Complete Surgical Excision Research Articles

A Report on a Case and Literature Review on Cervical Sympathetic Chain Schwannoma that Mimics a Paraganglioma

Background: Cervical sympatric schwannoma is a rare benign tumor originating from de Schwan cells. Its clinical presentation is misleading and it can remain asymptomatic for a long time. Mostly, it appears as slow slow-growing cervical mass and may be a differential diagnosis with other neck masses such as paragangliomas. We discuss a case of Cervical sympatric schwannoma and go over its radiological, surgical, and surgical characteristics. Case Presentation: With no prior medical history, a 61-year-old lady appeared with a right cervical mass that had been present for over two years but had lately grown in size without causing dysphagia, dysphonia, or dyspnea. Clinical examination found a firm, slightly pulsatile, non-painful latero-cervical mass measuring 2 × 3 cm. Without other abnormalities on examination of the upper aerodigestive tract or thyroid gland and no neurological deficit. Cervical Ultrasound showed an oval tissular mass with regular contours in close contact with the right common carotid artery. Computed Tomography showed a right superior jugulocarotid mass located behind the vascular axis of the neck with early central vascularization. On magnetic resonance imaging (MRI), this mass was well limited, hypointense on T1 and hyper-intense on T2 with intense contrast enhancement, corresponding to a paraganglioma or schwannoma. A full blood work came back negative. Our patient underwent a complete surgical excision of the tumour which originated in the deep branches of the cervical plexus. Following surgery, the patient had Horner’s syndrome, histopathology confirmed the diagnosis of schwannoma. Conclusions: It is still challenging to differentiate between cervical sympathetic chain schwannoma and paraganglioma clinically and radiological. In the case of the schwannoma surgical approaches must be as conservative as possible to avoid damages of the origin nerve and the patient must be aware of the possibility of Horner syndrome.

Cutaneous Syncytial Myoepithelioma: An Uncommon and Distinct Variant of Cutaneous Epithelioid Neoplasm.

Cutaneous syncytial myoepithelioma (CSM) is an uncommon and distinct variant of cutaneous myoepithelioma. We aim to present a case of CSM to enhance the recognition of this unique variant, encompassing its clinical characteristics, histopathological features, immunohistochemical staining, and therapeutic approaches. A 10-year-old girl presented with a dome-shaped nodule located on the skin of her left medial distal arm. Microscopic examination of the skin biopsy revealed a well-defined dermal nodular lesion, surrounded by an epidermal collarette. Tumor cells were composed of epithelioid to spindle-shaped cells with round-to-oval nuclei, small nucleoli, and abundant eosinophilic cytoplasm with a syncytial-like growth pattern. A moderate degree of nuclear pleomorphism was noted. Mitotic activity was not prominent. Immunohistochemical staining revealed positive staining for epithelial membrane antigen, GLUT1, collagen IV, and S100. Smooth muscle actin, CD10, and CD68 showed patchy positivity. CD31, CD34, p63, SOX10, anaplastic lymphoma kinase (ALK), glial fibrillary acidic protein, pankeratin (AE1/AE3/PCK26), Melan-A, and CD1a were negative. Fluorescence in situ hybridization targeting TFE3 and ALK genes was negative. The differential diagnosis included ALK-negative epithelioid cell histiocytoma, epithelioid perineurioma, and CSM. Based on the above findings, a diagnosis of CSM was rendered. CSM is a benign cutaneous neoplasm composed of sheets of histiocytoid or short spindle cells with pale eosinophilic cytoplasm with a syncytial-like growth pattern. Clinically, CSM often presents as a painless, slow-growing nodule or plaque in a broad anatomical distribution with a preference for the distal extremities.. CSM is characteristically positive for epithelial membrane antigen (EMA) and S100 protein and negative for keratins. In challenging cases, molecular testing for EWSR1 gene rearrangement and EWSR1-PBX3 gene fusion aid in confirming the diagnosis. The histologic features of CSM present a unique set of challenges posing a diagnostic dilemma, as they can bear resemblance to a range of benign and malignant cutaneous neoplasms including ALK-negative epithelioid cell histiocytoma, epithelioid perineurioma, malignant or nevoid melanoma, and epithelioid sarcoma. An accurate diagnosis is crucial for guiding proper clinical management considering that this entity typically demonstrates an excellent prognosis following a complete surgical excision.

