A case of large deep fibrolipoma in the left subclavicular region that compromised the branchial plexus and thoracic duct: A case report

Abstract

Introduction: A fibrolipoma of the left subclavicular region, a neoplasm rarely encountered in this region, was compromising the branchial plexus and thoracic duct, causing thoracic outlet syndrome in a symptomatic patient.

Case presentation: A 41-year-old Asian woman was brought to our ENT (ear-nose-throat) clinic because of slowly progressive swelling of the left subclavicular region since 10 years before, which became painful with time, associated with increasing subpectoral and shoulder pains, left arm swelling, and left forearm paresthesias.

Discussion: The exact etiology of fibrolipomas remains disputed, and endocrine, dysmetabolic, genetic, and traumatic factors have been often considered. A fibrolipoma characteristically grows by simple expansion in a well-encapsulated fashion without the tissue infiltration that is more characteristic of liposarcomas.

Conclusion: The purpose of this case report is to highlight an unusually large tumor of this type in a dangerous area that caused thoracic outlet syndrome-like symptoms.

Keywords: Benign tumors; Branchial plexus; Fibrolipoma; Lipoma; Thoracic duct.

Fig. 1

Intraoperative picture of the fibrolipoma.

Fig. 2

Intraoperative picture of the fibrolipoma.

Fig. 3

Fibrolipoma with a fibrous tissue bundle interspersed among lobules of mature adipocytes. Hematoxylin-eosin staining, original magnification 20.

Fig. 4

Fibro-Llipoma with prominent bundles of mature fibrous tissue traversing the lobules of mature adipocytes. Hematoxylin-eosin staining, original magnification H & E,40×.