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Giant lipoma of the back affecting quality of life.

Guler O, Mutlu S, Mahirogulları M - Ann Med Surg (Lond) (2015)

Bottom Line: Postoperative early phase complications did not occur.Cosmetic and functional results of the surgery and patient satisfaction were excellent.After surgery patient's quality of life was improved and restriction of body function was disappeared.

View Article: PubMed Central - PubMed

Affiliation: Orthopedics and Traumatology Department, Medipol University, Medical Faculty, Istanbul, Turkey.

ABSTRACT
Lipomas are benign tumours composed of adipose tissue. They may be localized in almost all body parts and may be in a giant form. Some of these giant lipomas may transform malignity and cause problems in daily living and detoriate quality of life. Mass localization also restrict body functions. In the present study, a 72-year-old man who presented with a mass enlarged in a time period of two years and because of this could not lie in the supine position, sit in an erect position and dress easily, go outside because of his physical appearance. With surgical treatment a 38 × 22 × 21 cm mass weighing 3575 g was successfully resected. Postoperative early phase complications did not occur. During 48 months of postoperative period, any recurrence was not detected and the patient was free of all his complaints. Cosmetic and functional results of the surgery and patient satisfaction were excellent. After surgery patient's quality of life was improved and restriction of body function was disappeared.

No MeSH data available.


Related in: MedlinePlus

Excised specimen. Weight, 3575 g; size, 38 × 22 × 21 cm.
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fig2: Excised specimen. Weight, 3575 g; size, 38 × 22 × 21 cm.

Mentions: A 72-year-old man presented with a complaint of a gibbosity that prevented him from lying in the supine position, caused difficulty while sitting in an erect position and dressing, and led to avoidance of going outside because of his physical appearance. He had been aware of the lipoma for 10 years; however, the lesion had enlarged rapidly over a period of 2 years. Our patient had no relevant family history, systemic disease, or specific predisposing factors. A physical examination revealed a mobile mass with distinct contours and thickened skin overlying its apex; it was localised exclusively in the mid-thoracic region, but extended from the cervical region to the upper lumbar region (Fig. 1a). No deficits were detection on neurological examination. The patient's body mass index was 29.4 kg/m2 (height: 170 cm, weight: 85 kg). Ultrasound (US) examination revealed a lipoma-like mass that measured 34 × 20 × 17 cm and was sharply contoured, homogenous, and isoechoic with subcutaneous fat tissue and that possibly contained fat necrosis related to two calcifications (3 and 2 cm in size, respectively). Magnetic resonance imaging (MRI) confirmed that the mass was 34 × 20 × 17 cm in size, hyperintense on T2-weighted (T2W) and T1W transmissible spongiform encephalopathy (TSE) images, hypointense on fat-saturated TSE images, and exhibited no contrast enhancement on T1W TSE images after intravenous (IV) contrast infusion. The mass also had a signal characterisation similar to the subcutaneous fat tissue and necrotic fat tissue related to the two calcifications (3 × 3 cm and 2 × 2 cm in size, hypointense on T1W and T2W TSE images, and without contrast enhancement after IV contrast infusion). It was a fibrous septated structure with no evidence of malignant transformation or paravertebral intramuscular expansion and was detected at the posterior of the left hemithorax between T1 and T12 (Fig. 1b). The preoperative diagnosis was a lipoma. The patient was prepared for surgery while in the prone position. The patient did not receive local anaesthesia. A fusiform incision that circumscribed the overlying thickened skin and continued longitudinally to the terminal ends was performed. The neoplastic mass and its overlying thickened skin were excised totally from posterior of thoracolumbar area by using surgical blade for skin incision and monopolar electrocautery for mass excision with haemostasis control. A Hemovac drain was inserted at the end of surgery. The patient was mobilised on the first postoperative day. For postoperative analgesia, the patient received acetaminophen (1000 mg every 8 h as an IV infusion) and diclofenac sodium (75 mg every 12 h as an intramuscular injection). The Hemovac drain was removed 24 h postoperatively, and the contents measured 320 ml. One unit of erythrocyte suspension was infused postoperatively. No haematomas, incision complications, infection, or neurological complications were detected postoperatively. The patient was discharged on postoperative day 2. A specimen was sent for histopathological examination, and the results indicated a lipoma weighing 3575 g and measuring 38 × 22 × 21 cm (Fig. 2). At the final follow-up (48 months after treatment), the patient was found to be free from all complaints and very satisfied. He was able to lie in the supine position, sit in an upright position, and dress himself without difficulty, and he was satisfied with his appearance because of the resolution of the gibbosity (Fig. 3). He answered, “yes” to the question: Would you like to receive the same treatment again for this problem?


