case_images: PMC11116667_01
case_images: Preoperative clinical and imaging presentation of a giant liposarcoma of the neck. (A) Preoperative anterior section. (B) Preoperative dorsal view. (C, D) Preoperative lateral views. (E) Preoperative CT of the neck shows a large posterior cervical mass with clear borders, measuring approximately 162 x 92 x 166 mm, with a CT value of approximately -108 HU. Separation shadows are seen within the mass. (F-H) MRI of the cervicothoracic segment showed a large cervical mass with a double-high signal, reduced T2-fs signal, and a linear separation signal shadow in the neck; a linear enhancement shadow was seen on DWI. Cervicothoracic MRI showed a large cervical mass with double high signals in the cervical spine, reduced T2-fs signals, and linearly separated signal shadows, measuring approximately 166x17.6x10.7 cm, with low signals on DWI and linear enhancement on the enhancement scan. The cervical spine was normal with physiological curvature; a mass-like T2-FS high signal shadow was seen in the spinal cord at the C2 level.
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case_images: Over the last ten years, the mass has experienced a gradual increase in size, currently measuring about 20 cm x 19 cm x 10 cm, as depicted in ( Figures 1A-D ). The visualization of specific internal shadows further supported the diagnosis of a giant neck lipoma ( Figure 1E ). Additionally, a distinct T2-fs high-signal nodular shadow was observed in the spinal cord at the C2 level, corresponding to the typical features of a lipoma ( Figures 1F-H ).
case_images: Intraoperative clinical images. (A-C) Preoperative design of transverse incision and trimming of the shuttle flap. (D-G) Intraoperative clinical views of the intact mass. (H) Rejected shuttle flap.
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case_images: A transverse incision was made on the posterior aspect of the neck ( Figures 2A-C ), followed by a skin incision that exposed a large mass, encapsulated mainly by an intact outer membrane. Subsequent to the removal of the pathological tissue for analysis ( Figures 2D-G ), hemostasis was achieved, excess skin was excised according to a predetermined plan ( Figure 2H ), and the site was closed with sutures, followed by the insertion of a negative pressure drainage tube.
case_images: Postoperative clinical and imaging findings. (A) Postoperative pathological findings (B) Postoperative neck MRI showing complete excision of the subcutaneous neck mass. (C-F) Postoperative clinical images of the patient.
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case_images: Consequently, the final diagnosis of a large subcutaneous lipoma in the neck region was established ( Figure 3A ). Postoperative recovery proceeded without complications, and a follow-up MRI confirmed the complete excision of the mass ( Figure 3B ). Figures 3C-F ), with a full restoration of mobility. Following thorough deliberations at a multidisciplinary meeting, the patient was discharged on the sixth day post-operation.