Sunday, January 29, 2017

A Lipoma On The Chest Wall

A 54 years old male presents with a history of a large painless chest wall swelling on right side, which is there for the last seven years and has gradually increased in size. It was soft in consistency and non-adherent to the underlying ribs.

                                                 the swelling as seen from the back. 

An X ray chest was done which is shown below:

Chest X-ray shows a homogeneous soft tissue mass lesion without any calcification arising from the right lateral chest wall. The underlying ribs are normal; they show no erosion or pressure effect.

Diagnosis: History, clinical finding and X-ray chest are suggestive of lipoma.

Discussion: Ideally, CT is important as it provides a definitive diagnosis of lipoma but the patient
failed to report back after chest X-ray. Most chest wall lipomas that originate are superficial, in this case arising from right posterolateral chest wall
 On CT and MRI lipomas appear homogeneous and show no contrast enhancement, it may have multiple thin septa which may enhance on contrast CT and have low signal intensity on fat-suppressed T1-weighted MR images. Spindle cell lipoma is a rare, painless, and slow-growing
neoplasm in which mature fat cells are replaced by collagen-forming spindle cells.

Lipomas are well-defined encapsulated mass lesions made up of adipocytes very similar to normal fatty tissue generally seen between 50–70 years of age. Lipomas that originate in the chest wall may be superficial or deep extending into the chest.
In chest, lipoma may be seen in the mediastinum though very uncommon. Then there are cardiac lipomas, they are the second most common benign cardiac tumors, their origin can either be epicardial, endomyocardial or subendocardial in location, most common in relation to left ventricle and right atrium.

1 comment:

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