Massive intrathoracic lipoma in men1 syndrome

Alessandro Sturiale; Francesco Giudici; Giovanni Alemanno; Tiziana Cavalli; Rami Addasi; Carmine Santomaggio; Giulia Meoni; Maria Luisa Brandi; Francesco Tonelli

doi:10.1016/j.ijscr.2014.10.071

Massive intrathoracic lipoma in men1 syndrome

Int J Surg Case Rep. 2015:6C:247-50. doi: 10.1016/j.ijscr.2014.10.071. Epub 2014 Dec 12.

Authors

Alessandro Sturiale¹, Francesco Giudici², Giovanni Alemanno², Tiziana Cavalli², Rami Addasi², Carmine Santomaggio³, Giulia Meoni⁴, Maria Luisa Brandi⁵, Francesco Tonelli²

Affiliations

¹ Digestive Surgery Unit, Department of Surgery and Translational Medicine, University of Florence Medical School, Careggi University Hospital, Florence, Italy. Electronic address: alexstur@yahoo.it.
² Digestive Surgery Unit, Department of Surgery and Translational Medicine, University of Florence Medical School, Careggi University Hospital, Florence, Italy.
³ Department of Pneumology, University of Florence Medical School, Careggi University Hospital, Florence, Italy.
⁴ Department of Oncology, Medical Oncology 1, Careggi University Hospital, Florence, Italy.
⁵ Regional Centre for Hereditary Endocrine Tumors, Unit of Metabolic Bone Diseases, Department of Internal Medicine, University of Florence, Florence, Italy.

Abstract

Introduction: The multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant syndrome characterized by the onset of hyperparathyroidism, gastroenteropancreatic neuroendocrine tumors and pituitary lesions.

Presentation of case: This appears to be the first described case of a massive intrathoracic lipoma in MEN1. The patient was affected with primary hyperparathyroidism treated with a total parathyroidectomy followed by a distal pancreatectomy for insulinoma. At follow-up, the computed tomography showed a massive lesion on the left emithorax suggestive of a lipoma. At the onset of a mild dyspnea we decided to perform the surgical excision of the mass obtaining a complete relief of the symptoms.

Discussion: This case is evidence of the importance of a strict follow-up of such patients.

Conclusion: Lipomas are the most frequent benign soft tissue tumors. They are usually sporadic but are sometimes related to hereditary syndromes. Intrathoracic localizations are rare and can arise mainly in the mediastinum, bronchus or lung. The diagnosis is often incidental; despite preoperative imaging will accurately show the features of the lesions, it is impossible obtain an accurate diagnosis-hence, the treatment of choice remains the surgical excision.

Keywords: GEP-NET; Intrathoracic lipoma; MEN 1 syndrome; Surgery.