Giant Lipoma in the Lateral Neck Causing Internal Jugular Vein Deformity

J. Choi, Sang Seong Oh, Kwang Seog Kim, J. Hwang, Sam-Yong Lee
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Abstract

Lipoma is one of the most common benign soft tissue tumors. However, giant lipomas compressing and deforming the neurovascular structure rarely occur in the lateral neck. A 70-year-old man visited our outpatient clinic for treatment of a visible painless neck mass that had been identified 2 years prior. Neck magnetic resonance imaging revealed that a 10 × 9 × 4 cm fatty mass located between the sternocleidomastoid and sternohyoid muscles invaded the carotid sheath. Under general anesthesia, the mass was excised without damage to the adjacent neurovascular structures. Upon histopathological examination, the mass was identified as a lipoma. During the surgery, enlargement of the internal jugular vein was observed under the resected mass. However, on ultrasound examination, the function of the internal jugular vein was evaluated as good. No recurrence or neurological and vascular complications were reported during a 6-month follow-up after the surgery. As a giant lipoma located in the deep layer of the lateral neck can deform important cervical structures, its impact on the surrounding structures should be carefully assessed preoperatively to minimize the rate of possible complications.
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颈外侧巨大脂肪瘤引起颈内静脉畸形
脂肪瘤是最常见的良性软组织肿瘤之一。然而,压迫和变形神经血管结构的巨大脂肪瘤很少发生在侧颈。一名70岁男子因2年前发现的可见无痛颈部肿块而到我们门诊就诊。颈部磁共振成像显示位于胸锁乳突肌和胸舌骨肌之间的一个10 × 9 × 4 cm的脂肪团侵入颈动脉鞘。在全身麻醉下切除肿块,未损伤邻近的神经血管结构。经组织病理学检查,肿块被确定为脂肪瘤。手术中,在切除的肿块下观察到颈内静脉肿大。但经超声检查,颈内静脉功能良好。术后6个月随访无复发或神经及血管并发症。由于位于颈部外侧深层的巨大脂肪瘤可使颈部重要结构变形,术前应仔细评估其对周围结构的影响,以尽量减少可能的并发症发生率。
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