Giant Thoracic Wall Lipoma Mimicking Plexiform Neurofibroma: A Case Report

Abstract

Lipoma, a benign tumour of adipose tissue and mesenchymal origin, can occur anywhere in the body where normal fat deposits are present. Aside from the usual locations of the upper extremity, thigh, back, and shoulder, it is also seen very rarely in the posterior cervical region, face, and chest wall. Depending on the size, it is called a giant lipoma, i.e >5 cm. To differentiate giant lipoma with other differentials like neurofibroma and liposarcoma, Fine Needle Aspiration Cytology (FNAC) is required to reach the definitive diagnosis and plan for the required surgical treatment. Here, a rare case of a 53-year-old male is reported, with chief complaints of swelling in front of his chest for the past 25 years. On evaluation, Magnetic Resonance Imaging (MRI) thorax reported a large, elongated, lobulated soft tissue mass in the subcutaneous plane of the anterior thorax. Under general anaesthesia, an elliptical incision was given and a complete portion of the mass was excised. Histopathological examination revealed, encapsulated adipose cells, capillaries, and connective tissue stroma, pathognomic of Lipoma. Postoperatively, there was haematoma formation, which was managed conservatively. In the evidence based system, chronology of approach for skin and soft tissue swelling need to be followed, which starts from FNAC followed by Computed Tomography (CT) and MRI.