Congenital Facial Infiltrating Lipomatosis: A Rare Cause of Facial Asymmetry in Infants.

Congenital facial infiltrating lipomatosis (CFIL) is a rare condition that typically affects the trunk and limbs, but can also occur in the face. Managing CFIL is a significant challenge due to its diffuse involvement in important facial structures. This case report aims to describe a rare form of lipomatosis and discuss the clinical and therapeutic aspects of this entity. The patient was a 5-year-old girl who was admitted to our department due to a right paralateronasal swelling that had been present for 5 months. During the physical examination, a swelling of the right nasolabial was observed. A computed tomography scan of the facial bone revealed an extra bony soft tissue mass near the vestibule of the right nostril in contact with the frontal process of the maxillary bone and the anterior wall of the right maxillary sinus. The patient underwent excision under general anesthesia. The histological report indicated congenital focal lipomatosis. There was no recurrence of swelling a year after initial surgery. Facial infiltrating lipomatosis is a rare congenital disorder in which mature lipocytes invade adjacent tissue. Due to its diffuse infiltration and involvement of important facial structures, complete surgical excision is often impossible. Specific management of this condition requires insight into its pathogenesis as surgical removal of the mass is usually unsuccessful.

Inflammatory myofibroblastic tumor of the urinary bladder: A systematic review of the literature and report of a case

ABSTRACT Introduction: Inflammatory myofibroblastic tumors (IMTs) are intermediate-grade lesions that frequently recur and rarely metastasize. There are currently no guidelines on the management of bladder IMTs. This systematic review aims to describe the clinical presentation and compare the management options for bladder IMTs. Methods: A PubMed/Medline search was conducted, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the following Mesh terms: (“inflammatory myofibroblastic”) AND (“tumor”) OR (“tumor”) AND (“bladder”) AND (“case report”). A total of 75 case reports were included in the analysis. Results: The mean age of the patients was 36 years. 65% of the cases initially presented with hematuria. 68% of the tumors stained positive for anaplastic lymphoma kinase, and 20% invaded the muscularis. Patients underwent either transurethral resection of the bladder tumor (TURBT) only (34%), TURBT followed by complementary partial cystectomy (16%), or TURBT followed by radical cystectomy (4%). 36% and 9% of the cases underwent partial and radical cystectomy after the initial diagnosis, respectively. Cystectomies were performed using an open (74%), laparoscopic (14%), robotic-assisted (10%), or unknown (2%) approach. At a mean follow-up of 14 months, the recurrence and metastasis rates were about 9% and 4%, respectively. In addition, we present the case of a 49-year-old woman with a bladder IMT who underwent TURBT followed by laparoscopic partial cystectomy. The patient remains tumor free postoperatively (follow-up period of 12 months). Conclusion: A complete surgical excision of the bladder IMT is crucial for the optimal management of these cases. Proper differentiation of this tumor from sarcoma or leiomyosarcoma leads to the best outcomes.

INTRA-ORAL LINGUAL SCHWANNOMA - A RARE CASE REPORT FROM AN INDIAN TERTIARY CARE HOSPITAL

Schwannomas are most noted in the head and neck region, and their occurrence in the oral cavity is rare. Due to the rarity of intraoral schwannomas, are typically excluded from the differential diagnosis of tongue masses. Here we present such a case report describing the rare occurrence of an intra-oral lingual schwannoma in a young, male patient. The diagnosis was noted after histopathological assessment of the lesion, highlighting the importance of histopathology. Complete surgical excision of the lesion was effective without recurrence.

An algorithmic approach to the management of peripheral nerve tumours.

This article reviews the pathology and management of peripheral nerve tumours, including a framework for investigation and decision-making. Most tumours are benign, including schwannomas and neurofibromas, but malignant peripheral nerve sheath tumours can occur. The risk of malignant change is remote for schwannomas but higher for neurofibromas, particularly in neurofibromatosis type 1. Magnetic resonance imaging is useful for defining the relationship of a swelling with adjacent nerves but is not definitive for tissue diagnosis. Increasing size, pain and neurological deficit suggest malignant change and TruCut needle biopsy is indicated, although there is a risk of sampling error. Excision biopsy preserving nerve function may be carried out for benign tumours to relieve symptoms. Malignant tumours require a multidisciplinary approach. Complete surgical excision with clear margins is the only curative treatment and may be supplemented with radiotherapy and chemotherapy. However, prognosis remains poor, particularly for patients with neurofibromatosis.

