Wubishet Mesfin, Shimelis Betre, Tigabie Workye, Lemma Ashenafi
Department of Pediatrics, Arsi University College of Health Sciences, Asella, Ethiopia.
Department of Pediatrics, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia.
Clin Med Insights Case Rep. 2025 Jan 4;18:11795476241312825. doi: 10.1177/11795476241312825. eCollection 2025.
Lipomas can occur almost anywhere in the body, but they are exceptionally rare in the retroperitoneal region. While lipomas are common in adults, they are quite uncommon in children. Even among adults, retroperitoneal lipomas are not frequently encountered. When symptomatic, retroperitoneal lipomas may present with abdominal swelling, pain, or constipation, as noted in previous literature. However, there have been no reported cases of retroperitoneal lipomas causing recurrent diarrhea in children.
We present a rare case of a large retroperitoneal lipoma in a 3-year-old child who experienced recurrent diarrhea and intermittent abdominal pain for 2 months, without any urinary symptoms. All Laboratory investigations were within reference ranges for his age. A CT scan showed a large abdominal mass likely from the retroperitoneum, potentially a lipogenic tumor, though liposarcoma could not be excluded. The patient was successfully treated with complete surgical excision, and histopathological analysis confirmed the diagnosis of a benign lipoma.
Retroperitoneal lipoma is a rare variant of lipoma in children, often presenting with various nonspecific and misleading symptoms. Due to the rarity of this condition and the limited awareness among clinicians, it frequently leads to misdiagnosis. Radiologic imaging, particularly CT and MRI scans, are essential diagnostic tools for identifying these tumors. This case report emphasizes the importance of maintaining a high index of suspicion for this rare condition when clinicians encounter recurrent diarrhea and concerning radiological findings. The characteristic behavior of retroperitoneal lipomas in children is still not well-defined; therefore, long-term follow-up is recommended.
脂肪瘤几乎可发生于身体的任何部位，但在腹膜后区域极为罕见。脂肪瘤在成年人中较为常见，在儿童中则相当少见。即便在成年人中，腹膜后脂肪瘤也不常遇到。如既往文献所述，有症状的腹膜后脂肪瘤可能表现为腹部肿胀、疼痛或便秘。然而，尚无腹膜后脂肪瘤导致儿童反复腹泻的病例报道。
我们报告一例罕见的3岁儿童腹膜后大脂肪瘤病例，该患儿有2个月的反复腹泻和间歇性腹痛，无任何泌尿系统症状。所有实验室检查结果均在其年龄的参考范围内。CT扫描显示一个可能源于腹膜后的腹部大肿块，可能是脂肪瘤性肿瘤，不过不能排除脂肪肉瘤。该患者通过完整手术切除成功治愈，组织病理学分析确诊为良性脂肪瘤。
腹膜后脂肪瘤是儿童脂肪瘤的一种罕见变体，常表现出各种非特异性且易误导的症状。由于这种情况罕见且临床医生认识有限，常导致误诊。放射影像学检查，尤其是CT和MRI扫描，是识别这些肿瘤的重要诊断工具。本病例报告强调，当临床医生遇到反复腹泻和相关放射学表现时，对这种罕见疾病保持高度怀疑的重要性。儿童腹膜后脂肪瘤的特征性表现仍未明确界定；因此，建议进行长期随访。
