BCWT may originate from vascular, peripheral nerve, osseous, cartilaginous, or adipose tissue and are very rare lesions. In the literature, few research studies of this group of tumours have been reported. In particular, the imaging features of BCWT are non-specific: only combination of imaging appearance, location and clinical information may suggest a diagnosis [1
Chest radiography can be used to determine the location, size, and growth rate of the mass. However, CT enables a more accurate assessment of tumour morphology, composition, location and extent [1
In the case we report, CT scan evidenced a solid neoplasm with homogeneous fat density with spotted areas of calcification. According to these radiological features and the absence of signs of chest wall invasion, we did not perform a fine needle aspiration biopsy preoperatively and a radical excision was indicated and performed.
Generally, chest wall lipomas occur in obese patients who are 50–70 years of age and, in most cases, are deep lesions, larger and less well circumscribed than subcutaneous ones [2
]. In our case, the patient was 68 years old and the tumour (an extremely large mass measuring 27 cm in its major axis) apparently originated from the left serratus anterior muscle. Moreover, the capsule was difficult to see clearly on CT scans.
In conclusion, chest wall giant lipomas are rarely reported in the literature [3
]. To our knowledge, this is the first case reporting a giant, symptomless lipoma of the chest wall developed over a thirty-year period.