The largest reported intrathoracic lipoma: a case report and current perspectives review

Abstract

BackgroundThe huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome.Case presentationA 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma.ConclusionThe tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.

Successful removal of the largest reported intrathoracic lipoma with bilateral extension: a case report

“…Although intrathoracic lipoma is usually detected incidentally in a chest X-ray, a homogeneous fat attenuation mass (50–150 HU) that creates obtuse angles with the chest wall and displaces neighboring pulmonary parenchyma and arteries on a chest CT permits a conclusive diagnosis [ 1 , 2 , 5 , 11 ]. Additionally, magnetic resonance imaging (MRI), particularly with fat saturation, is supportive in determining the lipomatous nature of the tumor.…”

“…Lipomas are the most prevalent benign mesenchymal tumors, while intrathoracic lipoma is a rare entity. On the other hand, giant lipoma involving both hemithorax is far more unusual, with only a few occurrences documented in the literature [ 1 – 3 ]. Lipomas in the intrathoracic region often go unnoticed, especially if they are small.…”

Extrapericardial Pleural Lipoma: A Surgical Case Report and Current Literature Review

“…Conservative clinical and radiological follow-up may be suitable for elderly patients and those in poor general condition, especially in the presence of small asymptomatic lesions [11,16] . Although pleural lipoma never evolves towards liposarcoma, most authors argued surgical excision would be recommended for diagnostic and therapeutic considerations, because the possibility of liposarcoma occurrence and/or in ltrating development of the tumor cannot be excluded preoperatively [5,16] . If compressive symptoms occur due to progressive enlargement then surgical resection should be considered in a t patient.…”

“…Few cases have been reported worldwide [2] . While typically asymptomatic, pleural lipomas may cause symptoms such as dyspnoea, nonproductive cough, chest pain, and dysphagia if they compress adjacent structures [3,4,5] . Although pleural lipoma is benign tumor, it should be completely resected from diagnostic and therapeutic perspectives [6,7] .…”

Pleural lipoma: when to intervene

“…The potential size of lipomas leads to an extensive workup with unnecessary and invasive procedures by providers that lack awareness of such entities. Reports have been documented with lesions reaching 25 cm in size 3 and necessitating thoracic surgery for removal secondary to mass effect/ compression of surrounding anatomy. Our patient was followed with serial imaging studies, without biopsy, of a moderately sized, fatty mass on her CT imaging with no significant effect on her functional status.…”