title: Lipoma or liposarcoma? A cautionary case report.
abstract: MERRF syndrome (myoclonic epilepsy with ragged-red fibres) is a mitochondrial encephalomyopathy characterised by a mixed seizure disorder and myoclonus. The condition is associated with multiple large cervical lipomas that often require surgical excision. Comprehensive clinical examination combined with pre-operative radiographic imaging is vital in such cases to help differentiate benign fatty masses from potential liposarcomas. We describe a case in which a lipoma-like liposarcoma was identified following excision of what was expected, on clinical and radiological grounds, to be a lipoma. This case highlights the potential for sarcomatous changes in suspicious lipomas, and the key role that imaging plays in differentiating benign from malignant.
authors.affiliation: Department of Plastic Surgery, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne, NE1 4LP, UK.
authors.forename: A P
authors.initials: AP
authors.lastname: Jones
authors.forename: C J
authors.initials: CJ
authors.lastname: Lewis
authors.forename: P
authors.initials: P
authors.lastname: Dildey
authors.forename: G
authors.initials: G
authors.lastname: Hide
authors.forename: M
authors.initials: M
authors.lastname: Ragbir
mesh_terms: D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008067:Lipoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D008080:Liposarcoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D017243:MERRF Syndrome / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009333:Neck; D018570:Risk Assessment; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods