Introduction: Head and neck lipomas have seldom drawn attention in the literature, except in isolated case reports.

Aims: This study aimed to assess the presentation variability of head and neck lipomas as well as the relative importance and efficiency of pre-operative diagnostic methods used.

Materials and methods: A retrospective review was undertaken of medical records and imaging studies of 24 patients with histopathologically proven head and neck lipomas, over a three-year period.

Results: The 24 patients had 26 lipomas. Men predominated (62.5 per cent). The posterior subcutaneous neck was the most common site. Three patients had deep lipomas affecting the hypopharynx, larynx and parotid gland; all were correctly diagnosed pre-operatively. Computed tomography (CT) scan with specific radiodensity recording was the preferred pre-operative investigation.

Conclusions: Lipomas should be considered in the differential diagnosis of soft-tissue head and neck masses even in rare locations. A CT or magnetic resonance imaging scan can correctly diagnose a lipoma pre-operatively, thereby allowing better treatment planning.