Chest wall tuberculosis: Precision surgery with indigo carmine in limited cases for safe and intuitive lesion excision.

In addition to treatment with antituberculosis drugs, complete surgical excision is important for the cure of chest wall tuberculosis. However, surgery is often challenging to perform due to different factors such as the strong adhesion of tuberculous lesions to the surrounding normal tissue, growth of neovascularization, and presence of fragile necrotic tissues. Firm adhesions, bleeding, and fragile tissue make it difficult to determine the boundary with normal tissue and completely excide the lesion. Moreover, ingenuity is required. Herein, we report the identification of the boundary between the lesion and normal tissue by injecting indigo carmine into the abscess to completely excide the lesion, which is considered an intuitive and safe method.

Evaluation of the efficacy of the Z-plasty surgical technique vs. secondary wound healing mechanism in the treatment of the pilonidal sinus, A clinical trial.

Background: The most important step in the treatment of a pilonidal sinus is eradication by surgical excision. Over the years, a wide variety of surgical techniques have been reported for wound closure, yet their management still poses a challenge. The current study compares the results of two different methods of wound management: secondary wound healing versus the Z-plasty surgical technique. Material and Method: The current clinical trial recruited 84 uncomplicated pilonidal sinus patients who were to undergo complete surgical excision of the pilonidal sinus. For wound healing, the 84 subjects were equally divided into two groups of 42 patients each. One group was selected for Z-plasty surgical wound closure and the other for the secondary healing mechanism. Outcomes measured consisted of demographic data, length of operation, complications, severity of pain, number of dressings, recurrence, and complete healing time. Result: Age or gender distribution and the median BMI (kg/m²) did not significantly differ between the two groups. The length of the operation for Z-plasty subjects was significantly longer (P <0.0001). The median number of dressing changes for secondary wound healing patients was 38.69, which was significantly higher than the 4.95 dressing changes for the Z-plasty group. The total time recorded for complete wound healing was 21.61±4.27 days in the Z-plasty group and 41.23±24.28 days for secondary wound healing subjects, which was statistically significant . 24 hours postoperation, patients in the secondary wound healing group had significantly more pain and the VAS scores of the Z-plasty and secondary wound healing groups was 3.42±0.76 and 6.09±1.2, respectively. Concerning the recurrence rate, there were no significant differences between the two groups. SPSS version 22 performed the analyses and the independent t-test compared the continuous variables. A P value <0.05 was considered statistically significant Conclusion: Z-plasty is a safe and effective procedure in terms of wound complications and recurrence rate. This method is also cost-effective and better received by patients.

Thickness of melanocytes in giant congenital melanocytic nevus for complete surgical excision: clinicopathological evaluation of 117 lesions according to the area and size

BackgroundGiant congenital melanocytic nevi (GCMN) are usually defined as nevi that exceed 20 cm in maximal diameter or 15% of the total body surface area. There have been reports of life-long malignant change risks arising from GCMN, leading to surgical excision of GCMN. This study aims to evaluate the thickness of melanocytes based on clinical factors in order to provide objective information for the complete resection of the lesion.MethodsOverall, 75 patients diagnosed with GCMN between 2000 and 2021 were included, and their clinical records were collected retrospectively. 117 pathologic slides obtained during excision were reviewed to measure nevus thickness. Clinical factors were assessed with a generalized estimated equation model for association with nevus thickness.ResultsThe thickness of nevus was significantly associated with the location and size. Nevus thickness was more superficial in the distal extremity than in the head and trunk (P = 0.003 [head]; P < 0.001 [trunk]; P = 0.091 [Proximal extremity]). Nevi sized 60 cm or more were significantly deeper than those measuring 20–29.9 cm (P = 0.035). An interaction between size and location existed (P < 0.001). Trunk and distal extremity lesions consistently exhibited uniform thickness regardless of lesion size, whereas head and proximal extremity lesions showed variations in thickness based on lesion size.ConclusionGCMNs have differences in thickness according to location and size. Therefore, it is necessary to devise an approach optimized for each patient to treat GCMN.Mini-abstractIn the study, it was emphasized that the thickness of GCMN is correlated with clinical factors, specifically the location and size of the nevus. Consequently, these findings underscore the need for individualized treatment plans for effective surgical intervention.

