Spindle cell lipoma is an uncommon histologic variant of lipoma, and reports at the larynx or hypopharynx are extremely rare. We present our experience with a 53-year-old man with a huge spindle cell lipoma of the pyriform sinus and tried to remove the tumor using a transoral robotic approach. The tumor was successfully removed with 3-dimensional visualization providing an excellent view of the resection margin and the dissection plane. Furthermore, geometric resection could be conducted in the narrow pharyngeal lumen and working space using the articulated robotic arms. We suggest that spindle cell lipoma should be considered for differential diagnosis in benign hypopharyngeal tumors and that transoral robotic surgery may be successfully used in huge benign tumors of the hypopharynx.
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