PMC7758652_01
(a), (b) and (c) clinical appearance of left lateral chest wall giant lipoma, (d) pre operative chest radiography, (e) intra operative image of the giant lipoma, and (f) post operative chest radiography.
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The giant ellipsoidal non tender well demarcated swelling, having soft to firm in consistency with slight mobility was located on the left lateral thoracoabdominal wall extending superiorly from the left axilla to left upper half of lateral abdominal wall inferiorly, posteriorly 2 cm off the spine and extending anteriorly to anterior axillary line (Figure 1(a) and (b)). Chest X-ray showed ground glass opacity over left thoracoabdominal wall (Figure 1(c)); ultrasonogrpahy showed ill defined heteroechoic mass in left lateral thoraco abdominal wall in the subcutaneous plane 21 cm x 18 cm x 16 cm without any internal vascularity, calcification or necrosis. Computer enhanced chest tomography revealed a well encapsulated giant lipoma with multiple septations without calcifications, necrosis or rib/intra pleural extension over the left lateral thoracoabdominal wall, having an average of 165.87 Hounsfield units (HU) with an area occupying an average area of 108.17 sqcm (Figure 2(g) and (h); Figure 1(d)). Intra operatively the mass was located below the muscular plane, just above the rib cage not infiltrating into the ribs, intercostals muscles or pleura; could be easily excised along with its capsule intact uneventfully (Figure 1(e)). Mass weighted 1.5 kg with histology showing mature adipocytes without nuclear atypia arranged in lobules separated by fibrous septa (Figure 1(f)).
(g) and (h) CECT Chest- (g) axial section and (h) coronal section, showing well encapsulated giant lipoma with multiple septations without calcifications/necrosis or rib / intra pleural extension; on left lateral chest wall, (i) and (j): Histo pathological images, (i) low power field (10 X) showing mature adipocytes separated by fibrous tissue septae containing capillaries and inflammatory cells, and (j) high power field (40 X)-showing mature white adipocytes with flattened eccentric nuclei with thinned out cytoplasm.
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Computer enhanced chest tomography revealed a well encapsulated giant lipoma with multiple septations without calcifications, necrosis or rib/intra pleural extension over the left lateral thoracoabdominal wall, having an average of 165.87 Hounsfield units (HU) with an area occupying an average area of 108.17 sqcm (Figure 2(g) and (h); Figure 1(d)).