90-year-old patient presented with a giant gluteal lipoma of the right hip with a history of 20 years.
A 90-year-old male patient presented with a 20-year history of a giant gluteal lipoma. The painless mass slowly grew in size over the years on the patient’s right hip. However, despite being well-aware of the slow-growing mass, the patient refused any treatment.
He was referred for surgical consultation by his family doctor because of an abnormal gait and unbalanced walking. A preliminary diagnosis of a benign lipoma was made. To confirm the diagnosis, a CT scan was performed. However, because of the size of the lesion it could not be scanned entirely.
Imaging showed that the tumour-like lipoma was in contact with the sacrum, the ischiadicum and the greater trochanter. In addition to this, an infiltration of the flexor’s muscles of the right leg were also suspected. The lipoma was mainly vascularised by the enlarged superior gluteal artery.
Treatment
The surgical team advised removal of the mass surgically. The patient and family were adequately explained the pros and cons of the intervention before the surgical procedure was performed. The lipoma removed measured 30 x 60 cm and weighed 20 kg.
Follow-up
The mass was biopsied and sent for a histopathological analysis which confirmed that the tumour was benign. For functional reconstruction of the gluteal region, the skin was preserved. The process of wound management was simple with an unremarkable postoperative period.
The patient was referred for intensive physiotherapy to help him recover his walk. After 5 weeks of therapy, he was able to walk independently.
References
Giant gluteal lipoma surgical management https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700553/
