Torsion of a lipoma of parietal peritoneum: a rare case mimicking acute appendicitis

Laparoscopic extraction of a symptomatic upper abdominal pedunculated parietal peritoneal lipoma arising intermittent abdominal pain: a case report

INTRODUCTION

Lipomas arising in the parietal peritoneum are rare, and some of them cause abdominal pain due to torsion of the pedunculated peritoneum. We encountered a case of parietal peritoneal lipoma arising upper peritoneum. In this report, we describe the detail of clinical presentation and discuss its potential pathogenesis and treatment strategy.

CASE PRESENTATION

45 year-old Japanese female patient presented with long-lasting intermittent pain in the left upper abdominal region. Abdominal imaging showed a well-defined fatty mass measuring 40 mm in size, suggesting a parietal peritoneal lipoma. Laparoscopy revealed a tumor with a twisted peduncle; however, no adhesion of the surrounding tissues and ischemic changes were visible. The tumor was easily removed by dissection of the tumor pedicle.

CONCLUSION

Parietal peritoneal lipoma often shows pedunculated form and it causes abdominal pain by the torsion of tumor pedicle. Therefore, this type of lipoma should be considered a more aggressive surgery.

Parietal peritoneal lipomas: a first case report of two lipomas of the parietal peritoneum

Parietal peritoneal lipomas are a rare surgical entity with seven case reports in the published literature. Their aetiology remains nebulous and includes theories such as misplaced embryonic tissue, adipose hyperproliferation, trauma and fat herniation or excessive obesity. This is the first case report in the literature with two parietal peritoneal lipomas incarcerated in an umbilical hernia. We strongly advocate for an international rare tumour registry, given the sparsity of data on these tumours and their possible malignant potential, which we believe would help potentiate an effective treatment protocol for future cases.

A giant lipoma of the parietal peritoneum: Laparoscopic excision with the parietal peritoneum preserving procedure - a case report with literature review

BACKGROUND

Lipomas are very common benign tumors of mature fatty tissue that can occur in any part of the body. However, lipomas of the parietal peritoneum are extremely rare.

CASE PRESENTATION

A 36-year-old man presented with urinary frequency for 6 months. On computerized tomography of the abdomen and pelvis, a well-defined fatty mass measuring 20 × 11 × 6.5 cm in size, was found in the lower abdominal cavity. We performed a laparoscopic parietal-peritoneum-preserving excision of the mass. The patient was discharged without complications on post-operative day 6.

CONCLUSIONS

To our knowledge, a laparoscopic excision with preservation of the parietal peritoneum for a giant parietal peritoneal lipoma has never been reported. Herein, we report a case of a giant lipoma of the parietal peritoneum successfully managed by laparoscopy.