Giant Breast Lipoma: A Case Report Highlighting an 18-Year Clinical Progression

Abstract

 Background. Lipoma is the most common benign mesenchymal tumor of adipose tissue, yet its occurrence as a “giant” mass in the breast is rare. Giant breast lipomas are defined by a dimension exceeding 10 cm or a weight greater than 1 000 grams. These lesions pose a significant diagnostic challenge as their massive size and potential for accelerated growth can mimic more aggressive pathologies, such as phyllodes tumors or well-differentiated liposarcomas. Methods. This report describes the clinical presentation, radiological evaluation, and surgical management of a 36-year-old female with no significant comorbidities who presented with a massive right breast lump. The patient reported a notably prolonged 18-year history of the mass, which had entered a phase of accelerated enlargement over the preceding five years, causing physical discomfort and significant mammary asymmetry. Results. Physical examination revealed a soft, mobile, non-tender mass measuring 15x10 cm, without skin changes or chest wall fixation. Computed tomography confirmed a well-circumscribed, fat-density lesion with internal septations and no osseous destruction. The patient underwent complete surgical excision. Histopathological analysis confirmed the diagnosis of a benign giant breast lipoma composed of mature adipocytes with no evidence of cellular atypia or malignancy. Conclusion. Despite an unusually long clinical course and radiological features that may mimic malignancy, giant breast lipomas can be successfully managed through surgical resection. Accurate preoperative imaging and definitive histopathology are essential to ensure appropriate treatment and excellent aesthetic outcomes.