Unusual Thoracic Lipoma; A Case Report and Literature Review

Lipomas are rarely encountered in the thoracic cavity. A pleural origin of lipoma is extremely rare. In fewer occasions it infiltrates the intercostal space and has an hourglass development. Therefore, the intrathoracic and extrathoracic dumbbell-shaped lipoma is a very rare finding. We present the case of a 77-year-old Caucasian woman with an hourglass-shaped lipoma originating from the left parietal pleura and passing outside the thorax through the first intercostal space. The one-year follow-up revealed no changes. Intrathoracic and extrathoracic hourglass type lipomas are a very rare pathology. When they occur, a non-surgical approach may be adopted as long as compression symptoms are absent and the follow-up imaging examinations reveal no lesion growth. In our case, the patient’s history and the imaging investigations support the benign nature of the tumor. Particularly, in our case, the size of the lipoma was small compared to the long duration of its evolution and there were no signs and symptoms of intra-thoracic compression. The taken therapeutic approach complies with the patient’s options and fits in the current generally accepted recommendations.