Andrade-Tobar et al. (2026)
atípica y seleccionar el abordaje. La evidencia disponible es de muy baja certeza por su
naturaleza observacional, el sesgo de publicación y el seguimiento incompleto.
Palabras claves: lipoma; cuello; lipoma gigante; cirugía; tomografía computarizada; resonancia
magnética; resultados postoperatorios; deformidad estética.
Abstract
Background: Giant cervical lipomas are uncommon benign lesions whose large volume may
cause cosmetic deformity, restricted neck mobility and, in deep locations, compressive
symptoms. Evidence is largely limited to case reports and small case series. Objective: To
synthesize the clinical and imaging characteristics, surgical approaches, complications, and
aesthetic-functional outcomes reported in patients with giant cervical lipomas. Methods:
Systematic review of case reports and case series. A giant lipoma was defined as a lesion
measuring at least 10 cm in one dimension or weighing ≥1000 g. Cervical, cervicothoracic,
cervicofacial, and deep lesions with a predominant cervical component and a final diagnosis
compatible with lipoma were eligible. Diffuse lipomatosis, Madelung disease, atypical lipomatous
tumor/well-differentiated liposarcoma, insufficiently sized lesions, and cases lacking adequate
diagnostic confirmation were excluded. The verified rapid search was updated on August 28,
2026, using PubMed/MEDLINE, open-access literature, and citation chasing. Owing to marked
heterogeneity and non-comparative designs, narrative synthesis was performed without meta-
analysis. Results: The currently verified evidence set includes 33 publications encompassing 53
patients reported between 1973 and 2026. Posterior lesions predominated in historical series,
while recent reports increasingly document anterior, supraclavicular, cervicothoracic,
cervicofacial, and parapharyngeal tumors. Computed tomography and magnetic resonance
imaging were the main planning modalities in modern cases. Complete excision was the dominant
treatment, most often through cervical/transcervical approaches; selected mediastinal or deep
extensions required sternotomy, neurovascular dissection, or combined approaches. Major
complications were uncommon in published cases, and recurrence was exceptional when follow-
up was reported. Aesthetic contour, neck mobility, and compressive symptoms generally
improved after resection. Conclusions: Complete excision after appropriate imaging-based
anatomic planning generally yields favorable outcomes. Assessment should consider depth,
growth rate, heterogeneity, septa/nodules, and proximity to critical structures in addition to size,
both to exclude atypical adipocytic neoplasia and to tailor surgery. Certainty of evidence remains
very low because the literature is dominated by uncontrolled reports, publication bias, and
incomplete follow-up.
Keywords: lipoma; neck; giant lipoma; surgery; computed tomography; magnetic resonance
imaging; postoperative outcomes; cosmetic deformity.
excepcional. En la literatura se ha
1
. Introducción
lipomas son
difundido la definición de lipoma
gigante” como aquel que alcanza al
Los
neoplasias
“
benignas de tejido adiposo maduro y
constituyen una de las lesiones
mesenquimales más frecuentes. Sin
embargo, la región de cabeza y
cuello representa una proporción
menor de sus localizaciones y la
presentación como una masa
cervical de gran tamaño es
menos 10 cm en una dimensión o
pesa 1000 g o más, criterio útil para
estandarizar reportes, aunque su
repercusión clínica depende también
de
la
profundidad
y
del
compartimento
anatómico
comprometido [2,17,18].