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Journal of Dermatology Research and Therapy





DOI: 10.23937/2469-5750/1510010



Lipoma on the Antitragus of the Ear

Hyeree Kim, Sang Hyun Cho, Jeong Deuk Lee and Hei Sung Kim*


Department of Dermatology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea


*Corresponding author: Hei Sung Kim, Department of Dermatology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Donsuro, Bupyeong-gu, Incheon, 403-720, Korea, Tel: 82-32-280-5100, Fax: 82-2-506-9514, E-mail: hazelkimhoho@gmail.com
J Dermatol Res Ther, JDRT-1-010, (Volume 1, Issue 1), Case Letter; ISSN: 2469-5750
Received: November 9, 2015 | Accepted: November 27, 2015 | Published: November 30, 2015
Citation: Kim H, Cho SH, Lee JD, Kim HS (2015) Lipoma on the Antitragus of the Ear. J Dermatol Res Ther 1:010. 10.23937/2469-5750/1510010
Copyright: © 2015 Kim H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Keywords

Auricular lipoma, Ear helix lipoma, Cartilagious lipoma, Antitragal lipoma

Lipomas are the most common soft-tissue neoplasm [1,2]. Although they affect individuals of a wide age range, they occur predominantly in adults between the ages of 40 and 60 years [2]. They most commonly present as painless, slowly enlarging subcutaneous mass on the trunk, neck, or extremities. Involvement of the head, hands, and feet is uncommon [2]. To our knowledge, lipoma on the cartilaginous portion of the ear (auricular helix) has been reported only three cases so far [1,3,4]. Herein, we report a rare case of lipoma on the antitragus of the ear.

A 31 year-old Korean woman presented with an asymptomatic, solitary, 0.5 cm-sized, skin-colored, firm, immovable mass on the antitragus of the left ear for one year (Figure 1A). She denied of previous trauma or infection. We initially suspected the mass as a dermatofibroma or nevus, because of its clinical manifestation. We performed a skin biopsy for confirmative diagnosis.


.
Figure 1(A): There is a 0.8 cm-sized, skin-colored, firm mass on the antitragus of left ear for 1 year.
Figure 1(B): Histopathologic findings revealed mass are composed of lobules of mature white adipose tissue divided by delicate and inconspicuous fibrous septa containing thin-walled capillary-sized vessels. (H & E, x100) View Figure 1



.




Histopathology revealed an unencapsulated intra dermallipoma composed of lobules of mature adipocytes separated by delicate fibrovascular septa (Figure 1B). A final diagnosis of dermal lipoma was made. We recommend complete excision, but the patient was lost to follow-up.

Lipomas are benign tumors made up of mature fat cells [5]. They can be solitary or multiple, small or big, symptomatic or asymptomatic. Lipomas are mostly asymptomatic but rarely accompany pain by pressing the adjacent structures. Apart from the fat cells, they may also contain fibrous tissue, nerves or vascular tissue. Such cases are named accordingly as fibrolipoma, neurolipoma, angiolipoma [5]. Based on their location, they are also classified as dermal, subcutaneous, submucous or intramuscular lipomas [2,5].

Approximately 15% of all lipomas occur in the head and neck area with the posterior neck being the most common site [1]. They rarely involve the face, scalp, orbit, nasal cavity, paranasal sinuses, nasopharynx, cranium or ear [6]. When the lipomas are on the ear, most are located in internal auditory canals, where approximately 150 cases have been reported in the literature worldwide [7]. Lipomas rarely originate from the external ear where only a few cases have been reported from the ear lobule [5], and a only three cases from the cartilaginous part of ear [1,3,4] (Table 1). Bassem et al. reported a case of lipoma of the pinnal helix on the 82-year-old woman, which presented a single, 3x3x2 cm-sized, pedunculated mass [1]. Mohammad and Ahmed reported two cases of cartilaginous lipoma, one is conchal lipoma and the other is helical lipoma in 2015 [3,4]. To our knowledge, only these three cases of lipomas that have been on the cartilaginous part of the ear.



Table 1: Summary of report of lipoma on the cartilaginous part of the ear View Table 1


Lipomas from the cartilaginous part of the ear are very rare, but it is possible because of the presence of a thin adipose tissue layer on the auricle [1]. It should be considered as a differential diagnosis of benign tumors of auricle which usually includes papilloma, fibroma and chondromata and hemangioma [1].

Lipomas are removed mostly for cosmetic purposes. The treatment of choice is complete excision under local anesthesia [1,2,5,6,7]. Most lipomas are benign except liposarcoma. Local recurrence is rare except for the intramuscular forms. Metastasis does not occur [2].

So far, only three case of lipomas on the cartilaginous part of the ear has been reported, making this location very unusual for a lipoma [1,3,4].

We herein report a rare case of lipoma on the antitragus of the left ear.


References
  1. Bassem M, Amir F, Aaron T, Ashish B, Hisham Zet (2012) Lipoma of the pinnal helix: a very unusual location for a very common tumour. BMJ Case Rep 10: 1136-1137.

  2. Katz S, Goldsmith L, Wolff K, Paller A, Paller A, et al. (2012) Fitzpatrick's dermatology in general medicine. In: Neoplasm of subcutaneous fat. Thomas B, (8th edn) Mc-Graw-hill, New-York, 1489-1491.

  3. El-Anwar M, Sweed A (2015) Conchal Lipoma: A New Lipoma Site. J Int Adv Otol 11: 92-94.

  4. Ahmed HS, Mohammad EA (2015) Helical lipoma in adult female. Indian J Otol 21: 303-305.

  5. Nambi G, Sachi K, Paul MK, Gupta AK (2009) Lipoma--common tumour in an uncommon location. J Plast Reconstr Aesthet Surg 62: e490-491.

  6. Barnes L (2000) Tumors and Tumor-Like Lesions of the Soft Tissues. In: Leon Barnes, Surgical Pathology of the Head and Neck (2nd edn), 915-918.

  7. Bacciu A, Di Lella F, Ventura E, Pasanisi E, Russo A, et al. (2014) Lipomas of the internal auditory canal and cerebellopontine angle. Ann Otol Rhinol Laryngol 123: 58-64.

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