Saoussen Ben Marzouk, Souphia Rabti, Wael Farjaoui, Basma Ben Hassine, Roua Mighri, Bechir Khalifa Mohamed
General Surgery Department, Military Hospital of Tunis, Mont Fleury-1008, Tunis, Tunisia; Faculty of Medicine of Tunis, 15, Djebel Lakhdhar Street - 1007 Bab Saadoun, Tunis, Tunisia.
General Surgery Department, Military Hospital of Tunis, Mont Fleury-1008, Tunis, Tunisia; Faculty of Medicine of Tunis, 15, Djebel Lakhdhar Street - 1007 Bab Saadoun, Tunis, Tunisia.
Int J Surg Case Rep. 2025 Jul;132:111443. doi: 10.1016/j.ijscr.2025.111443. Epub 2025 May 14.
Lipoma is a very common benign tumor of diverse localization, formed by mature adipocyte cells without cyto-nuclear atypia. Intra-abdominal localization, particularly from omental origin, is uncommon and can present with diffuse abdominal pain, intestinal occlusion, or perforation.
We present the case of a 43-year-old man (BMI 24.8, normoglycemic, normal lipid profile) with right hypochondrial pain and a palpable abdominal mass. Contrast-enhanced CT and MRI revealed a fatty intraperitoneal mass measuring 14 cm in length, originating from the greater omentum. Fine needle aspiration cytology (FNAC) was not performed preoperatively due to the highly suggestive benign imaging features. Surgical exploration confirmed an 8 cm lipomatous mass adherent to the greater omentum, which was completely resected. Histopathological examination confirmed a lipoma without malignancy.
Omental lipomas represent a subset of intraperitoneal adipose tumors, primarily affecting adults aged 40-60. While both contrast-enhanced CT and MRI aid in diagnosis, MRI provides superior tissue characterization for fat-containing lesions. Histology remains essential to rule out liposarcoma, with core needle biopsy indicated for lesions with concerning features. Surgical removal with capsule preservation minimizes recurrence risk, which remains low (2-5 %) but warrants long-term surveillance.
Omental lipomas are uncommon, usually asymptomatic, and require imaging for diagnosis and surgery for definitive treatment. Surveillance imaging is recommended to monitor for recurrence.
脂肪瘤是一种非常常见的良性肿瘤，可发生于身体的不同部位，由成熟的脂肪细胞构成，无细胞核异型性。腹腔内脂肪瘤，尤其是起源于大网膜的，较为少见，可表现为弥漫性腹痛、肠梗阻或穿孔。
我们报告一例43岁男性患者（体重指数24.8，血糖正常，血脂谱正常），有右季肋部疼痛及可触及的腹部肿块。增强CT和MRI显示一个长14厘米的腹腔内脂肪性肿块，起源于大网膜。由于影像学表现高度提示为良性，术前未进行细针穿刺细胞学检查（FNAC）。手术探查证实一个8厘米的脂肪瘤样肿块附着于大网膜，将其完整切除。组织病理学检查证实为无恶性特征的脂肪瘤。
大网膜脂肪瘤是腹腔内脂肪性肿瘤的一个亚型，主要影响40 - 60岁的成年人。虽然增强CT和MRI都有助于诊断，但MRI对含脂肪病变的组织特征显示更优。组织学检查对于排除脂肪肉瘤仍然至关重要，对于具有可疑特征的病变建议进行粗针活检。完整保留包膜进行手术切除可将复发风险降至最低，复发风险仍然较低（2 - 5%），但需要长期监测。
大网膜脂肪瘤较为少见，通常无症状，诊断需要影像学检查，明确治疗需要手术。建议进行监测性影像学检查以监测复发情况。
