English

Abstract

INTRODUCTION: Pelvic lipomatosis is a rare benign disorder characterized by deposition of mature fat tissue in the pelvic cavity and absence of delimitation by a capsule. Peak incidence of this disease is between 25 to 60 years of age with a staggering male predominance of 10:1. CASE REPORT: A 45 yr. old male presented with epigastric swelling and abdominal pain. Clinically, he was diagnosed with epigastric hernia. Ultrasound showed bladder wall thickening with bilateral hydroureteronephrosis. CT showed bilateral hydrouretronephrosis with pear shaped bladder, non-encapsulated fatty mass surrounding urinary bladder symmetrically, with attenuation similar to that of subcutaneous fat suggesting extensive pelvic lipomatosis. On laparotomy there is a large pelvic lipoma filling the whole of pelvis and bladder was surrounded by fatty tissue all around along with lipoma of the cord. Patient underwent pre peritoneal hernioplasty for ventral hernia and excision of pelvic lipoma and the lipoma of the cord. DISCUSSION: Pelvic lipomatosis is a benign overgrowth of adipose tissue with small amount of inflammatory and fibrotic components found especially in the perivesical and perirectal spaces. The best definitive diagnostic procedure is CT. Various treatments have been attempted, but no single treatment has proved effective to date.