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June 1, 2008

Giant Subcutaneous Tumors on the Thighs—Quiz Case

Author Affiliations

Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2008

Arch Dermatol. 2008;144(6):795-800. doi:10.1001/archderm.144.6.795-a

A 32-year-old morbidly obese man (316 kg, body mass index, 102.7 [calculated as weight in kilograms divided by height in meters squared]) with no medical history presented with a 2-year history of 2 progressively enlarging tumors on his bilateral thighs. These tumors were asymptomatic, but they greatly interfered with ambulation.

Physical examination revealed 2 pedunculated, oblong, soft, nontender subcutaneous tumors (Figure 1). The tumors grew from the distal right and proximal left thighs and measured 30 × 4 × 5 cm and 102 × 30 × 50 cm, respectively. The overlying skin was extremely edematous with several shallow pressure ulcerations. Focal lichenification and erythema were present on the larger tumor, reflecting chronic rubbing on the ground while walking. An intraoperative incisional biopsy specimen of the larger tumor was sent for histologic examination (Figure 2 and Figure 3).