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Case number:	013
Age:	75
Clinical presentation:	Postmenopausal woman with average risk of breast cancer presented with a painless right breast lump of long duration. The lump had gradually grown to the present size. Examination revealed a large firm lump (> 10 cm) in the right breast.

Mammography:

Breast composition:	ACR category a (the breasts are almost entirely fatty)
Mammography features:
‣ Location of the lesion:	Right breast, upper quadrants at 2–9 o’clock, anterior, middle, and posterior thirds
‣ Mass:
• Number:	1
• Size:	11.0 × 5.0 cm
• Shape:	Oval
• Margins:	Circumscribed
• Density:	Fat-containing
‣ Calcifications:
• Typically benign:	None
• Suspicious:	None
• Distribution:	None
‣ Architectural distortion:	None
‣ Asymmetry:	None
‣ Intramammary node:	None
‣ Skin lesion:	None
‣ Solitary dilated duct:	None
‣ Associated features:	None

Ultrasound:

Ultrasound features: Right breast, upper quadrants at 2–9 o’clock
‣ Mass
• Location:	Right breast, upper quadrants at 2–9 o’clock
• Number:	1
• Size:	10.5 × 4.5 cm
• Shape:	Oval
• Orientation:	Parallel
• Margins:	Circumscribed
• Echo pattern:	Isoechoic
• Posterior features:	No posterior features
‣ Calcifications:	None
‣ Associated features:	None
‣ Special cases:	None

BI-RADS:

BI-RADS Category: 2 (benign)

Further assessment:

Further assessment advised: Referral for cytology

Cytology:

Cytology features:
‣ Type of sample:	FNAC
‣ Site of biopsy:
• Laterality:	Right
• Quadrant:	Upper half
• Localization technique:	Palpation
• Nature of aspirate:	Greasy, yellowish material
‣ Cytological description:	Smears show only adipose tissue fragments. Ductal epithelial cells not seen
‣ Reporting category:	Benign
‣ Diagnosis:	Only adipose tissue
‣ Comments:	None

Case summary:

Postmenopausal woman presented with a large painless lump on her right breast of long duration. Diagnosed as lipoma, BI-RADS 2 on imaging and as benign adipose tissue on cytology.

Learning points:

Nearly 15% of all mesenchymal tumours are lipomas. Giant lipomas are defined as lesions with a diameter of at least 10.0 cm, as is seen in this case.