Lipoma of the breast: a diagnostic dilemma

Giant breast lipoma: A case report

INTRODUCTION

Lipoma is the most common benign tumor of adipose tissue. Giant lipoma of the breast is defined as lesions larger than 10 cm and weighing more than 1000 g. A breast lipoma rapidly enlarging and fast growing; can be managed as a malignant tumor. It is crucial to make a correct diagnosis to prevent an overtreatment.

CASE PRESENTATION

A 48-year-old patient presented with a painless, huge rapidly growing tumor in her right breast. Physical examination and imaging studies was suggestive of benign lipomatous breast tumor: A breast lipoma, a fibroadenolipoma or adenolipoma, an angiolipoma, or a breast fatty hamartoma. The patient underwent surgical excision of the mass, and histological examination confirmed the diagnosis of a giant breast lipoma.

DISCUSSION

Giant breast lipoma is a rare benign tumor that develops in the breast tissue. They can mimic various breast conditions, even neoplastic conditions. Giant breast lipomas are often treated with surgical excision to avoid recurrence.

CONCLUSION

Giant breast lipoma rapidly growing can pose a diagnostic challenge due to its resemblance to various benign or malignant pathologies. Unnecessary invasive investigations can be avoided with better understanding and improved imaging-based diagnosis of giant breast lipoma.

A 5 kg giant breast lipoma in a 40-year-old woman: a case report

Introduction and importance

Lipomas are benign tumours composed of adipocytes surrounded by a thin fibrous capsule. Although they make up 16% of mesenchymal tumours, the occurrence of breast lipomas is uncertain. Giant lipomas, measuring 10 cm or more in diameter or weighing at least 1000 g, commonly occur in the upper back, neck, and thigh, and are rare in the breast. Given its rarity, accurately diagnosing a giant breast lipoma is crucial to prevent potential overtreatment, as it might otherwise be mistaken for a malignant tumour.

Case presentation

A 40-year-old woman presented with a painless, gradually enlarging left breast mass. Physical examination and imaging studies revealed a lipoma-compatible mass. Surgery was performed, and the 5 kg mass was enucleated and identified as a lipoma on histopathology. The patient had an uneventful postoperative recovery and was satisfied with the outcome of the surgery after 2 months of follow-up.

Clinical discussion

Breast lipomas are more common in the 40-60 years age group, with giant lipomas occurring more frequently in the latter half of this age range. They can mimic various breast conditions, including neoplastic and non-neoplastic conditions, and are often treated with surgical excision to avoid recurrence. The location of the lipoma in the breast can be subcutaneous or intramuscular, and preserving the future pedicle of reduction mammoplasty/mastopexy is essential.

Conclusion

Giant breast lipoma is an infrequent condition that can manifests as progressive enlargement of the breast, posing a diagnostic challenge due to its resemblance to various benign or malignant pathologies.

Wisepatern mastopexy for natural breast ptosis symmetrization after giant lipoma excision: Case report

INTRODUCTION AND IMPORTANCE

Giant breast lipoma is an uncommon benign tumor that develops in the breast parenchyma. Wisepatern technique involves lifting the skin in both vertical and horizontal directions to raise and reshape the breasts into a less ptotic shape.

CASE PRESENTATION

A 40-year-old woman came to the Surgical Oncology Polyclinic with the breast size is asymmetric, the right is 4× larger than the left. The patient's request for a tumor removal procedure with a symmetrical approach on the right breast alone, we opted for a Wisepatern surgical technique. Residual skin tissue was discovered and de-epithelialization was performed to remove it, but it was not discarded and instead inserted into the breast cavity to create the effect of a mass filling empty areas left after tumor removal.

CLINICAL DISCUSSION

The Wisepatern technique is highly preferred due to its versatility, ease of execution, and ability to achieve consistent outcomes in mastopexy and breast reductions. It effectively addresses excess skin, avoids large dog-ears and longer scars, and allows for a more natural-looking appearance by utilizing a shortened vertical scar and partial subpectoral pocket for implant positioning.

CONCLUSION

Mastopexy is a surgical procedure that can effectively treat giant breast lipoma by removing the lipoma and reshaping the breast tissue. However, it is important for patients to be fully informed about the risks and benefits of the procedure and to undergo appropriate follow-up to ensure a successful outcome.

