Recurrent Giant Intramuscular Lipoma of the Vastus Medialis Muscle: A Case Report and Comprehensive Review of the Literature

Lipomas are the most common benign soft tissue tumors, yet their occurrence within deep muscular compartments (intramuscular lipomas) is relatively rare. Unlike superficial subcutaneous lipomas, intramuscular variants often display an infiltrative growth pattern, leading to significantly higher recurrence rates if not adequately and completely excised. We present a compelling case of a 40-year-old female with a recurrent giant intramuscular lipoma located in the left vastus medialis muscle. The patient had undergone a surgical excision of a mass in the same anatomical location ten years prior. Clinical examination, plain radiography, and magnetic resonance imaging (MRI) revealed a deep-seated, 8.2-cm lipomatous mass engaging the quadriceps musculature. The patient was treated with an extended marginal re-excision. This report discusses the diagnostic challenges, radiological characteristics, and surgical management of recurrent deep-seated lipomas. We emphasize the absolute necessity of preoperative MRI to distinguish these lesions from atypical lipomatous tumors and the importance of adequate surgical margins to prevent recurrence in infiltrative subtypes.