Omental lipoma: a rare cause of a giant intra-abdominal mass

Abstract

Primary tumors of the omentum, let alone omental lipomas, are rare causes of a large intra-abdominal mass. We report a case of an adult male presenting with an intra-abdominal mass, representative of a giant omental lipoma radiologically, confirmed on histopathology after complete resection at laparotomy. The case highlights the preoperative workup of a suspected omental lipoma, including the utility of various radiological modalities in differentiating from malignant pathologies, and anatomical characterization of the lesion for surgical planning.

Giant omental lipoma, a rare etiology of right-iliac fossa pain in adult: A surgical case report

“…Large-sized lipomas may lead to bowel obstructions and distension [9] . Initially, the omental lipoma diagnosis relies on physical examination that includes mass inspection and palpation [4] , [5] , [12] . In the presented case, the physical examination was normal.…”

“…Furthermore, an abdominal CT scan adds a greater diagnostic value of omental lipomas [11] , [12] . It provides definitive fat content characterization by determining the attenuation values (−80 to −120 HU) that leads to the lesion localization within the omentum [4] . Although USG and CT are important diagnostic tools, MRI adds better demonstration of the surrounding anatomy [10] .…”

“…Although USG and CT are important diagnostic tools, MRI adds better demonstration of the surrounding anatomy [10] . Both CT and MRI help in the detection of complications, such as bleeding or torsion, that may develop in symptomatic patients [1] , [4] . In our case, an abdominal CT scan was performed, revealing a right-sided large intra-abdominal mass-like lesion described as: Large well-defined mixed hypo and hyperdense misty soft-tissue attenuation lesion The lesion is seen on the right hypochondria and extends to the midline of the abdomen It measures about 2.4 × 10 × 20 cm Lesion associated with mass effect compressing the transverse colon inferiorly No radiological evidence of acute appendicitis …”

“…Despite being the most common benign mesenchymal tumors of soft tissue, omental lipomas are extremely rare [1] , [2] , [3] , [4] . In an adult, giant omental lipomas account for less than ten published cases reported worldwide [5] .…”

“…In an adult, giant omental lipomas account for less than ten published cases reported worldwide [5] . Typically, patients with omental lipomas are asymptomatic, while large lipomas can cause non-specific symptoms and abdominal distension [3] , [4] . Here we report a 61-year-old gentleman who presented with right iliac fossa pain.…”