Intrathoracic fibrolipoma resected using complete thoracoscopic surgery: a case report

Abstract

BackgroundOther than adipocytes, lipomas may contain mesodermal components such as varying proportions of fibrous tissues and blood vessels. Fibrolipoma is an uncommon variant of lipoma and comprises a high proportion of fibrous components. An intrathoracic fibrolipoma is extremely rare; to the best of our knowledge, only three such cases have been reported till date.Case presentationA 51-year-old female presented with a left intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A pedunculated tumor originating from the parietal pleura was resected using complete thoracoscopic surgery. Pathological examination indicated a diagnosis of fibrolipoma. Intrathoracic fibrolipomas are extremely rare; this is one of the first reported cases of successfully resecting an intrathoracic fibrolipoma using complete thoracoscopic surgery.ConclusionsThe tumor was asymptomatic and relatively small when detected during a medical checkup. This enabled the successful resection of the tumor via complete thoracoscopic surgery. Although fibrolipomas are histologically benign, careful observation and follow-up are essential owing to the possibility of recurrence.

The largest reported intrathoracic lipoma: a case report and current perspectives review

“…Few cases have been reported worldwide. To our knowledge, this presented case is the fourth reported [1]. Herein we report a single case as very huge intrathoracic lipoma (25 × 20 × 10 cm) compressing the right lung up and displacing the diaphragm and liver down which has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome.…”

“…Since they were first described by Abbott and Webb in 1935 [2], Lipomas are classified as benign tumors that develop from adipose tissues at any site all over the body, they may contain mesodermal components other than adipocytes, including varying proportions of fibrous tissues and blood vessels [1]. It is the most frequent adult benign tumors (account for 20% of all benign soft-tissue tumors; though, fibro-lipomas are rare and only account for 0.03% of all) [1]. Intrathoracic lipoma may raise from the mediastinal fat covering the mediastinal pleura as in our case, or from the parietal pleura and its extension either intra- or extra-thoracic (i.e., Dumbbell-shaped lipoma) [3].…”

“…CT-scan with contrast enhancement deemed as an essential tool to clearly define the relation of the mass to the adjacent structures (exhibit attenuation of fat of approximately − 100 HU on CT images), in our case the plain CT was non-conclusive but with enhanced contrast there is clear plane of cleavage and with an adipose density. The CT scan allows the attenuation values of fat density to be assessed and help determine the origin and extension, as well as the involvement of adjacent organs [1].…”

“…Furthermore, MRI helps in distinction between lipomas and well-differentiated liposarcomas based on margins, signal homogeneity, and septa or nodules [8]. Positron Emission Tomography (PET) scanning may also be an objective and useful modality for preoperatively evaluating tumors involving adipose tissue [1].…”

“…This can potentially avoid needless invasive investigations and alleviate patient anxiety [9]. CT scanning is a very helpful tool in clinical diagnosis, but surgical resection, with thoracotomy or VATS, remains a valuable procedure for establishing a firm diagnosis and complete excision [1, 10], some advocate the needle biopsy if the radiological diagnosis is not clear. Liposarcomas of the pleura are very rare tumors diagnosed mainly via CT-scans with lipomas being the main differential diagnosis.…”