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CASE REPORT
Year : 2018  |  Volume : 19  |  Issue : 2  |  Page : 148-150

Pedunculated nevus lipomatosus cutaneous superficialis of the scrotum successfully removed by excision


1 Department of Dermatology, Venereology and Leprosy, SGT Medical College Hospital and Research Institute, Gurgaon, Haryana, India
2 Department of Pathology, SGT Medical College Hospital and Research Institute, Gurgaon, Haryana, India

Date of Web Publication26-Mar-2018

Correspondence Address:
Shikhar Ganjoo
Assistant Professor, Department of Dermatology, Venereology and Leprosy, SGT Medical College Hospital and Research Institute, Gurgaon
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpd.IJPD_39_17

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  Abstract 


Nevus lipomatosis cutaneous superficialis is a rare cutaneous condition characterised by mature adipocytic hamartoma in the dermis amongst and splitting the collagen bundles. It was first reported in 1924. The first case report from India was in the year 1994. There is only 1 previous case report of the nevus occurring in the scrotum. The following case is reported for its rarity both in incidence and also the site involved. The lesion is asymptomatic and needs no treatment usually but since the lesion occupied a large area of scrotum we went ahead and did an excision of the nevus.

Keywords: Excision, nevus lipomatosus cutaneous superficialis, scrotum


How to cite this article:
Ganjoo S, Sawhney M P, Sharma U. Pedunculated nevus lipomatosus cutaneous superficialis of the scrotum successfully removed by excision. Indian J Paediatr Dermatol 2018;19:148-50

How to cite this URL:
Ganjoo S, Sawhney M P, Sharma U. Pedunculated nevus lipomatosus cutaneous superficialis of the scrotum successfully removed by excision. Indian J Paediatr Dermatol [serial online] 2018 [cited 2019 Dec 13];19:148-50. Available from: http://www.ijpd.in/text.asp?2018/19/2/148/211815




  Introduction Top


Nevus lipomatosus cutaneous superficialis is an uncommon benign hamartomatous skin lesion defined by the presence of aggregates of mature adipose tissue among the collagen bundles due to nevoid fatty growth within the papillary and reticular dermis. It is characterized clinically by multiple, variable-sized, flesh colored to yellowish sessile plaques with cerebriform surface or small solitary nodules. It was first reported by Hoffman and Zurhelle in 1921.[1] We hereby report a 10-year-old boy with lesions involving the scrotum for its rarity.


  Case Report Top


A 10-year-old boy born of nonconsanguineous marriage presented with a history of an asymptomatic growth over the scrotum since birth with a history of rapid growth for the past 1 year. There was no history of any neurological deficit or developmental delay in the child. There was no family history of a similar condition. The general physical examination was unremarkable and local examination revealed a large 4 cm × 3 cm skin-colored, well-defined, soft and pedunculated growth with a cerebriform surface over the left side of scrotal sac [Figure 1]. Both the testes were present in their respective scrotal sac. There were no café-au-lait macules or axillary freckling.
Figure 1: A soft pedunculated growth on left side of scrotum

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Radiological examination with high-resolution ultrasound and color Doppler showed homogeneously echogenic lesion without significant intralesional vascularity. Any connection of the lesion to the underlying testicular tissue and any arteriovenous malformation were ruled out. Excision biopsy was performed with the aid of electrofulguration since the lesion was pedunculated [Figure 2]. With a differential diagnosis of plexiform neurofibromatosis, nevus lipomatosus cutaneous superficialis (NLCS), and fibroepithelial polyp, the excised growth was sent for histopathology.
Figure 2: Macroscopic appearance of the specimen

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Hematoxylin and eosin sections from the skin biopsy showed infolding of the epidermis with islands of mature adipose tissue in papillary and reticular dermis splitting the collagen bundles consistent with the diagnosis of NLCS [Figure 3] and [Figure 4]. Foci of fibrosis intermixed with fat were also seen.
Figure 3: Growth successfully excised

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Figure 4: Collection of mature adipocytes in dermis (H and E, ×100)

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  Discussion Top


NLCS is a rare benign hamartomatous mature adipocytic collection in the papillary and reticular dermis. Two clinical types are distinguished: the classical type and the solitary type.[1],[2] The classical type, first reported by Hoffman and Zurhelle, consists of multiple, soft, nontender, pedunculated, cerebriform, yellowish or skin-colored papules or nodules usually situated on the pelvic girdle area in a zonal pattern and occurs at birth or during fist three decades of life. The solitary form usually occurs after the age of 20 years and presents with a single nodular lesion with no particular predilection sites.

The first ever reported patient from India [3] was in 1994 wherein the authors demonstrated a sessile nevus lipomatosus of 5 years duration which also had ulceration in the superficial part of the lesion postulated to be due to ischemia from compression of dermal capillaries. Other peculiar features in that patient were an unusually large size of 15 cm, extension beyond midline, and classical comedo-like plugs over many of the nodules in the cerebriform pattern of presentation.

There have been very few case reports of NLCS at unusual sites, such as the clitoris or in the inguinal region [4],[5] and a single report of involvement of the scrotum.[6] Hence, we report this patient for its rarity. Treatment for an NLCS is generally not needed, but a simple surgical excision may be performed without recurrence.[7],[8] However, in our patient, the NLCS occupied a large area of the scrotum and hence an excision biopsy was performed with the help of an electrocautery.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Yap FB. Nevus lipomatosus superficialis. Singapore Med J 2009;50:e161-2.  Back to cited text no. 1
[PUBMED]    
2.
Jones EW, Marks R, Pongsehirun D. Naevus superficialis lipomatosus. A clinicopathological report of twenty cases. Br J Dermatol 1975;93:121-33.  Back to cited text no. 2
[PUBMED]    
3.
Dhar S, Kumar B, Kaur I. Naevus lipomatosus superficialis of Hoffman and Zurhelle. Indian J Dermatol Venereol Leprol 1994;60:39-40.  Back to cited text no. 3
  [Full text]  
4.
Namazi MR. Nevus lipomatosus cutaneous superficialis of the groin arising in the fifth decade of life. J Drugs Dermatol 2008;7:787-8.  Back to cited text no. 4
[PUBMED]    
5.
Hattori R, Kubo T, Yano K, Tanemura A, Yamaguchi Y, Itami S, et al. Nevus lipomatosus cutaneous superficialis of the clitoris. Dermatol Surg 2003;29:1071-2.  Back to cited text no. 5
[PUBMED]    
6.
Park MY, Kim YC. A soft lesion on the scrotum: A quiz. Nevus lipomatosus superficialis. Acta Derm Venereol 2009;89:549-50.  Back to cited text no. 6
    
7.
Knuttel R, Silver EA. A cerebriform mass on the right buttock. Dermatol Surg 2003;29:780-1.  Back to cited text no. 7
[PUBMED]    
8.
Brasanac D, Boricic I. Giant nevus lipomatosus superficialis with multiple folliculosebaceous cystic hamartomas and dermoid cysts. J Eur Acad Dermatol Venereol 2005;19:84-6.  Back to cited text no. 8
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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