# Indeterminate Subcutaneous Lesion of the Nasal Dorsum in an Adolescent: A Multidisciplinary Approach to a Rare Case of Spindle Cell Lipoma

## TL;DR

A 16-year-old girl had a rare nasal tumor that was diagnosed only after surgery and lab tests, showing the need for detailed exams in unusual cases.

## Contribution

Reports a rare case of spindle cell lipoma in an adolescent at an unusual nasal location, emphasizing the importance of histopathology in diagnosis.

## Key findings

- The lesion was diagnosed as a spindle cell lipoma via histopathology after multidisciplinary evaluations failed.
- The tumor showed CD34 positivity and a low Ki-67 index, indicating benign characteristics.
- Spindle cell lipoma in the nasal dorsum of an adolescent is extremely rare.

## Abstract

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—including dermatological, otorhinolaryngological, and radiological evaluations (ultrasound, CT, and MRI)—the 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.