Letter to the Editor
Re: Co-existence of intramuscular spindle cell lipoma with an intramuscular ordinary lipoma: Report of a case. Response to Laliotis et al.

Dear Editor,

We would like to thank Laliotis et al. for taking the time to respond to our previously published letter to the editor [1, 2]. The reason we wrote our letter was not to express “disbelief in the data provided” as stated by Laliotis et al. but rather to initiate a discussion and clarification regarding this very unique case. In addition, it is not unusual for other physicians to comment on previously published work. That is why almost every journal has a letter to the editor section. In fact, we are very glad we did it, because now the case has much better presentation and clarity. Furthermore, our literature review and letter to the editor helped to identify that this may be the first described case of separate location co-existence of intramuscular spindle cell lipoma and intramuscular lipoma, which makes the case even more unique.
Second, we respectfully disagree regarding the role of cytogenetics in the diagnosis of adipocytic tumors. Denying the role of an important and growing diagnostic modality such as cytogenetic analysis may possibly lead to misdiagnosis. Combined with careful histological examination, cytogenetics has greatly improved the diagnostic accuracy in adipocytic tumors [3]. In addition, in one of the articles cited by Laliotis et al. the author recommended in his algorithm to use cytogenetics if there are “lesions arising in rare anatomic locations”, which we consider this case represents [3]. We, however, agree that this is still not a widely available diagnostic modality, but hopefully in future it will be more available and will become routine practice in the diagnosis of lipomatous lesions.
In conclusion, we are very thankful to Laliotis et al. for sharing this very interesting case with the meical community and further providing additional information in order to improve the accuracy of reporting of medical information and advance medicine as a whole.

References

1. Chernev I, Mctighe S, Stanley DP. Re: co-existence of intramuscular spindle cell lipoma with an intramuscular ordinary lipoma. Report of a case. Pol J Pathol 2014; 65: 160-161.
2. Laliotis A, De Bree E, Vasilaki S, et al. Re: Co-existence of intramuscular spindle cell lipoma with an intramuscular ordinary lipoma: Report of a case Ivan Chernev, Shane Mctighe, Dirk P. Stanley. Pol J Pathol 2014; 65: 250-252.
3. Nishio J. Contributions of cytogenetics and molecular cytogenetics to the diagnosis of adipocytic...


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