J Korean Med Sci.  2009 Apr;24(2):333-336. 10.3346/jkms.2009.24.2.333.

Giant Mesenteric Lipoma As an Unusual Cause of Abdominal Pain: A Case Report and a Review of the Literature

• Cha JM
• Lee JI
• Joo KR
• Choe JW
• Jung SW
• Shin HP
• Kim HC
• Lee SH
• Lim SJ

• KMID: 1779141
• DOI: http://doi.org/10.3346/jkms.2009.24.2.333

Abstract

We report a rare case of giant mesenteric lipoma presenting with colicky abdominal pain. A 29-yr-old woman underwent laparoscopic resection for a giant mesenteric lipoma causing compression of the ileal loop. The resected ileal segment was encased by a giant fatty tissue, and normal mucosal fold patterns of the resected ileum were effaced by the mass. Microscopically, the mass was characterized by homogenous mature adipose tissue without cellular atypia, which was compatible with the diagnosis of a mesenteric lipoma. Despite the benign nature of this tumor, total excision with or without the affected intestinal loop should be considered if intestinal symptoms such as abdominal pain are present.

Keyword

Mesentery; Lipoma; Computed Tomography; Abdominal Pain; Laparoscopy

MeSH Terms

Abdominal Pain/*etiology
Adipose Tissue/pathology
Adult
Diagnosis, Differential
Female
Humans
Ileal Diseases/etiology
Laparoscopy
Lipoma/complications/*diagnosis/surgery
*Mesentery/pathology
Peritoneal Neoplasms/complications/*diagnosis/surgery
Tomography, X-Ray Computed

Figure

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  Fig. 1 Contrast-enhanced CT scan of a mesenteric lipoma. The coronal reformation image shows a prominent mass with homogenous fatty attenuation (arrows) in the lower abdominal cavity. A narrowing and elongation of an entrapped small bowel segment was observed (arrowheads).

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  Fig. 2 A small bowel follow-through image shows upward deviation of the entire small bowel loop, except for one segment of the ileal loop (arrows) entrapped within the prominent fatty tissue. Note the diverticula in the entrapped ileal loop.

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  Fig. 3 Resected small bowel and mesenteric lipoma. The normal mucosal fold pattern of the resected small bowel lumen was effaced.

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  Fig. 4 Microscopic findings of the mesenteric lipoma. (A) The tumor revealed mature fat cells proliferating in the subserosal layer (H&E; original magnification, ×20). (B) Mature adipocytes are relatively uniform in size and lack cytologic atypia (H&E; original magnification, ×200).

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