%0 Journal Article
%T A Massive Posterior Neck Mass: Lipoma or Something More Sinister?
%A Matthew F. Ryan
%A Brandon Allen
%J Case Reports in Emergency Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/205936
%X Lipomas are slow-growing benign soft-tissue tumors which are typically asymptomatic and occur in approximately 1% of the population. A lipoma is considered to be of excessive size when it is greater than 10£¿cm in length (in any dimension) or weighs over 1000£¿g (Kransdorf (1995)). We describe a case of a man presenting with a giant posterior neck mass which greatly reduced the sagittal range of cervical spine. A discussion of the pathophysiology of lipomas and a literature review regarding giant lipomas versus malignancy follows. 1. Introduction Lipomas are slow-growing benign soft-tissue tumors which are typically asymptomatic and occur in approximately 1% of the population [1]. Lipomas are often small and solitary lesions and can grow in any area of the body where adipose tissue is present. Whereas the majority of lipomas grow on the extremities and trunk, only 13% are reported to form on the neck and the head [2]. The tissue in a lipoma is mature typically adipose which often forms in a septated lobules encased in fibrous connective tissue. A lipoma is considered to be of excessive size when it is greater than 10£¿cm in length (in any dimension) or weighs over 1000£¿g [3]. We describe a case of a man presenting with a giant posterior neck mass which greatly reduced the sagittal range of cervical spine. A discussion of the pathophysiology of lipomas and a review of the literature regarding giant lipomas versus malignancy follows. 2. Case A 32-year-old man presents to the emergency department with the chief complaint of pain and discomfort caused by a large posterior neck mass. The patient states that he noticed the mass for a few months and now it has grown to the point where he can no longer fully extend his neck. He has constant midline neck pain, headaches, and parasthesias in his fingers bilaterally which began approximately one week prior to presentation. The size of the lipoma inhibited the patient¡¯s ability to look directly up without turning his head sideward. The patient¡¯s pain, decreased range of motion, and parasthesias have gradually worsened to the point where his symptoms are aggravated by any movement of his head or neck. He denies trauma or recent injuries and insists that he had not noticed any other symptoms until he ¡°slept funny¡± about two months ago. The patient also denies fevers or constitutional symptoms and reports no other neurological deficits other than parasthesias. Physical exam reveals a well-developed (BMI = 27), well-appearing man who looks his stated age. His heart rate, blood pressure, and respiratory rate are within
%U http://www.hindawi.com/journals/criem/2013/205936/