Letters to Editor
Nikhil Panse, Parag Sahasrabudhe,
Sagar Khade
1 Department of Plastic Surgery, 1Department of General Surgery, B.J. Government Medical College and Sassoon Hospital, Pune, Maharashtra, IndiaAddress for correspondence:
Dr. Nikhil Panse, Vimal Niwas, Sudarshan Society, Near Model Colony Postoffice, Shivajinagar, Pune - 411 016, Maharashtra, India. E-mail: nikhil.panse@rediffmail.com
REFERENCES
1. Ahuja RB. Ethical practice of evidence-based medicine: A review for plastic surgeons. Indian J Plast Surg 2013;46:11-7.
2. Burns PB, Rohrich RJ, Chung KC. The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg 2011;128:305-10.
3. Available from: http://www.plasticsurgery.org/Medical_ Professionals/Health_Policy_and_Advocacy/Health_Policy_ Resources/Evidencebased_GuidelinesPractice_Parameters/ Description_and_Development_of_Evidencebased_ Practice_Guidelines/ASPS_Evidence_Rating_Scales.html. [Last accessed on 2014 Sep 30].
4. Loiselle F, Mahabir RC, Harrop AR. Levels of evidence in plastic surgery research over 20 years. Plast Reconstr Surg 2008;121:207e-11.
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How to cite this article: Panse N, Sahasrabudhe P, Khade S. The
levels of evidence of articles published by Indian authors in Indian journal of plastic surgery. Indian J Plast Surg 2015;48:218-20.
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Giant lipoma of the back
Sir,
Giant lipomas are occasional mesenchymal tumours that
are usually located deep in the body. The lipoma cells
are believed to arise from primordial mesenchymal fatty
tissue cells; thus, they are not of adult fat cell origin.
They tend to increase in size with body weight gain,
but interestingly, weight loss usually does not decrease
their sizes. They do not cause any symptoms other than
those determined by the space occupying mass. They are
described as ‘giant’ beyond 1 kg of weight and 10 cm of
diameter.
In literature, giant lipomas of the back were reported
as exceptional findings, with variable weight and
dimensions.
[1-3]Giant lipomas are usually surgically
treated by direct excision, even though their treatment
through liposuction is described.
[4]An 84-year-old man was admitted to our hospital
because of a subcutaneous mass in his upper back.
Thirty years earlier, he had noticed a firm, small,
painless subcutaneous mass on the upper back [Figure
1]. The mass had progressively enlarged over the years.
He never consulted a doctor before coming to our
attention. The patient was in a state of good health
before admission.
On physical examination, a well-circumscribed, freely
movable giant subcutaneous mass, approximately 40 cm
in diameter, was palpated in the upper back. Computed
tomography showed a huge heterogeneous hypodense
mass located in the subcutaneous fat tissue [Figure 2].
There was no evidence of calcification or necrosis in the
tumour. Magnetic resonance imaging showed a mass of
mixed heterogeneous high intensity, identical to that of
the subcutaneous adipose tissue. The patient underwent
complete surgical excision under general anaesthesia.
The mass had dimensions of 36 cm × 40 cm × 24 cm
and weighed 5.75 kg after removal [Figure 3]. To the best
of our knowledge, this could be the largest lipoma ever
described in literature.
Figure 1: Macroscopic appearance
Letters to Editor
Figure2: Preoperative chest computed tomography scan
Figure 3: Surgical specimen
Figure 4: Six months after surgical excision
Histopathologic examination showed a benign neoplasm
composed of normal adipose cells with strands of
connective tissue. The patient had a postoperative
course without complications or recurrences. After 6
months of follow-up, the patient was very pleased with
the result [Figure 4].
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Luca Grimaldi, Roberto Cuomo,
Antonio Castagna, Andrea Sisti,
Giuseppe Nisi, Cesare Brandi,
Carlo D’Aniello
Division of Plastic Surgery, Department of General and Specialist Surgery, University of Siena, Siena, Italy
Address for correspondence:
Andrea Sisti, Division of Plastic Surgery, Department of General and Specialist Surgery, University of Siena, Siena, Italy. E-mail: asisti6@gmail.com
REFERENCES
1. Terzioglu A, Tuncali D, Yuksel A, Bingul F, Aslan G. Giant lipomas: A series of 12 consecutive cases and a giant liposarcoma of the thigh. Dermatol Surg 2004;30:463-7.
2. Pachani AB, Shojai AR, Gautam R, Topno M, Panchal A, Sharma V, et al. A giant congenital lipoma over the back. Indian J Surg 2010;72:361-2.
3. Hakim E, Kolander Y, Meller Y, Moses M, Sagi A. Gigantic lipomas. Plast Reconstr Surg 1994;94:369-71.
4. Silistreli OK, Durmus EU, Ulusal BG, Oztan Y, Görgü M. What should be the treatment modality in giant cutaneous lipomas? Review of the literature and report of 4 cases. Br J PlastSurg 2005;58:394-8.
Access this article online
Quick Response Code:
Website:
www.ijps.org
DOI:
10.4103/0970-0358.163074
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Grimaldi L, Cuomo R, Castagna A, Sisti A,
Nisi G, Brandi C, et al. Giant lipoma of the back. Indian J Plast Surg 2015;48:220-1.
Indian Journal of Plastic Surgery May-August 2015 Vol 48 Issue 2 221
