A case of lipoma of lateral anterior neck treated with surgical enucleation
A-62-year old man presented to Maxillofacial Surgery, Galeazzi Hospital, Milan, Italy, in January 2011 for evaluation. He complained about the appearance of a lesion in the parotid region since about two years. During the is period, the mass caused him breathing difficulties, preventing regular sleep.\nImaging (CT and MRI) showed a big echogenic mass extending from pre-tragal region up to the ascending branch of the mandible. The inferior margin of the lesion involved the pharyngeal and the superior margin was achieved by the top of the skull base. The imaging was compatible with a diagnosis of lipoma [].\nAn open surgical removal was our choice for the treatment. A pre-tragal access with cervical discharge was performed, with an incision to the angle of the jaw, and after a dissection of the masseter and buccinator muscles with the preservation of the facial nerve, the lesion was reached []. The parotid margin of the lesion presented a capsule but it was lacking in the terminal portion. The surgical specimen was sent to the pathology laboratory for definitive diagnosis. The gross specimen measured 10 × 2.5 × 2 cm and had a soft consistency. It was yellow in colour. The microscopic examination revealed a specimen composed of fragments of mature adipose tissue with foci of chronic inflammation. Based on the microscopic findings and clinical history, a diagnosis of lipoma was made.\nNo complication was recorded in the post-operative period and no further surgery was performed. The follow up showed no recurrence in the same position and with the same characteristics, after one year. At present, the patient has no breathing difficulties and has regular sleep.