Deep Cervical Lipomas: Case Series and Scoping Review of the Literature
Meghana Bhaskara1, Emily H Chestnut1, Brent Molden2
1Indiana University School of Medicine, Indianapolis, IN, USA.
Introduction:
Management of deep cervical lipomas (DCLs) is described only in case reports and series in the literature. We aim to present a scoping review of this literature and the largest case series of surgically resected DCLs to describe presentation, workup, and efficacy of transcervical resection for DCLs.
Methods:
A systematic search for surgically resected solitary DCLs was conducted in PubMed, Embase (Elsevier), Scopus, and Cochrane library on 12/19/2025 using PRISMA methodology. Study protocol was registered in PROSPERO (CRD420251052065) and articles were screened independently by 2 authors, with conflicts resolved by a third reviewer. All solitary DCLs resected via a transcervical approach at a tertiary center from 2014 to 2025 were reviewed.
Results:
From a total of 1459 articles, 144 studies met criteria, and 163 cases (median age 45 years, 25.2% pediatric, 67.5% male) were included. The most common presenting symptom was swelling (81.6%), and 63.2% were enlarging. A total of 232 imaging studies, most commonly CT (n = 102), were conducted amongst 90.8% of patients for an average of 1.4 imaging studies per patient. Biopsy was performed in 27.6% of patients, with 43.4% of biopsies being inconclusive or inconsistent with benign fatty tumor. Postoperative complaints were noted for 9.8% of patients, with only 3.1% (n = 5) having persistent complaints. Two recurrences were noted. The institutional cohort of 10 patients (median age 55 years, 10% pediatric, 90% male, 90% non-Hispanic White) mirrored the literature, with the most common presenting symptom being palpable neck mass (80%), at least one imaging study per patient on average, no persistent complaints, and one recurrence.
Conclusion:
DCLs are less common than subcutaneous lipomas but follow a similar clinical course. Presentation most commonly occurs as a palpable mass, most of which are enlarging. Imaging without biopsy is often sufficient for workup. Transcervical resection is diagnostic and therapeutic with minimal morbidity.
