Symptomatic giant lipoma of the neck in an adolescent

Lipomas are the most common soft tissue tumours in adults, but they represent less than 10% of paediatric mesenchymal tumours. In adults, they are typically slow growing and painless. We describe an adolescent with a rapidly enlarging neck mass causing dyspnoea and chest pain. Physical examination revealed a soft mobile mass extending from the angle of the mandible to the clavicle, with imaging demonstrating a 3×6×15 cm lipoma extending to the superior mediastinum with mass effect on key neck and mediastinal structures. It was surgically resected without complications and all presenting symptoms resolved. Along with the two other reported cases of giant lipomas of the neck in children, this presentation illustrates the rapid growth and symptomatic nature of giant lipomas in children. Surgical excision is the recommended treatment.