An unusual case of lipoma attached to the frontalis muscle

Frontalis associated intramuscular lipoma: a case report

“…The term "frontalis-associated lipoma" was coined by Zitelley and Salasche et al in the year 1989. 5 They typically present as a smooth asymptomatic dome shaped nodule arising on the forehead with normal overlying skin. Due to their location these lipomas are less mobile and firmer than lipomas at other sites.…”

“…They may arise in one of four locations: within the frontalis muscle, between the frontalis muscle and the deep investing fascia, in loose areolar tissue between the deep investing fascia of the frontalis muscle and the periosteum also called as "subgaleal lipomas," and/or beneath the periosteum. 5,6 A clinical examination is usually sufficient to diagnose a frontalis associated lipoma however ultrasonography, computed tomography and magnetic resonance imaging have a role in diagnosis. 4 Histopathologically, intramuscular lipoma can be of two types, wellcircumscribed and infiltrative types.…”

“…Circumscribed type shows presence of fibrous capsule and composed of mature adipocytes similar to superficial lipoma as in our case, whereas infiltrative lipoma is associated with muscle atrophy and degenerative changes. 4,5 Surgical removal is considered to be the tried and tested method of treatment with a transverse, forehead crease incision most commonly being done under local anaesthesia. Alternative techniques for removal of frontalis associated lipomas include liposuction, removal using distant forehead incisions using endoscope or blind removal using a surgical raspatory.…”