A patient came to our clinic with a large cervical tumour on the left side of the neck. He had undergone surgery for a gill cyst in the same location 18 years ago.
He explained the slow and painless growth of the mass, which had been growing for approximately 10 years.
The limits of the tumour include the left greater body of the hyoid bone at the anterior level, the mastoid region at the superior level, the clavicle at the inferior part and the external occipital protuberance as the posterior limit.

The consistency of the mass is soft and it is not attached to deep planes.
No lymph nodes or other masses were palpable and the intraoral examination was normal.
The rest of the physical examination was completely unremarkable.
It was decided to perform cervicofacial magnetic resonance imaging (MRI), which revealed a homogeneous, well-defined mass that did not invade neighbouring structures and with a fatty density.

A sample was taken by fine needle puncture aspiration (FNA) which confirmed the initial suspicions of lipoma.
It was decided to perform surgical excision of the tumour. An approach was made at the level of the posterior hairline, resecting a 5*10cm skin spindle to improve direct closure.

During the operation, a specimen weighing 459.5g and measuring 25*16*4.8cm was obtained.
On the first postoperative day the patient showed a rapidly growing haematoma at the level of the posterior suture, which required emergency evacuation and haemostasis of a small vessel at the level of the left trapezius muscle.
After the seventh postoperative day the patient was discharged.
Pathological studies confirmed the diagnosis of lipoma without atypia
He is currently progressing satisfactorily and is being monitored in our outpatient clinic.

