Master, Doctor, First Degree Specialist Huynh Ba Tan, from the Department of Surgical Oncology at the Cancer Center, Tam Anh General Hospital, Ho Chi Minh City, noted the tumor's soft, fatty tissue-like density and rapid growth. An MRI revealed the 25x10 cm tumor was deeply embedded within the latissimus dorsi muscle, unlike typical subcutaneous lipomas.

A lipoma is a benign tumor composed of fatty tissue, usually soft, painless, slow-growing, and mobile under the skin. About 1% of cases involve tumors developing within muscle fibers. Lipomas exceeding 10 cm are classified as giant lipomas. "This is the first time I have treated a patient with a 25x10 cm lipoma that developed in the muscle area," said Doctor Tan.

Traditional tumor removal, which only excises the mass, carries a high risk of recurrence and may not be thorough if the tumor is malignant. Doctor Tan decided to remove a portion of the latissimus dorsi muscle containing the tumor, along with its surrounding margins, to ensure complete removal and prevent recurrence.

Doctor Tan checks on Hoang during a follow-up visit. Photo: Tam Anh General Hospital

During the three-hour surgery, the medical team faced challenges because the giant tumor had displaced the anatomical structures of the back. The lipoma was situated close to and enveloped the thoracodorsal nerve and artery. The team meticulously dissected the tumor to avoid damaging critical nerves and structures, while preserving the tumor capsule to prevent the spread of potentially malignant cells.

The team successfully removed the entire tumor, weighing nearly 2 kg, along with a portion of the latissimus dorsi muscle. They also managed the surgical cavity and placed drains to minimize the risk of fluid accumulation, hematoma, and post-surgical infection.

Post-surgery, Hoang walked normally and was discharged after 12 hours of monitoring. Pathology results confirmed the tumor was an atypical benign lipoma, a type with a higher recurrence risk than common lipomas. This type of tumor also lies on the borderline between benign and malignant, carrying a long-term risk of becoming cancerous.

Lipomas commonly appear on the shoulders, neck, back, or arms, and are prevalent in individuals aged 40-60. Various factors can cause lipomas, including genetics, Dercum’s disease (a rare disorder causing painful lipoma growth), familial adenomatous polyposis (FAP), Gardner syndrome, and Madelung’s disease (multiple symmetrical lipomas).

Most lipomas are benign and cause little pain, leading many to seek medical attention only when the tumor grows large. However, an increase in size can compress nerves, affect blood vessels, and contribute to other health issues. Some cases may present symptoms similar to liposarcoma, a rare cancer of fat cells in the arms and legs.

Individuals who discover a lump on their body should seek medical examination. Depending on the case, doctors may recommend ultrasound, MRI, or other diagnostic techniques to determine the tumor's nature, assess its size, depth, vascular proliferation, and nerve compression.

Khai Minh

*Patient's name has been changed