Presentation
Progressive painless swelling of the lower neck.
Patient Data
Age: 60 years
Gender: Male
From the case:
Soft tissue lipoma
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Large lobulated well-encapsulated subcutaneous mass at the cervicothoracic region, lateralized to the right, displacing the trapezius muscle anteriorly. It displays a high signal on T1 and T2, attenuated on fat sat sequences with thin internal septations. No enhancement is seen on postcontrast sequences.
Case Discussion
MRI features most consistent with soft tissue lipoma of cervicothoracic location.
The main differential diagnosis includes:
- liposarcoma: usually thick enhanced septa or evidence of local invasion
- Madelung disease: appears as multiple and symmetric, non-encapsulated masses of fatty tissue, involving the posterior aspect of the neck and upper trunk, indistinguishable from the adjacent fatty tissue
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