안면부에 발생한 거대 지방종의 치험례

Abstract

Purpose: Lipomas of the skin are one of the most frequently encountered tumors in plastic surgical practice. Huge lipomas of all areas of the body have been described. Large lipomas of the face, however, are not so common. We report on the treatment of a huge lipoma of the forehead causing distortion of the eyebrows. Methods: A 55 year old man was referred to our department by the neurosurgeons. He was primarily admitted for removal of a meningioma of the left frontal lobe of his brain. More striking was a huge protruding mass of 75x60x30mm covering almost the whole left half of his face's upper third and displacing his left eyebrow downward by almost 1cm. MRI showed a large lipoma, which caused 3cm anterior protrusion of the overlying skin. A meningioma of the left frontal lobe was also seen. The lipoma was removed via an external approach. Before closure of the skin a 3.5 cm wide strip of muscle and skin was resected. The multilobulated specimen was covered by a thin capsule and weighed 95g. The pathologist diagnosed it as benign lipoma. Results: The postoperative course was uneventful. At 11 months after the operation the resulting scar was inconspicuous, the position of the eyebrows was almost symmetric and a symmetric brow elevation was observed. Conclusion: We describe the largest facial lipoma reported in the recent literature. By using an open approach, skin excision and redraping, we achieved an aesthetically satisfactory outcome.