Asian Journal of Case Reports in Surgery

Giant lipomas of the chest wall are uncommon benign soft-tissue tumours and may clinically or radiologically resemble well-differentiated liposarcoma, particularly when they are large, rapidly enlarging, deep-seated, or associated with atypical imaging features. This case report describes a 60-year-old man with a progressively enlarging swelling over the left lateral chest wall that had been present for 15 years, with a rapid increase in size during the preceding year. The swelling was associated with prominent superficial veins, pressure-related skin ulceration, and a recent heavy, dragging sensation, although there was no functional impairment. Clinical examination revealed a large, firm, non-tender globular mass measuring approximately 16 × 18 cm in the left infra-axillary region. Ultrasonography confirmed a subcutaneous lesion. Computed tomography of the chest showed a large lateral chest wall mass measuring 13.2 × 14.8 × 19.2 cm, with predominantly fat attenuation, internal linear soft-tissue components, and calcifications, raising concern for a lipomatous neoplasm. Fine-needle aspiration cytology demonstrated mature adipocytes. Complete surgical excision was performed, including removal of the ulcerated overlying skin. The resected specimen measured 18 × 18 × 20 cm and weighed 1,200 g. Histopathological examination confirmed a benign lipoma. The postoperative course was uneventful, and the patient was discharged after drain removal. This case emphasises the importance of clinical, radiological, cytological, operative, and histopathological correlation in evaluating giant lipomatous chest wall tumours.