Renal cell carcinoma with an “uncoiling” tumor thrombus: intraoperative shift from level III to level IV

BackgroundThe gold standard treatment for renal cell carcinoma (RCC) with tumor thrombus (TT) is complete surgical excision. The surgery is complex and challenging to the surgeon, especially with large tumor thrombus extending into the inferior vena cava (IVC) and right atrium. Traditionally, these difficult cases required the use of cardiopulmonary bypass (CPB) with or without deep hypothermic cardiac arrest, but in recent years, different surgical techniques derived from the field of liver transplantation have been used in efforts to avoid CPB.Case presentationWe present a case of RCC with TT level IIIc (extending above major hepatic veins) that “uncoiled” intraoperatively into the right atrium after division of the IVC ligament, transforming into a level IV TT. Despite the new TT extension, the surgery was successfully completed exclusively through an abdominal approach without CPB and while using intraoperative transesophageal echocardiography (TEE) monitoring and a cardiothoracic team standby.ConclusionsThis case highlights the need for a multidisciplinary approach and the utility of intraoperative continous TEE monitoring which helped to visualize the change of the TT venous extension, allowing the surgical teamto modify their surgical approach as needed avoiding a catastrophic event.

Operative treatment of pulmonary primitive neuroectodermal tumor: a case report and literature review

BackgroundPulmonary primitive neuroectodermal tumor (PNET), a member of the Ewing sarcoma family of tumors, is a rare malignancy that is associated with a grim prognosis. To date, fewer than 30 cases of pulmonary PNET have been reported. In this case report, we present the clinical details of a 12-year-old girl with pulmonary PNET who underwent surgical treatment. We also conducted an analysis and summary of other relevant studies and the surgical outcomes.Case presentationIn May 2018, a 12-year-old girl was admitted with symptoms of cough and blood-tinged phlegm. A computed tomography scan revealed a large mass, measuring 12.9 cm × 8.1 cm, in the right middle and lower lungs. A percutaneous lung biopsy confirmed poorly differentiated tumor cells with a nested growth pattern. Immunohistochemical staining demonstrated positive expression of CD99, CD56, Vimentin, and Synaptophysin. The patient was diagnosed with pulmonary PNET. Following three cycles of neoadjuvant chemotherapy, a substantial reduction in tumor volume was observed. Subsequently, the patient underwent a surgical procedure involving pneumonectomy and partial resection of the left atrium with the assistance of cardiopulmonary bypass. The patient was discharged 37 days after surgery. During a three-year follow-up period, she exhibited no signs of tumor recurrence and has successfully returned to school.ConclusionsThis case highlights the successful management of an advanced PNET with neoadjuvant chemotherapy, pneumonectomy, and partial resection of the left atrium employing cardiopulmonary bypass. The patient remained disease-free after three years. Our analysis of surgically treated cases indicates that neoadjuvant chemotherapy can contribute to improved prognoses for PNET patients. It is crucial to emphasize that complete surgical excision remains the cornerstone of treatment, underscoring the importance of surgeons considering radical surgical approaches whenever feasible for patients with pulmonary PNETs.

Review of recent advances in managing periocular skin malignancies.

Management of cutaneous malignancies can be particularly challenging when they are located in the periocular region. The standard of care for localized disease is complete surgical excision, but this may not be possible without significant disruption to visual structures and facial appearance. Definitive radiation may be an option for some patients who cannot or do not wish to undergo surgery. Advances in systemic treatment options for locally advanced and metastatic skin cancers in the past 10 years have prompted investigation into neoadjuvant treatment of periocular cancers. The use of chemotherapy, immune checkpoint inhibitors, and targeted therapies have all been reported with varying degrees of success. For many patients, targeted therapies or immune checkpoint inhibitors should be considered depending on the cancer type, symptoms, and goals with the input of a multidisciplinary cancer care team. In this article, we systematically review the latest updates in surgical, radiotherapeutic, and medical management of periocular malignancies.

