Case Report - Giant Lipoma in the thigh managed in a rural Nigerian hospital and a rapid review of the literature

Abstract

Lipomas are located in any location in the body in which lipomatous tissue is located, the commonest site being in the subcutaneous area and more commonly in the trunk and neck. These are the commonest benign tumours of the mesenchyme and they are composed of mature lipocytes. The age affected is usually in the fifth or sixth decade of life. They are usually small in size, often less than 2cm. They are defined as giant lipoma's when they have a diameter longer than 10cm or a weight more than 1kg. They can be single or multiple – the multiple lipomas are more common in women. The symptoms of a lipoma are usually those of pressure, often related to giant lipomata and depend on the location in the body – pain, nerve compression and lymphoedema are common. Lipoma rarely become malignant, but this complication is more common in the giant variants.

Giant lipomas are uncommon, usually present in the upper part of the body and often require advanced imaging in the preop workup to aid in the detection of any malignant transformation.

This unusual case is reported because it is scarce in the Nigerian literature, occurred in the lower limb and the patient presented at a rural hospital, where advanced imaging was not available.

A 64-year-old man who had a giant lipoma in the left thigh measuring 30 x 20 x 18 cm, was successfully treated at a rural hospital in Southern Nigeria, without the benefit of advanced imaging. He had serial sections of the huge mass, none of which revealed any sarcomatous change. Furthermore, this report highlights the need for contextually relevant treatment algorithms regarding resource constraints and a pay-from-pocket structure of health care and thus also has a patient advocacy framework.