CT confirmation of pelvic lipomatosis: two cases

Gerson, ES; Gerzof, SG; Robbins, AH

doi:10.2214/ajr.129.2.338

Cited by 31 publications

(5 citation statements)

References 8 publications

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“…A total of 42 studies, 1 – 3 , 7 – 45 including 231 patients with PL were finally included in this systemic review. The detailed literature search process is illustrated in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

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Surgical treatment of pelvic lipomatosis: a systematic review of 231 cases

Xia,

Xiong,

et al. 2023

Therapeutic Advances in Urology

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Background: Pelvic lipomatosis (PL) is a rare condition that is characterized by excessive growth of fat in the pelvic cavity. Studies have yet to systematically review surgical treatments for PL. Objectives: To provide a reference for selecting reasonable surgical treatments for PL patients according to previous literature on the surgical treatment of PL. Design and methods: We conducted this systematic review in accordance with the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) of Individual Participant Data guidelines. Literature on PL published from 1968 to 2022 was retrieved from the PubMed and EMBASE databases. Data were collected and analyzed independently by two independent investigators. Results: A total of 42 studies, involving 231 patients with PL, were included in the analysis. The surgical treatments included transurethral resection (TUR) (48.5%), ureteral stent placement (11.7%), percutaneous nephrostomy (1.3%), ureterocutaneostomy (1.3%), ureteral reimplantation (10.4%), ileal conduit (13%), and allograft kidney transplantation (0.4%). After excluding patients with unclear prognoses, 42.9% of patients showed improvement in lower urinary tract symptoms (LUTS) after TUR. Ureteral stent placement provided relief of hydronephrosis in 62.5% of PL patients. Percutaneous nephrostomy resulted in stable renal function in 33.3% of PL patients, while ureterocutaneostomy led to remission of postoperative hydronephrosis in 33.3% of PL patients. After ureteral reimplantation, 70.8% of patients experienced relief of hydronephrosis or had stable renal function. Ileal conduit led to remission of hydronephrosis, alleviation of symptoms, or maintenance of stable renal function in 83.3% of PL patients. One patient with PL had stable renal function after allograft renal transplantation. Conclusion: The surgical treatments for PL include TUR, ureteral stent placement, urinary diversion, and allograft renal transplantation. However, the choice of surgical method should be determined after comprehensive consideration of the patient’s condition.

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“…A total of 42 studies, 1 – 3 , 7 – 45 including 231 patients with PL were finally included in this systemic review. The detailed literature search process is illustrated in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“… 51 , 52 In PL patients who need urinary diversion, ureteral reimplantation is often combined with fat removal. 1 , 2 As early as 1977, Gerson et al 30 reported for the first time the case of a PL patient undergoing ureteral reimplantation. Ureteral reimplantation is an effective treatment for PL patients.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of pelvic lipomatosis: a systematic review of 231 cases

Xia,

Xiong,

et al. 2023

Therapeutic Advances in Urology

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“…Since the advent of computed tomography at least 15 cases have been reported establishing the diagnosis of pelvic lipomatosis (4,8,9,12,16,24,26). The typical finding reported and also present in our case is a redundant collection of non-encapsulated fatty tissue enveloping the pelvic organs and with an attenuation similar to that of subcutaneous fat.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography of Pelvic Lipomatosis

Bååth¹,

Nyman²,

Aspelin³

et al. 1986

Acta Radiologica. Diagnosis

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Pelvic lipomatosis is a non-malignant condition of unknown etiology characterized by an overgrowth of non-encapsulated fatty tissue in the perirectal and perivesical spaces of the pelvis. The symptoms are generally vague and the condition is often diagnosed accidentally. It may cause obstruction of the ureters, inferior vena cava and pelvic veins and may be associated with cystitis glandularis. The typical conventional radiographic findings, though not pathognomonic, are a high-positioned and pear-shaped bladder, tubular narrowing of the rectum and distal sigmoid colon and reduced attenuation of the pelvic soft tissues. Computed tomography demonstrates a non-encapsulated fatty mass surrounding the pelvic organs symmetrically and with an attenuation similar to that of subcutaneous fat. The fatty tissue may contain strands with a higher attenuation than that of fat. The findings at computed tomography seem to be pathognomonic for this condition and eliminate the need for routine surgical biopsies.

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“…Mediastinal lipomatosis and epicardial fat pad simulating tumors are easily diagnosed by computed tomography, making other diagnostic procedures unnecessary [1,2]. Pelvic lipomatosis occurring as either a diffuse or focal process can be verified using CT [8]. Fatty infiltration of the ileocecal valve, benign mesenteric or retroperitoneal fatty masses, and renal sinus lipomatosis have all been documented by computed tomography [3,4,9].…”

Section: Discussionmentioning

confidence: 99%