A Novel Foley Catheter-Based Brain Retraction Method for the Interhemispheric Approach: Technical Considerations and an Illustrative Video

BACKGROUNDManagement of interhemispheric pathologies requires surgical intervention through a restricted anatomical corridor ensconced within critical cerebral structures. The use of retractors to facilitate operative access may cause damage to cerebral tissue. The development of an innovative retraction technique designed to alleviate cerebral damage in such cases is imperative. OBJECTIVEIn this study, we present a novel and gentle retraction method to facilitate the interhemispheric approach. METHODSWe retrospectively examined data of nine right-handed patients who underwent surgical resection of interhemispheric lesions between 2021 and 2022. All patients underwent surgery for the first time because of this pathology. All operative specimens were histologically confirmed. Clinical characteristics, operative details, and follow-up data were retrospectively analyzed. RESULTSThe new retraction technique was successfully applied to eight tumor patients and one patient with an aneurysm. Eight patients had an anterior interhemispheric approach, and one patient had a posterior interhemispheric approach. Complete surgical excision was achieved in all patients with no postoperative complications. Postoperative Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) showed no signs of ischemia or contusion. All patients exhibited significant improvements in their symptoms. An illustrative video that elucidates the removal of an interhemispheric epidermoid tumor, employing the anterior ipsilateral interhemispheric approach, featuring the novel retraction method. CONCLUSIONSThe ideal retraction technique during the interhemispheric approach is still a challenge. Our novel retraction technique may help minimize brain parenchymal damage during surgical resection of interhemispheric lesions.

Digital mucous cyst marsupialization: Surgical technique

Digital mucous cysts are benign synovial fluid collections that typically involve the lateral or dorsal surfaces of the distal interphalangeal joints (DIPJs) or beneath the proximal nail fold. They are typically found in the setting of arthritic degeneration of the underlying joint and occur most frequently between the fifth and seventh decades. 1 Many treatment options for digital mucous cysts have been described, ranging from conservative/minimally invasive to complete surgical excision, with no consensus on best technique. Here, a surgical approach is presented which allows access to address the cyst pedicle as well as any underlying osteophyte while preserving the overlying skin with good outcomes even with compromised or involved dermis and epidermis. This is a reproducible, readily adaptable technique. The surgical technique is presented and reviewed in detail.

Inflammatory myofibroblastic tumor of the genitourinary tract: a narrative review.

Inflammatory myofibroblastic tumor (IMT) is a rare entity that is described in several organ systems. This comprehensive review aims to identify IMTs occurring at various genitourinary (GU) organ sites and describe patterns of clinical management in adult and pediatric patients. A comprehensive search of PubMed and Web of Science was conducted according to the Preferred Reporting Items for Systematic Review and meta-analyses statement. Two reviewers performed independent initial screening of abstracts. Eligible articles underwent full review and data extraction. The clinical features, diagnostic tests, treatment, and outcomes at each GU organ site were analyzed individually and summarized into a comprehensive review. Of the 270 articles identified, 112 met inclusion criteria. Articles primarily consisted of case reports or small series describing a total of 167 cases, of which 30 (18%) occurred in children. Most patients (96%) were symptomatic at presentation. The most frequently involved sites included bladder (106 cases) and kidney (n=33) followed by epididymis (n=6), urachus (n=6), ureter (n=5), prostate (n=4), testis (n=4), and spermatic cord (n=3). Complete surgical excision of the mass including partial or total removal of involved organs provided excellent outcomes. Incomplete excision was associated with early local recurrence and progression. Late recurrence or metastatic transformation was rarely noted (<2%). IMTs exhibit locally invasive, symptomatic and progressive phenotypes that affect all urologic organs in adults and children. Clinical features and imaging results are similar to those noted with urologic cancers. These tumors require complete surgical excision since incomplete resection increases the risk of symptomatic recurrence.

MERKEL CELL CARCINOMA: A CASE REPORT

Merkel cell carcinoma is a rare but highly agressive skin tumor. MCC clinically represents as cutaneous or subcutaneous nodule, and in 30% of the cases loco-regional metastasis are already there in primary diagnosis. Pathogenesis is essentially due to excessive exposure to UV light. The confirmation diagnosis is based on histological and immunological features on the lesion. The treatment methods require a complete surgical excision and radiotherapy.

Mediastinal Thymic Cyst in Adults: A Rare Case Report

Thymic cysts are rare, benign lesions located in the cervico-thoracic region, often incidentally discovered. The only curative treatment is complete surgical excision, which eliminates symptoms, prevents complications, and provides a definitive diagnosis through histopathological examination, typically revealing the presence of Hassall's corpuscles. Minimally invasive approaches are preferable. We present the case of a 40-year-old patient with an anterior mediastinal cystic mass that underwent successful complete surgical resection. The histopathological examination confirmed a diagnosis of benign unilocular thymic cyst, resulting in favorable clinical and radiological outcomes.

