x4) (b) Highly cellular stroma with mature adipocytes interspresed with bony trabaculae (H and E, x10) (c) Fibrocellular connective tissue with spindle cells and multinucleated cells. (H and E, x20) (d) Presence of bony trabaculae in close proximity to the adipocytes (Hand E, x40)
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F2
Microscopically, the lesion was well-circumscribed and revealed lobules of adipose tissue and calcified structures separated from the surface epithelium by fibro-cellular connective tissue stroma [Figures 2a and b]. Mass of moderately cellular spindle cells, bound on the deeper aspect by fibrous tissue were evident [Figure 2c]. Abundant myxoid tissue with a small collection of lipid laden macrophages were also seen [Figure 2d].
(a) S-100 protein positive spindle cells in the connective tissue (x10). (b) Strong and diffuse S-100 protein positivity of spindle cells (x20). (c) S-100 protein immunopositivity of adipocytes (x20). (d) Smooth muscle actin negative lesional tissue showing positivity GFAP positive spindle cells (x40)
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F3
Immunohistochemical analysis revealed S-100 and GFAP positivity of the spindle cells while actin was positive around the blood vessels but negative for spindle cells [Figures 3a-d].
Intra-operative
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F4
Treatment involved surgical excision of the lesion [Figures 4 and 5].
Post-operative
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F5
Treatment involved surgical excision of the lesion [Figures 4 and 5].