Giant lipoma of the back affecting quality of life.

Guler O, Mutlu S, Mahirogulları M - Ann Med Surg (Lond) (2015)

Excised specimen. Weight, 3575 g; size, 38 × 22 × 21 cm.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556780&req=5

fig2: Excised specimen. Weight, 3575 g; size, 38 × 22 × 21 cm.
Mentions: A 72-year-old man presented with a complaint of a gibbosity that prevented him from lying in the supine position, caused difficulty while sitting in an erect position and dressing, and led to avoidance of going outside because of his physical appearance. He had been aware of the lipoma for 10 years; however, the lesion had enlarged rapidly over a period of 2 years. Our patient had no relevant family history, systemic disease, or specific predisposing factors. A physical examination revealed a mobile mass with distinct contours and thickened skin overlying its apex; it was localised exclusively in the mid-thoracic region, but extended from the cervical region to the upper lumbar region (Fig. 1a). No deficits were detection on neurological examination. The patient's body mass index was 29.4 kg/m2 (height: 170 cm, weight: 85 kg). Ultrasound (US) examination revealed a lipoma-like mass that measured 34 × 20 × 17 cm and was sharply contoured, homogenous, and isoechoic with subcutaneous fat tissue and that possibly contained fat necrosis related to two calcifications (3 and 2 cm in size, respectively). Magnetic resonance imaging (MRI) confirmed that the mass was 34 × 20 × 17 cm in size, hyperintense on T2-weighted (T2W) and T1W transmissible spongiform encephalopathy (TSE) images, hypointense on fat-saturated TSE images, and exhibited no contrast enhancement on T1W TSE images after intravenous (IV) contrast infusion. The mass also had a signal characterisation similar to the subcutaneous fat tissue and necrotic fat tissue related to the two calcifications (3 × 3 cm and 2 × 2 cm in size, hypointense on T1W and T2W TSE images, and without contrast enhancement after IV contrast infusion). It was a fibrous septated structure with no evidence of malignant transformation or paravertebral intramuscular expansion and was detected at the posterior of the left hemithorax between T1 and T12 (Fig. 1b). The preoperative diagnosis was a lipoma. The patient was prepared for surgery while in the prone position. The patient did not receive local anaesthesia. A fusiform incision that circumscribed the overlying thickened skin and continued longitudinally to the terminal ends was performed. The neoplastic mass and its overlying thickened skin were excised totally from posterior of thoracolumbar area by using surgical blade for skin incision and monopolar electrocautery for mass excision with haemostasis control. A Hemovac drain was inserted at the end of surgery. The patient was mobilised on the first postoperative day. For postoperative analgesia, the patient received acetaminophen (1000 mg every 8 h as an IV infusion) and diclofenac sodium (75 mg every 12 h as an intramuscular injection). The Hemovac drain was removed 24 h postoperatively, and the contents measured 320 ml. One unit of erythrocyte suspension was infused postoperatively. No haematomas, incision complications, infection, or neurological complications were detected postoperatively. The patient was discharged on postoperative day 2. A specimen was sent for histopathological examination, and the results indicated a lipoma weighing 3575 g and measuring 38 × 22 × 21 cm (Fig. 2). At the final follow-up (48 months after treatment), the patient was found to be free from all complaints and very satisfied. He was able to lie in the supine position, sit in an upright position, and dress himself without difficulty, and he was satisfied with his appearance because of the resolution of the gibbosity (Fig. 3). He answered, “yes” to the question: Would you like to receive the same treatment again for this problem?

Bottom Line: Postoperative early phase complications did not occur.Cosmetic and functional results of the surgery and patient satisfaction were excellent.After surgery patient's quality of life was improved and restriction of body function was disappeared.

View Article: PubMed Central - PubMed

Affiliation: Orthopedics and Traumatology Department, Medipol University, Medical Faculty, Istanbul, Turkey.

ABSTRACT
Lipomas are benign tumours composed of adipose tissue. They may be localized in almost all body parts and may be in a giant form. Some of these giant lipomas may transform malignity and cause problems in daily living and detoriate quality of life. Mass localization also restrict body functions. In the present study, a 72-year-old man who presented with a mass enlarged in a time period of two years and because of this could not lie in the supine position, sit in an erect position and dress easily, go outside because of his physical appearance. With surgical treatment a 38 × 22 × 21 cm mass weighing 3575 g was successfully resected. Postoperative early phase complications did not occur. During 48 months of postoperative period, any recurrence was not detected and the patient was free of all his complaints. Cosmetic and functional results of the surgery and patient satisfaction were excellent. After surgery patient's quality of life was improved and restriction of body function was disappeared.

No MeSH data available.


Related in: MedlinePlus