Kadyogo Moussa, Compaoré Dina Alizèta, Ouédraogo Aida Sandrine, Ouoba Joséphine, Bayala Donald, Meda Christine N, Ouédraogo Aimé Sosthène, Sereme Moustapha
Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale du Centre hospitalier universitaire de Bogodogo, Ouagadougou, Burkina Faso.
Service d'anatomie et de cytologie pathologiques du Centre hospitalier universitaire de Bogodogo, Ouagadougou, Burkina Faso.
Med Trop Sante Int. 2022 May 19;2(2). doi: 10.48327/mtsi.v2i2.2022.234. eCollection 2022 Jun 30.
To report on a case of rare giant anterior cervical lipoma.
This was a 60-year-old male patient received in March 2020 for an anterior cervical swelling in progressive evolution since 20 years. The condition was negatively impacting the patient's quality of life with a feeling of cervical heaviness, discomfort, head movement limitations, with no sign of compression. Despite this significant discomfort, the patient first consulted several traditional practitioners with different traditional treatments without success, the mass having been taken for a goiter. It is in the face of the failure of traditherapeuts that the patient finally decided to consult in our care structure.
Physical examination found a large left paramedian formation which appeared soft, mobile vis-a-vis the two plans, and sensitive; it measured 13 cm on its longer axis, and surrounding skin showed scarifications, witness to previous traditional treatments. Cervical CT eliminated goiter and made it possible to diagnose a giant cervical lipoma. A cervicotomy was performed under general anesthesia with a total one-block excision of an encapsulated mass. The evolution was favorable with a good healing. The histological examination of the mass identified a well-differentiated lipoma. There was no relapse up until 24 months later.
The giant anterior cervical lipoma is rare. The differential diagnosis is mainly posed with a large goiter or liposarcoma. CT or MRI make it possible to confirm the diagnosis. Its treatment is exclusively surgical and the examination of the operative piece by the pathologist confirms the diagnosis. An extended post-operative monitoring is recommended given the risks of relapse and of malignant degeneration.
报告一例罕见的巨大颈前脂肪瘤病例。
这是一名60岁男性患者,于2020年3月因颈部前方肿胀前来就诊,该肿胀自20年前起呈进行性发展。这种情况对患者的生活质量产生了负面影响,患者感到颈部沉重、不适,头部活动受限,且无压迫迹象。尽管有明显不适,但患者最初咨询了几位传统治疗师并接受了不同的传统治疗,但均未成功,肿块曾被误诊为甲状腺肿。面对传统治疗的失败,患者最终决定到我们的医疗机构就诊。
体格检查发现左旁正中一个大的肿物,质地柔软,在两个平面上均可移动,有压痛;其长轴测量为13厘米,周围皮肤有瘢痕,这是先前传统治疗的痕迹。颈部CT排除了甲状腺肿,得以诊断为巨大颈前脂肪瘤。在全身麻醉下进行了颈切开术,完整切除了一个有包膜的肿块。病情进展顺利,愈合良好。对肿块进行组织学检查,确定为高分化脂肪瘤。直到24个月后均无复发。
巨大颈前脂肪瘤很罕见。主要鉴别诊断为大的甲状腺肿或脂肪肉瘤。CT或MRI有助于确诊。其治疗仅为手术治疗,病理学家对手术标本的检查可确诊。鉴于有复发和恶性变的风险,建议进行长期的术后监测。