A Case of Giant Anterior Neck Lipoma

—Preoperative Diagnosis Using CT Values—

Abstract

Lipomas are benign, slow-growing tumors of the head and neck that usually cause few symptoms. When lipomas gradually increase in size, it is sometimes difficult to distinguish them from liposarcomas, which are malignant tumors.

We report the case of a 72-year-old female patient with a giant lipoma arising from the anterior neck. Computed tomography (CT) showed a 13.9 × 4.6 × 10.3 cm giant mass in the anterior neck. Fine-needle aspiration performed under ultrasound guidance, showed no evidence of malignancy, suggesting that the tumor was a benign lipoma. Preoperative CT images were transferred to the Synapse Vincent volume analyzer to measure the tumor volume and CT values: the tumor volume was 496 mL and the mean radiodensity of the tumor was －58 HU (standard deviation, 27 HU); these values lent support to the diagnosis of a benign lipoma. The tumor was surgically removed without any intraoperative complications and the tumor weight was 481 g. After extubation in the operating room, the patient was admitted to the intensive care unit for safe airway management. The postoperative course was uneventful, and the final pathological diagnosis was lipoma. There was no evidence of recurrence at the 3-month follow-up. Herein, we present a case of a giant lipoma of the anterior neck in which measurement of the tumor radiodensity in Hounsfield units (HU) on CT was useful for the diagnosis.