Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2022; 10(5): 1675-1683
Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1675
Giant retroperitoneal lipoma presenting with abdominal distention: A case report and review of the literature
Zhi-Yan Chen, Xian-Long Chen, Qi Yu, Qing-Bo Fan
Zhi-Yan Chen, Qi Yu, Qing-Bo Fan, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730, China
Xian-Long Chen, Department of Pathology, Peking Union Medical College Hospital, Beijing 100730, China
Author contributions: Chen ZY wrote and revised the manuscript; Chen ZY and Fan QB were part of the clinical team that treated the patient; Chen XL participated in the review of the pathology; Yu Q and Fan QB revised the manuscript and supervised the study.
Supported by the National Key Research and Development Program, No. 2018YFC1002105.
Informed consent statement: Informed written consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: No conflict of interests exists to any of the authors.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Bo Fan, MD, Professor, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. qbfan@sohu.com
Received: August 21, 2021
Peer-review started: August 21, 2021
First decision: November 17, 2021
Revised: December 8, 2021
Accepted: January 8, 2022
Article in press: January 8, 2022
Published online: February 16, 2022
Processing time: 173 Days and 11.4 Hours
Abstract
BACKGROUND

Retroperitoneal lipomas are extremely rare tumors and tend to be large in size (> 10 cm) when diagnosed, causing various clinical manifestations. Preoperative diagnosis of retroperitoneal lipomas is difficult. There is a lack of relevant information about the management and prognosis of these benign tumors due to limited reports.

CASE SUMMARY

A 53-year-old woman who complained about progressive abdominal distention and aggravating satiety was referred to the gynecological outpatient department of Peking Union Medical College Hospital. Computerized tomography (CT) revealed an immense mass with fat density, measuring 28.6 cm× 16.6 cm in size. Adjacent organs, including the intestinal tract and uterus, were squeezed to the right side of the abdomen. An exploratory laparotomy was performed with suspicion of liposarcoma. Intraoperatively, a giant yellowish lobulated mass was found occupying the retroperitoneum and it was removed by tumor debulking. Postoperative histopathological results confirmed the diagnosis of retroperitoneal lipoma.

CONCLUSION

Retroperitoneal lipoma is a very rare condition and is difficult to differentiate from well-differentiated liposarcoma. Radiographic investigations, especially CT and magnetic resonance imaging, are important for preoperative diagnosis. Surgical resection is the fundamental treatment, which is difficult due to its size and relation to neighboring structures.

Keywords: Retroperitoneal lipoma; Well-differentiated liposarcoma; Retroperitoneal tumors; Treatment; Prognosis; Case report

Core Tip: Retroperitoneal lipomas are rare benign tumors originating from adipose tissues and they tend to have large sizes. Imaging examinations, especially computerized tomography and magnetic resonance imaging, are fundamental diagnostic tools for these tumors. Surgical resection is the main treatment method. En bloc resection is commonly required. Postoperative histopathology determines the final diagnosis, and immunohistochemical analysis could be useful in the differentiation of liposarcomas. Regular follow-ups are also required for the patients.