A pain in the groin

Abstract

334 Vol 350 • August 2, 1997 Computed tomograph scan showing a large anterior abdominal wall “lipoma” (arrows) A 64-year-old woman with Dercum’s disease (adiposis dolorosa) attended the gynaecological clinic in February, 1996, with a 4-week history of lower left-sided abdominal and pelvic pain. An ultrasound scan showed uterine fibroids and she underwent hysterectomy and bilateral salpingo-oophorectomy. This did not relieve her symptoms and in July, 1996, she consulted her general practitioner with worsening pain. There was an obvious sausage-shaped lump in the left iliac fossa. She was reassured that this was another lipoma. 4 months later she was still in pain and had frequent bowel motions. A colonoscopy was normal and she was again reassured, as she was not keen to have the lipoma removed. She came back 3 months later with increasing discomfort, and at this time an ultrasound scan, requested to assess the size and position of the lump, failed to identify it. A computed tomograph scan was reported as showing a large abdominal wall lipoma (figure). She was offered surgical excision again, but declined. Despite further reassurance her symptoms got worse.