53 year old with C/O swelling of back of neck 7 years and right thigh since 5 years.

53 year old male presented to the opd with C/O swelling of back of neck 7 years and  right thigh since 5 years.


HOPI : Patient was apparently asymptomatic 7  yrs back then he developed swelling in back of neck which was insidious in onset gradually progressed  to present size.
5 years back he had H/o trauma + (?wooden stick injury) 
6 months later he noticed the swelling Initially started on the right side and progressed to involve first the lateral part for 2 years then progressed to medial part of the thigh also 

On prolonged activity there is a little bit increase in size of the swelling with tightening of overlying skin

No pain or restriction of movements

PASTILLNESS 

N/K/C/O Epilepsy HTN DM CAD CVA TB Asthma

 Personal history: 
Normal appetite takes veg diet (non veg stopped 2 years ago).He is a garment shop owner, regular bowel habits , normal micturition , no allergies and addictions.
Family History:
Father has hypertension 

GENERAL PHYSICAL EXAMINATION 
Patient conscious coherent cooperative 
Moderately built and nourished
No, icterus, cyanosis, clubbing,pallor,edema,lymphadenopathy 
Vitals:

Bp:130/90mmhg

RR-16cpm

PR-98 bpm 

TEMP-98.1F

Cardiovascular System : S1, S2 heard, no murmurs


Respiratory System : BAE +.Normal vesicular breath sounds heard.Position of trachea central.


Central Nervous System : patient is conscious coherent and cooperative. Higher mental functions intact 


Per abdomen : soft, non tender ,no guarding and rigidity 

LOCAL EXAMINATION:

INSPECTION:

A single swelling over Right Thigh region of size 20*15 cm and of elliptical shape.No discharge from the swelling,no visible pulsations dilated veins scars sinuses seen.

No redness, skin over the swelling is shiny.


PALPATION:

No local rise of temperature or tenderness.

All inspectory finding are confirmed 


A single swelling over Right Thigh region of size 20*15 cm and of elliptical shape and cystic in consistency.Surronding skin is normal. All borders are well defined and swelling non mobile in all directions.skin over the swelling is pinchable.

INVESTIGATIONS:







XRAY 




                                     


                     TRUCUT BIOPSY 










Provisional Diagnosis:
Lipoma over the nape of neck
Swelling over Rt thigh ?Lipoma
of the Right Thigh

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