Approach and management of a giant lipoma in the left lumbar region

INTRODUCTION: Lipomas are the most common benign tumors of the adipose tissue and can be located in any region of the body. In most cases lipomas are small and asymptomatic, but they can at times reach considerable dimensions and, depending on their anatomic site, hinder movements, get inflamed, cause lymphedema, pain and/or a compression syndrome. PRESENTATION OF CASE: We here report the case of an otherwise healthy patient who came to our observation with a giant bulk in the left lumbar region which had been showing progressive growth in the previous 5–6 years. Physical examination, ultrasound and MRI were carried out in order to characterize the size, vascularization and limits of the lesion. Due to the pain and restriction of movement that this bulky lesion caused, surgical excision of the lesion was performed. DISCUSSION: Giant lipomas display an important differential diagnosis problem with malignant neoplasms, especially liposarcomas, with which they share many features; often the final diagnosis rests on histological evaluation. We here discuss the diagnostic problems that arise with a giant lipoma and all the possible approaches concerning treatment of such a big lesion, explaining the reasons of our approach and management of a common tumor in our case presenting unusual dimensions and location. CONCLUSION: Our approach revealed to be successful in order to nurse our patient's pain, restore the mobility and address the aesthetic issues that this lesion caused. Postoperative checkups were carried out for one year and no signs of relapse have been reported.