Rare differential diagnosis of solid cervical swelling

Introduction The intramuscular lipoma is a common mesenchymal soft tissue tumor. However, an occurrence in the head and neck region is very rare.

Material and Methods A 50-year-old man, without previously known chronic diseases, was assigned to our clinic due to a painful swelling of the right side of his neck that had been noticed for about 2 months. Clinically, a pressure-dolent, doughy swelling was found in region III right, directly adjacent to the sternocleidomastoid muscle with a size of approx. 7 cm x 5 cm and visible contour change of the right side of the neck. In sonography of the soft tissues of the neck, a sharply limited, inhomogeneous mass within the muscle fascia could be visualized.

The outpatient computer tomography of the soft tissues of the neck done with contrast medium showed a swelling directly lateroventrally of the vascular vagina with density values around -100 HE without evidence for solid parts, which is compatible with a lipoma.

Results The extirpation of the mass was performed. During the operation, the fascia of the sternocleidomastoid muscle had to be opened to represent the capsule of the mass. Complete removal without complications was performed.

Conclusions A lipoma can occur not only intra- or subcutaneously, but also intramuscularly. It is important to differentiate it from other cervical masses, especially liposarcoma. This is possible on the basis of diagnostic indications. The therapy consists of a complete extirpation.

Poster-PDF A-1512.PDF

Publication History

Article published online:
10 June 2020