What should be the treatment modality in giant cutaneous lipomas? Review of the literature and report of 4 cases.

We present three females (20, 39 and 58 years old) and one male patient (47 years old), admitted to our clinic with 3-20 years history of giant lipomas on periscapular (n = 2), posterior cervical (n = 1) and abdominal areas (n = 1), respectively. The sizes of the tumours ranged from 15 x 14 cm(2) to 35 x 25 cm(2) weighing 1900-12 350 g. In all cases, the diagnosis of the lesions was by physical examination and confirmed with computed tomography, magnetic resonance imaging and ultrasonography. Incisional biopsy or aspiration cytology were used to exclude liposarcoma. Three lesions with surrounding capsule formation and lipofibromatous changes underwent open surgery. In one case, as the capsule formation was not evident, suction assisted lipectomy was attempted. However, no aspirate could be evacuated possibly due to the fibrotic nature of the lesion and open surgery was performed. The follow-up period was 14 months to 5 years and no recurrence was noted.