Aurora Muca1, Klarisa Prenga*1, Irda Rrugeja2, Mishel Qirinxhi1, Ridvan Alimehmeti1.
1Department of Neurosurgery, University Hospital Center “Mother Teresa”, Tirana, Albania,
2Department of Anatomical Pathology, University Hospital Center “Mother Teresa”, Tirana, Albania,
*Corresponding author:
Klarisa Prenga, Neurosurgery resident; Department of Neurosurgery, University Hospital Center “Mother Teresa”, Tirana, Albania; E-mail: [email protected], address – Kongresi i Manastirit, Tirana, Albania ZIP 1007.
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Abstract
Background: Intramuscular lipoma is an uncommon fatty tumor reported in up to 1.8% of all primary tumors of adipose tissue. It can occur at any age and is often found in the large muscles of the arms, legs and trunk. They have a slow growth and usually are asymptomatic. However, pain, paresthesia and decreased range of motion of the affected muscle have been reported.
Case Presentation: A 30-year-old male with a giant mass in the left thigh for 15 years, that had grown rapidly for the past 5 years. He complained of pain and a burning sensation when pressure was applied on the mass. MRI revealed an intra-intermuscular lipoma measuring: 31.6 x 10.3 x 11.6 cm.
Intervention: The patient underwent surgery. A giant a giant, yellow, intramuscular, lobulated mass was exposed. The mass was attached to the vastus lateralis muscle and originated from the periosteal layer of the trochanter. Dissection and cauterization of the capsule were carefully performed in order to prevent recurrences. Total resection of the mass was achieved.
Outcome: The postoperative course was uneventful. Full range of motion in both the hip and knee joints was preserved. The patient remains under continuous follow-up.
Conclusion: Intramuscular lipomas are deep-seated lesions that may resemble well-differentiated liposarcomas. Surgical excision is the treatment of choice in symptomatic patients and is also indicated for cosmetic reasons, particularly for giant lipomas. When sensory peripheral nerves are incorporated within the mass, nerve coagulation with intramuscular rerouting can be performed.
Keywords: Giant intramuscular lipoma, liposarcoma, vastus lateralis, FCLN incarceration.