Use of the oncoplastic reduction pattern technique following removal of a 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.

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.

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).