Exceptional etiology of a huge pedunculated chest wall tumor with over 40 years of evolution: A case report

Chest wall tumors are common and predominantly benign. Exceptionally, long-standing evolution over decades can lead to the development of giant tumors, posing substantial technical and strategic challenges in determining the optimal surgical approach. We report a rare case of a giant pedunculated chest wall lipoma that had been growing for over 40 years in a 73-year-old man. CT scan revealed a mass with a 5 cm-suprascapular-implantation base, hanging posteriorly and mimicking a pseudo-limb, measuring 17 × 7 cm in diameter and 34 cm in length. Complete surgical resection was performed, and histopathology confirmed a benign lipoma with no signs of malignancy. To our knowledge, this is the first reported case of a huge lipoma with more than 40 years of evolution and an unusual pedunculated presentation resembling a third upper limb. This case is exceptional due to its pedunculated appearance resembling an additional limb, and a slow evolution over more than 40 years. Complete surgical resection ensures a favorable prognosis.