Mesenchymal Tumors of the Breast: Fibroblastic/Myofibroblastic Lesions and Other Lesions

Mesenchymal breast tumors are a rare and diverse group of tumors that present some of the most challenging cases for multidisciplinary breast cancer teams. As a result of overlapping morphologies and a lack of large-scale studies on these tumors, practices are often heterogeneous and slow to evolve. Herein, we present a non-systematic review that focuses on progress, or lack thereof, in the field of mesenchymal breast tumors. We focus on tumors originating from fibroblastic/myofibroblastic cells and tumors originating from less common cellular origins (smooth muscle, neural tissue, adipose tissue, vascular tissue, etc.).

Giant Breast Lipoma: A Case Report

Lipomas are slow-growing, benign mesenchymal masses. Most lipomas are small, weighing only a few grams; however, if their size becomes exceptionally large, they are called giant lipomas. Giant lipoma of the breast is infrequently observed due to the rarity of size and location, with very few case reports available in the literature. Here, we report the case of a 48-year-old female patient who presented with a painless, huge lump in her right breast. The patient underwent surgical removal of the mass with a histologic examination confirming the diagnosis of a giant breast lipoma.

Benign Breast Diseases: Evaluation and Management

Benign breast disease is a spectrum of common disorders. The majority of patients with a clinical breast lesion will have benign process. Management involves symptom control when present, pathologic-based and imaging-based evaluation to distinguish from a malignant process, and counseling for patients that have an increased breast cancer risk due to the benign disorder.

Gigantomastia due to retromammary lipoma: An aesthetic management

INTRODUCTION

A "giant" lipoma is defined as a tumor having dimensions greater than 10 cm. Giant lipomas are rare and giant breast lipomas are exceptionally uncommon. Only six cases have been described in world literature till date. Herein we describe a case of giant breast lipoma and discuss its surgical management.

CASE REPORT

A 43-year-old lady presented with left sided unilateral gigantomastia. Clinical examination, radiology and histopathology diagnosed lipoma. Excision of the tumor was planned, together with correction of the breast deformity by reduction mammoplasty using McKissok technique. A tumor measuring 19 cm × 16 cm × 10 cm and weighing 1647 grams was removed. The nipple areola complex was set by infolding of the vertical pedicles and the lateral and medial flaps were approximated to create the final breast contour. The patient is doing well on follow up.

DISCUSSION

Giant lipomas are rare and of them, giant breast lipomas are extremely uncommon. They can grow to immense proportions and cause significant aesthetic and functional problems. The treatment is excision. But reconstruction of the breast is almost always necessary to achieve a symmetric breast in terms of volume, shape, projection and nipple areola complex symmetry compared to the normal opposite breast. Few authors have used various mammoplasty techniques for reconstruction of the breast after giant lipoma excision. Our case has the following unique features: (i) It is the third largest breast lipoma described in the literature till date, weighing 1647 grams; (ii) The Mckissock technique has been used for parenchymal reshaping which has not been previously described for giant breast lipoma.

CONCLUSION

This case demonstrates that reduction mammoplasty after giant lipoma removal is highly rewarding, resulting in a smaller-sized breast that is aesthetically more pleasing, has better symmetry with the contralateral breast, and provides relief from functional mass deficit.

[Rare benign breast tumors including Abrikossoff tumor (granular cell tumor), erosive adenomatosis of the nipple, cytosteatonecrosis, fibromatosis (desmoid tumor), galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma: Guidelines for clinical practice]

OBJECTIVES

To provide guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF), based on the best evidence available, concerning rare benign breast tumors: Abrikossoff (granular cell tumor), erosive adenomatosis of the nipple, cytosteatonecrosis, fibromatosis (desmoid tumor), galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma.

METHODS

Bibliographical search in French and English languages by consultation of Pubmed, Cochrane and international databases.

RESULTS

For erosive adenomatosis of the nipple, surgical excision is recommended to exclude Paget's disease or cancer (grade C). When surgery is performed for breast desmoid tumor or syringomatous adenoma, free margins are recommended (grade C). Without clinico-radio-histologic discordance, surgical abstention may be proposed for Abrikossoff tumor (granular cell tumor), cytosteatonecrosis, galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma (grade C).

Systemic granulomatous diseases associated with multiple palpable masses that may involve the breast: case presentation and an approach to the differential diagnosis

Palpable mass is a common complaint presented to the breast surgeon. It is very uncommon for patients to report breast mass associated with palpable masses in other superficial structures. When these masses are related to systemic granulomatous diseases, the diagnosis and initiation of specific therapy can be challenging. The purpose of this paper is to report a case initially assessed by the breast surgeon and ultimately diagnosed as granulomatous variant of T-cell lymphoma, and discuss the main systemic granulomatous diseases associated with palpable masses involving the breast.

Breast lesions with high signal intensity on T1-weighted MR images

Magnetic resonance imaging of the breast supplies much information concerning the signal characteristics of a lesion. Among these, high signal intensity on non-fat saturated T1-weighted imaging (WI) is a special finding. Such a finding may result from different causes, such as a paramagnetic substance or fatty, bloody or proteinaceous content. In this article, we present hyperintense breast lesions on T1-WI.

Giant lipoma of the breast

Lipomas are benign mesenchymal tumors that develop in areas of abundant adipose tissue. Due to the fatty composition of the breast, difficulties in diagnosis, treatment, and reconstruction are often encountered. We report a case of a 55-year-old female with a giant tumor of the right breast that comprised most of its mass, causing breast asymmetry. A thorough preoperative evaluation, followed by an uneventful difficult surgical resection and reconstruction, resulted in diagnosis of a benign lipoma. The case prompted this report because of its challenging size, location, diagnosis, and reconstructive solution.

Breast reshaping with dermaglandular flaps after giant lipoma removal: versatility of oncoplastic techniques

Lipomas of the breast are benign lesions that do not raise great interest in the literature and their incidence is unclear. They usually are small, benign soft tissue tumors of fat cells that can be treated by simple excision. Although lipoma is a banal condition, it often causes diagnostic and therapeutic uncertainty. The first reason for this is the normal fatty composition of the breast. Second, it may be difficult to distinguish a lipoma from other benign or malignant lumps. This report presents a rare case involving giant lipoma of the breast that compromised most of the mass of the breast. After resection, the remaining breast was reshaped using multiple dermaglandular flaps to restore the breast mound, and contralateral breast mammaplasty was performed for symmetry. This case is a good illustration of the oncoplastic reconstruction options available after wide local excision.

Use of the oncoplastic reduction pattern technique following removal of a giant breast lipoma

We present a case report of a 59-year-old patient with a giant lipoma of the left breast, extending to the left arm. She sought medical consultation because it had become heavy and caused pronounced breast asymmetry. The lesion was excised by means of an oncoplastic technique using the superior-medial pedicle wise-pattern breast reduction approach. We concluded that the use of the oncoplastic reduction pattern technique after removal of a giant breast lipoma is highly rewarding, resulting in a smaller-sized breast that is aesthetically more pleasing, has better symmetry with the contralateral breast, and provides relief from functional mass deficit. This technique minimizes the potential for a breast deformity once the tumor is resected.

Angiolipoma of the Female Breast: Clinicomorphological Correlation of 52 Cases

The authors analyzed 52 cases of female breast angiolipoma (AL). Age distribution was 25 to 80 years of age (56.81 ± 12.78). Most cases showed vascularity below 50%, and 14 cases had vascularity >50%. Cellular and low-vascularity ALs had different clinical and radiological presentations. The mean size was 7.00 ± 3.62 mm for cellular ALs and 19.61 ± 7.58 mm for low-vascularity ALs. In any paucicellular area, the authors could identify a cluster of at least 3 interconnected vessels. The endothelium was mostly flat with uniform, hyperchromatic nuclei, and mitoses and nucleoli were absent. Fibrin thrombi in proliferating capillaries were noted in 96% of cases. Low-vascularity AL can be reliably distinguished on needle core biopsy from other lipomatous and vascular tumors of the breast. Tortuosity and proliferation of capillaries with at least 3 interconnected capillary channels in 1 focus with associated fibrin thrombi constitute a very strong clue for the diagnosis of AL on a breast needle core biopsy. Definite diagnosis of cellular AL is not always feasible because of rare cases with mitotic activity and cellular atypia. Excision is often recommended for cellular AL.

Benign breast diseases: classification, diagnosis, and management

Benign breast diseases constitute a heterogeneous group of lesions including developmental abnormalities, inflammatory lesions, epithelial and stromal proliferations, and neoplasms. In this review, common benign lesions are summarized and their relationship to the development of subsequent breast cancer is emphasized.