Calcific Myonecrosis of Tibialis Anterior in a 76-Year-Old Man with Foot Drop

Background: Calcific myonecrosis is a rare entity that is considered a sequela of chronic compartment syndrome. A fusiform mass with central liquefaction and peripheral calcification replaces the affected muscle unit.&#x0D; Case Report: We are presenting a case of calcific myonecrosis of the tibialis anterior in a 76-year-old man. Although the mass was present for several years, the patient recently developed leg pain and foot drop. After radiological and histopathological diagnosis, patient was treated with surgical excision of the mass.&#x0D; Conclusion: Although calcific myonecrosis is a benign condition, due to the pressure effect on surrounding structures, it may be a source of leg pain and foot drop. Cortical erosion and scalloping of underlying major bone may be reasons for extremity pain. To relieve pain, alleviate pressure effect, and prevent pathological fracture of the underlying bone, complete surgical excision of the lesion is essential.

Successful Surgical Management of Giant Mediastinal Teratoma – A Case Report of a Difficult Case without Any Post-Operative Complication

Introduction. Mediastinal teratoma is a rare germ cell tumor, located in anterior mediastinum and is lack of population-based study. It usually occurs in the age of 20-40 years, accounting for 15% of anterior mediastinal masses in adults and 25% of anterior mediastinal masses in children. It is frequently diagnosed accidentally on chest imaging due to its asymptomatic nature. Hereby, we presented a case of giant anterior mediastinum teratoma with complete surgical excision without any post-operative complication. This case is unique due to its uneventful result after excision. From our literature research, we successfully avoid the potential post operative complications of resecting this tumor such as bleeding, wound dehiscence and even death. It is due to early diagnosis, treatment and good intraoperative management of lesion &amp; hemodynamics. Case Report. A 21-year old male was referred from pulmonologist oncologist to our Thoracic Surgical Unit with complains of dyspnea and chest pain. Physical examination showed no lung sounds in (R) hemithorax and was dull to percussion, ictus cordis shifted 2 fingerbreadths towards left-side. Chest X-ray showed a large well-defined lesion in (R) hemithorax and chest CT-scan with contrast showed hypodense mass on (R) hemithorax adhering &amp; compressing the lung, diaphragm, pericardium &amp; chest wall, with estimation size of 60 x 20 x 12 cm, lesion displaced the heart. Patient was then treated with complete surgical excision and found a huge cystic tumor with a size of 60 x 20 x 12 cm adhering to all parts of (R) lung, diaphragm and pericardium. He underwent (R) pneumonectomy due to adhesion. Histologic examination was consistent with mature teratoma. Patient showed no complication after surgery and was discharged uneventfully from our hospital after 5 days. Discussion. Approximately 95% of benign teratomas arise in the anterior mediastinum. The tumor grows progressively, mostly asymptomatic, dyspnea and substernal chest pain are the most common symptoms if present. Productive Cough of hair or sebum is a pathognomonic sign. Chest radiograph typically reveals a well-circumscribed anterior mediastinal mass that often protrudes into one of the lung, they are usually large at the time of diagnosis. Complete surgical excision is a treatment of choice of mediastinal teratoma, which can be performed through median sternotomy or thoracotomy or thoracoscopy. Some patients require additional procedures (eg, lobectomy, pericardiectomy) for complete tumor resection. Conclusion. There is still limited data on mediastinal teratoma. Early referral &amp; treatment show good prognosis. Benign Mediastinal Teratomas was tricky to be diagnosed, when it is diagnosed, it is usually very large in size. Complete Surgical Excision can be performed safely without any complications.

A giant, recurrent, subpectoral breast lipoma: case report

Lipomas are mesenchymal tumors composed of mature fat tissue and are considered one of the most common benign tumors. They are usually small in size, and giant lipomas are rare. The exact etiology of lipoma development is unclear, though several factors have been proposed. Intramuscular or subpectoral lipomas involving the pectoralis major muscle are uncommon. In this report, the author has described the case of a 52-year-old female patient who presented with an uncommon form of subpectoral, giant, recurrent breast lipoma. The patient had undergone a complete surgical excision. The author suggests an individualized assessment and treatment of each case.