20 kg Gluteal Lipoma

Case Report

We describe the case of a 90 year old patient with a giant gluteal lipoma having evolved over more than 20 years. The patient was well aware of this slow-growing painless mass on his right hip but refused any treatment. He was addressed to the surgical consultation by his family doctor for lameness and unbalanced walking. (figure 1A, B).

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A CT scan was performed. However, the lesion was so large that it could not be scanned entirely (figure 2). 

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Treatment

After discussing the pros and cons of an intervention with the patient and his family, the decision was taken to remove the mass surgically. The patient was installed in a dorsal decubitus position (figure 3A). The operation resulted in the removal of a 30×60 cm 20 kg lipoma (figure 3B).

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Outcome and follow-up

The pathology report confirmed that the tumour was benign. Skin was preserved in order to allow a functional reconstruction of the gluteal region. Wound management was simple, and follow-up was unremarkable. Additionally, the patient received intensive physiotherapy for walk recovery and after 5 weeks he could achieve completely independent walking.

Credits: Dr Alexis Litchinko, BMJ