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Soft tissue lipoma

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Progressive painless swelling of the posterior neck.

Patient Data

Age: 70 years
Gender: Male
mri

There is a well-encapsulated lobulated mass, posterior to the right trapezius muscle of high signal intensity on both T1W, and T2WI, attenuated on suppressed fat sequences (STIR and T1 fat sat) with multiple thin fibrous septations within (<2 mm). No enhancement is seen on postcontrast sequences.

Case Discussion

MRI features of a soft tissue lipoma.

The differential diagnosis should include:

  • liposarcoma: thick septa with enhancement or evidence of local invasion
  • normal adipose tissue: usually non encapsulated fatty mass, indistinguishable from the adjacent fatty tissue

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