Extraluminal lipoma with common femoral vein obstruction: A cause of chronic venous insufficiency

Abstract

A 49-year-old man, with a misdiagnosis of common femoral vein deep vein thrombosis presented with advanced chronic venous insufficiency. Further imaging revealed a patent common femoral vein with augmentation that was compressed by an extrinsic mass. Exploration identified a lipoma that was extravascular and was resulting in venous outflow obstruction. Excision of the lipoma resulted in clinical improvement and ulcer healing.

Giant lipoma of the face and neck – a case report

“…Clinical manifestations depend on the location of the tumor [9], sometimes tumors imitate neoplasms or post-traumatic lesions [7]. In the case of mediastinal lipomas, the most common are dyspnoea, cough, hoarseness, dysphagia, haemoptysis [12], in the lipoma of the face and neck there might be dyspnoea, hoarseness, dysphagia, cervical spondylitis and restriction of neck movement, as found in the presented patient. Often lipomas identical with those described in the case study do not give any symptoms but cause discomfort.…”

Common femoral vein canal lipoma causing chronic unilateral lower limb swelling

“…Prior to this investigation, pelvic ultrasound and CT of chest and abdomen and other investigations to rule out malignancy had failed to provide a diagnosis. In Gasparis et al 's case,10 the patient had previously been misdiagnosed as having DVT due to the mass having an echolucent appearance similar to acute thrombus on duplex scan. The diagnosis was eventually made on CT venogram that showed a lesion with cystic characteristics anterior to the CFV causing venous outflow obstruction.…”

Lipoma of the fossa femoralis mimicking a femoral hernia. Report of 2 cases

“…Its “benign” behaviour becomes fickle and insidious when localized in critical areas such as inguinal canal, femoral triangle or popliteal region [ 3 , 16 ]. In these anatomical minefields, lipoma can mimic hernias, cause venous insufficiency and may mislead the clinician from a correct diagnosis [ 4 , 5 , 8 , 18 ].…”

“…Frequently asymptomatic, lipoma may show a specific misleading symptoms hiding a correct preoperative diagnosis. Generally, its excision is required for cosmetic reasons, for the exclusion of malignancy, and for compression on adjacent organs or structures [ 4 , 5 ]. Further indications for excision include size (greater than 5 cm), subfascial location, rapid growth, clinical features such as pain, firmness, or irregularity [ 6 ].…”