This document summarizes a case presentation of a 32-year-old male patient with a neck swelling. The key details are: - The patient reported a gradually increasing swelling in the back of the neck over the past 2 years, which was initially small at 2cm and increased to its current size of 5cm. - On examination, the swelling was found to be a single, soft, globular mass that was well-defined, freely mobile, and had a positive slip sign but negative fluctuation test. - The provisional diagnosis given was subcutaneous lipoma in the nape of the neck based on the history and examination findings.

1. SHORT CASE
PRESENTATION
LIPOMA
DR JYOTIRMAYA NAYAK
ASSO PROF OF DEPT OF
GENERAL SURGERY
S.C.B MEDICAL COLLEGE AND HOSPITAL

2. PATIENT PARTICULARS
Name –Mr Pabitra sahoo
Age - 32 year .
Sex – male
Religion- Hindu
Resident- JAJPUR ROAD, JAJPUR .
Occupation- businessman .

3. Chief Complaints
• Swelling at the back of the neck for last 2 years .

4. History of Present illness
Patient was apparently alright 2 years back to start with her family
members noticed a swelling in the back of neck .
-It was insidious in onset , initially small size that is 2cm to start with
and gradually progressive to attain the current size of 5cm.
-No history of Pain over the swelling or sudden or rapid increase in size.
-No other swelling in the other parts of the body.

5. Past History:
- No past history of any surgeries.
-Not a known case of Hypertension,DM-2 , CAD , Pulmonary Tuberculosis ,
Asthma .

6. Family History
-He having no family history of any neck swelling .

7. Personal History
-He having Mixed Indian Diet .
-Not addicted to tobacco smoking or alcohol.
-Sleep pattern normal .
-Bowel and Bladder habit regular.

8. GENERAL EXAMINATION
Pt examined in a well lit room with informed consent with proper
exposure .
-He was conscious, well oriented and cooperative.
-He has average body built with BMI 0f 22.2 kg/m2
- He having Performance score of 90 in Karnowski PS .
-He is Well hydrated.

9. GENERAL EXAMINATION
He had no pallor/Icterus/cyanosis/ clubbing /
Pedal Edema/ generalized lymphadenopathy
• Patient is afebrile ,
• PR – 78 B/M in right radial artery with
regular Rhythm and normal Volume with
no radio- radial or radio-femoral delay .
• BP – 130/80 mmhg in right arm supine
position.
• RR-18 per minute Thoracoabdominal .

10. LOCAL EXAMINATION
I had examined the patient in a well lit room with adequate exposure head
to sitting position, from front and back after taking due consent .
INSPECTION:
•A single swelling of size approximately 5*3cm , ovoid in shape present at
the back of neck.
•Edge of the swelling clearly defined.
•No visible pulsation present.
•Superficial veins are not engorged.

11. INSPECTION
-Swelling moving up with the Deglutition .
-No movement seen on tongue protrusion .
-It has well defined margin and smooth surface .
-Skin over the swelling appears Normal .
-Inferior border of the swelling well appreciated.
-No other swelling noted in the same region or both side of neck .

12. PALPATION
-No local rise of temperature and Tenderness over the swelling .
-A single swelling of size 5*3cm present at the back of the neck.
-It has smooth surface with regular border , soft-firm consistency
, mobile in relation to the deeper structure .
•slip sign is positive,flactuation test negative.
•Swelling neither reducible nor compressible,and also
nonpulsatile.

13. SYSTEMIC EXAMINATION
• CVS : First(S1) and second (S2) heart sound heard normal. No murmur
associated .
• RS : B/L normal vesicular breath sounds , no added sounds .
• PER ABDOMEN : soft , non tender , no organomegaly, bowel sounds
normal
• CNS : no focal neurological deficits , motor and sensory functions
intact .
• MUSCULOSKELETAL: no proximal group of muscle involvement .

14. SUMMERY OF THE CASE
32 yrs hindu male patient presented with a gradually
increasing swelling in the back of neck for last 2yrs.the
swelling was about 2cm in size at the onset and then
gradually increased in size to attain the present size of about
5cm,soft ,globular swelling,slip sign positive,margin well
defined,freely mobile,flactuation negative.

15. PROVISONAL DIAGNOSIS
• MY PROVISIONAL DIAGNOSIS IS
subcutaneous lipoma in the nape of neck.

16. THANK YOU