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Atypical left sub-sternocleidomastoid muscle neck lipoma with carotid sheath encroachment

Dustin Hoang

Texas Tech University School of Medicine

Abstract: Atypical left sub-sternocleidomastoid muscle neck lipoma with carotid sheath encroachment Introduction: Neck Lipomas are rare, slow-growing, benign tumors that can be asymptomatic or cause various neck symptoms including pain, dysphagia, hoarseness, etc. They can vary widely in their origin and distribution. Many asymptomatic neck lipomas are located in the subcutaneous tissue but can also be found within the musculature of the neck or protruding into adjacent structures. Case Presentation: We describe a 30-year-old female patient that presented with mainly dysphagia due to a left anterior neck lipoma that was found to be encroaching on the carotid sheath. The patients neck lipoma was noticed for a few months before she came in for evaluation. The patient had a full range of motion in her neck, and rarely complained of pain but did notice a lot of difficulty swallowing. The lipoma was located sub-sternocleidomastoid, and extend to the lung apex. The lipoma was completely excised with good margins and the patient’s symptoms resolved after surgical intervention. Discussion: There have been multiple reports of neck lipomas previously, but few large lipomas extending to the lung apex and requiring carotid sheath dissection have been described and reported in the literature. We report a surgical approach that identified various structures and potential complications that can arise in patients with a sub-SCM neck lipoma. Conclusion: Sub-SCM neck lipomas are rare and difficult benign tumors to resect. This case report is an example of what a presentation could look like and the surgical approach taken to remove it.

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