Surgical resection of pleural lipoma after 9 years of serial imaging

Our plain-English summary of Surgical resection of pleural lipoma after 9 years of serial imaging, by C. Nahal, C. Purohit, A. Toma, et al (Journal of Cardiothoracic Surgery, 2026).

The study

• Authors: C. Nahal, C. Purohit, A. Toma, P. Seirafi
• Journal: Journal of Cardiothoracic Surgery
• Published: 2026;21(1)
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

Pleural lipomas are rare benign intrathoracic mesenchymal neoplasms. Although typically asymptomatic, they can enlarge and cause symptoms secondary to compression of surrounding intrathoracic structures. There is minimal reporting of pleural lipoma observed with computed tomography throughout prolonged periods of surveillance; therefore, differentiating well-differentiated malignant liposarcoma from imaging alone remains a diagnostic challenge. We present the case of a 74 year-old male with tobacco use and asbestos exposure who underwent surveillance of a pleural neoplasm over 9 years. Continued enlargement and morphological changes concerning for malignancy prompted video-assisted thoracoscopic surgical resection. The pleural mass was diagnosed as a pleural lipoma and the patient recovered well. Pleural lipomas, especially in patients with risk factors for malignancy, should be resected for accurate diagnosis and prevention of complications associated with compression of adjacent structures.

© 2026. The Author(s).

In plain English

This case report described one patient, a 74-year-old man whose mass on the lining of the left upper chest (a pleural mass) was followed with repeated scans for 9 years. The patient had a 30 pack-year smoking history, asbestos exposure during childhood (no fiber type was reported), and past meningioma, prostate cancer and bladder cancer. The mass gradually grew to 4.6 by 4.7 by 3.5 centimeters on CT, and the latest CT showed newly appearing calcifications. A PET scan 1 month before surgery showed no significant radiotracer uptake. Because of a higher suspicion of cancer, surgeons removed the mass in one piece by keyhole chest surgery (VATS). Pathology found a benign fatty tumor, an intramuscular lipoma variant with cartilage and bone components. A test negative for MDM2 amplification indicated a low likelihood of liposarcoma. At 1 month the patient had adequate breathing function and physical activity. The authors concluded that surgery was effective for accurate diagnosis and that pleural lipomas should be resected, especially in patients with risk factors for malignancy.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 74-year-old male patient with a left upper pleural-based mass, monitored with imaging over 9 years; authors are from the West Palm Beach Veterans Affairs Healthcare System, Florida, USA
• Exposure: Asbestos exposure during childhood (fiber type and source not reported), plus a 30 pack-year smoking history
• Main results:
  • The pleural mass gradually enlarged over 9 years to 4.6 by 4.7 by 3.5 centimeters on CT
  • The most recent CT showed newly appearing calcifications in the mass
  • PET imaging 1 month before surgery did not show significant radiotracer uptake
  • The mass was removed en bloc by video-assisted thoracoscopic surgery and did not extend into the ribs
  • Pathology consultation found an intramuscular lipoma variant with cartilaginous and osseous components
  • Fluorescence in situ hybridization was negative for MDM2 amplification, indicating low likelihood of liposarcoma
  • At 1 month follow-up the patient continued to have adequate respiratory function and physical activity
• The authors' conclusion: The authors concluded that VATS resection was effective for accurate diagnosis and prevention of complications, and that pleural lipomas, especially in patients with risk factors for malignancy, should be resected

Topics

Medical terms in this study, explained in our Lexicon: Surgical Resection, Intrathoracic, Neoplasm, Well-Differentiated, Asbestos Exposure.

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