Omolabake et al. European Journal of Biomedical and Pharmaceutical Sciences www.ejbps.com 133 AN UNCOMMON CASE OF GIANT THIGH LIPOMA: DIAGNOSTIC AND TECHNICAL CONSIDERATIONS IN A LOW RESOURCE SETTING WITH REVIEW OF LITERATURE BI. Omolabake* 1 , BA. Eke 1 , BA. Ojo 2 , RA. Vhriterhire 2 , ME. Efu 3 , LJ. Tsegha 4 and RD. Inienger 4 1 Department of Surgery, Benue State University, Makurdi, Nigeria. 2 Department of Anatomical Pathology, Benue State University, Makurdi, Nigeria. 3 Department of Anaesthesia, Benue State University, Makurdi, Nigeria. 4 Department of Surgery, Benue State University Teaching Hospital, Makurdi, Nigeria. Article Received on 11/06/2020 Article Revised on 01/07/2020 Article Accepted on 22/07/2020 INTRODUCTION Lipomas are benign fatty tumours and are the commonest tumour of mesenchymal origin. [1] They are ubiquitous in nature and can occur anywhere in the body. [1] A giant lipoma, defined as a lipoma which weighs >1kg or measures >10 cm in one of its dimensions. [2,3] , is an uncommon entity [4,5] and presents peculiar challenges to the surgeon. The aim of this paper is to present the index case and highlight some of these challenges particularly in a low-resource setting. CASE REPORT The index case is a 57 year old woman presenting with a progressive swelling of her left thigh of 7 months duration. Swelling was initially painless, but had become painful in the last month prior to presentation, with discomfort during walking. There was no preceding history of trauma. She had received prior care in an alternative (traditional) medical practice but with no improvement. Examination finding revealed a hemispherical swelling in the anterior aspect of the left thigh extending almost its entire length. Swelling measured 25×20×6 cm, had a lobulated surface, regular outline and firm consistency. There was slight tenderness and differential warmth. It was mobile vertically and horizontally, free from the overlying skin but attached to the underlying quadriceps muscle. There was no accompanying neurovascular compromise or lymph node enlargement. The contralateral limb was grossly normal. An MRI was requested but was not available. An ultrasound scan was done instead. This reported a huge, fairly homogeneous mass located in the quadriceps muscle with a poorly defined posterior margin. Doppler interrogation of the mass showed poor blood supply. An X-ray of the left thigh excluded significant calcification of the mass and bony involvement. A core needle biopsy was done and histopathology report was consistent with a lipoma. Patient was reactive to Hepatitis C Virus (HCV). Other preoperative tests including lipid profile were essentially normal. An excision of the mass was done under sub-arachnoid block. Approach was via an elliptical incision placed in the summit of the mass and longitudinally disposed. The finding was of a huge well-encapsulated sub-fascial fatty mass located in the anterior compartment of the left thigh. It extended from the inguinal crease to just above the patella. There was attachment to, but no infiltration of the quadriceps femoris muscle which appeared atrophic and displaced. A closed active drain was brought out of the wound which was closed in layers and compressive dressing applied. The postoperative course was uneventful and patient was discharged after 5 days, with the drain removed a day before discharge. The biopsy specimen was preserved in 10% formalin solution and sent for histological evaluation. The specimen measured SJIF Impact Factor 6.044 Review Article ejbps, 2020, Volume 7, Issue 8, 133-136. European Journal of Biomedical AND Pharmaceutical sciences http://www.ejbps.com ISSN 2349-8870 Volume: 7 Issue: 8 133-136 Year: 2020 *Corresponding Author: BI. Omolabake Department of Surgery, Benue State University, Makurdi, Nigeria. ABSTRACT Giant lipomas are rare and can pose diagnostic and therapeutic challenges in their management. A case of giant thigh lipoma in a 57 year old woman is presented, with a discussion of challenges of management in a low resource setting. These tumours behave differently from typical lipomas and mimic malignancy, which should be considered and excluded. Rarely, malignant transformation of a giant lipoma may occur and long term follow-up is necessary because of the risk of recurrence. KEYWORDS: Giant lipoma, thigh lipoma, low-resource.