Giant lipoma of the left neck: rare location

AbstractGiant lipoma is a rare cause of a large painless neck mass, these lipomas are usually found on the extremity, but rarely occur in the head and neck, computed tomography (CT) scan is very suitable for the diagnosis, Surgical excision is the best treatment. We describe a case of a man with a massive lipoma of the left neck, histological finding confirmed the diagnosis of spindle-cell lipoma, well managed with surgical excision.IntroductionLipomas are the most common type of soft tissue mesenchymal tumors, occur in the head and neck region in approximately 13% of cases, considered giant when it is weighs more than 1000 g or >10 cm in any dimension [1]. We report the case of a 60-year-old man with a massive lipoma of the left neck, with successful management.Case reportA 60-year-old man patient presented to the ENT department with 6 years’ history of increasing left sided neck mass, had been growing slowly, with an inability to fully turn his head, he denied any dysphagia, breathing difficulty, neurological symptoms or comorbidities. A large, smooth oval mass, 10 *7 cm in size (figure 1), was palpated along the left side of the neck. The skin of the mass showed normal, no erythema or inflammatory finding was detected. CT scan shows a low-attenuation massive mass involving the deep cervical fascia in the left side of the neck. There was no associated lymphadenopathy (figure 2). Under general anesthesia the patient underwent left neck dissection, a soft, friable and well encapsulated lipoma was discovered, extending into the prevertebral, jugular carotid and above clavicle plane and thus abutting the paravertebral muscles. In addition, the accessory nerve, brachial plexus, phrenic nerve, internal jugular vein, carotid artery and vascular element above the clavicle, at risk during the surgery, were identified and preserved. the mass was resected completely with the encapsulated sac of lipoma, muscles, nerve and vascular elements were respected, hemostasis ensured and no Plastic reconstruction was required. Histologic findings, fat tissues within muscle tissues benign spindle-cell with no malignant features confirmed the diagnosis (figure 3). Postoperatively, the patient demonstrated no neurological deficit and recovered the ability to fully turn his head and shoulder mobility. After 6 months’ follow-up the patient remind free of symptoms and no recurrence has been observed.