Lipoma Masquerading as Soft Tissue Sarcoma: A Rare Case Report

Giant lipomas of the head and neck are rare benign tumors that can mimic soft tissue sarcomas. We report the case of a 38-year-old male who presented with a large 25x18 cm posterior neck mass associated with sinus and intermittent low-grade fever for ten days. Routine laboratory tests were normal. Ultrasonography showed a well-defined hypoechoic subcutaneous lesion without cystic areas or calcifications. FNAC demonstrated mature fat cells in strands of fibrous stroma, compatible with a lipoma. A contrast-enhanced CT scan showed no underlying bone or spinal involvement. The mass was surgically excised, and histopathology confirmed the benign diagnosis. No recurrence occurred on follow-up. This case underscores the importance of integrating cytology, imaging, and histopathology to differentiate giant lipomas from malignant tumors and guide clinical decision-making in such rare presentations.