Breast reconstruction with parenchymal cross after giant lipoma removal

Lipomas are benign tumors composed of mature fat, usually encapsulated. A literature review showed that the vast majority of lipomas are small, weighing only a few grams, and grow slowly. According to Hawary et al. (Ann Saudi Med 19(2):174-176, 1999) a giant breast lipoma is characterized by a lesion of at least 5 cm in one dimension and weighs more than 500 g. We present a rare case of a giant breast lipoma with slow growth over 22 years that compromised the entire hemithorax through the right iliac fossa. A 49-year-old woman was referred to our plastic surgery unit because of complaints of severe breast asymmetry due to an enormous mass in the right breast. Twenty-two years earlier she had noticed a soft, mobile, nonpulsatile mass in the inferior quadrant of her right breast. She did not look for medical treatment for all those years for fear of it being cancer. Ultrasound suggested a lipomatous lesion. Open mass biopsy revealed lipoma. The patient underwent a whole mass resection, reconstruction with a parenchymal cross flap, and left breast symmetrization with an inverted T technique. An excellent result with a high degree of patient satisfaction was achieved with the procedure. Parenchymal cross flaps seem to be an option in these situations.