[A case of pedunculated intrathoracic chest wall type lipoma]

The case was a 52-year-old female. Though the abnormal shadow on the chest X ray film was pointed out in 1990, she had been observed as a benign intrathoracic tumor for one year and four months. But she was admitted to our hospital for further evaluation because the mass shadow enlarged subsequently. The mass shadow was suspected as intrathoracic lipoma by the CT and MRI. However, because the shadow enlarged and its inner part was not single density that was equal to subcutaneous adipose tissues, left thoracotomy was performed. The tumor was pedunculated from the fatty tissue of the fifth intercostal space near the tubercle of rib. It was easily resectable, encapsulated and measured 6.0 x 3.5 x 2.5 cm in size. It was histologically diagnosed as benign lipoma. Preoperative diagnosis of the present tumor became possible to a certain extent by means of CT and MRI. However, in view of imperfect differentiation between lipoma and liposarcoma, the surgical treatment should be considered.