The lipoma is a circumscribed mesenchymal tumor originating from adipose tissue. The lesion is usually small and asymptomatic, and is most frequently located in the neck region. The case af a 77-years-old woman with chronic extrasystolic arhuthmia caused by a non specified ischemic cardiopathy is reported. The woman presented a swelling at the front of her neck, observed for the first time about 6 months previously. This swelling progressively increased in size, provoking dysphagia, dysphonia, persistent cough, dyspnea, light jugular turgor and palpitations. Chest X-rays showed an opaque area at the front of the neck, which extended beyond the jugular incisure by about 2 cm. MR of the neck showed a gross lipomatous formation at the front, mainly of the left, continuing in the front mediastinal region; the trachea was dislocated to the right and compressed at the back; the vasculo-nervous fasciculus, especially on the left, was compressed and envelopped by the adipose formation. The Holter test confirmed the presence of venrticular and supra-ventricular extrasystoles. Surgery was carried out under local anaesthesia because the displacement of the laryngo-tracheal axes precluded intubation. Histological analysis of the 9 x 4 2.2 cm mass confirmed the diagnosis of lipoma. After removal of the mass all the symptoms, which had been provoked by compression, as well as the cardiac arrhythmias disappeared. The prompt disappearance of the latter was particularly surprising. The possibility of the external compression of the nervous structures of the neck should be taken into consideration in cases of ventricular arrhythmia of unknown origin, and systematic study of the region carried out.

Giant cervicomediastinal lipoma

CUTILLI, Tommaso;SCHIETROMA, Mario;
1999

Abstract

The lipoma is a circumscribed mesenchymal tumor originating from adipose tissue. The lesion is usually small and asymptomatic, and is most frequently located in the neck region. The case af a 77-years-old woman with chronic extrasystolic arhuthmia caused by a non specified ischemic cardiopathy is reported. The woman presented a swelling at the front of her neck, observed for the first time about 6 months previously. This swelling progressively increased in size, provoking dysphagia, dysphonia, persistent cough, dyspnea, light jugular turgor and palpitations. Chest X-rays showed an opaque area at the front of the neck, which extended beyond the jugular incisure by about 2 cm. MR of the neck showed a gross lipomatous formation at the front, mainly of the left, continuing in the front mediastinal region; the trachea was dislocated to the right and compressed at the back; the vasculo-nervous fasciculus, especially on the left, was compressed and envelopped by the adipose formation. The Holter test confirmed the presence of venrticular and supra-ventricular extrasystoles. Surgery was carried out under local anaesthesia because the displacement of the laryngo-tracheal axes precluded intubation. Histological analysis of the 9 x 4 2.2 cm mass confirmed the diagnosis of lipoma. After removal of the mass all the symptoms, which had been provoked by compression, as well as the cardiac arrhythmias disappeared. The prompt disappearance of the latter was particularly surprising. The possibility of the external compression of the nervous structures of the neck should be taken into consideration in cases of ventricular arrhythmia of unknown origin, and systematic study of the region carried out.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11697/12263
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