GIANT CERVICAL LIPOMAS: CLINICAL AND RADIOLOGICAL CHARACTERISTICS, SURGICAL STRATEGIES, COMPLICATIONS, AND AESTHETIC-FUNCTIONAL OUTCOMES

Abstract

DOI: https://doi.org/10.46296/yc.v10i19.0963

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.