Pseudolipoma of Glisson's capsule. Report of six cases and review of the literature.

We report six cases of pseudolipoma of Glisson's capsule. The patients ranged from 53 to 83 years old (mean 67.7 years), and all were men. Pseudolipoma of Glisson's capsule was detected by imaging studies before operation in two cases, and noted incidentally in the remaining four. Computed tomography demonstrated a subcapsular low-density nodule with or without a high-density spot. All but one patient had a history of abdominal operation. Grossly, the pseudolipoma was a solitary encapsulated nodule on the surface of the anterior aspect in five, and posteroinferior to the right lobe in one. The pseudolipomas ranged from 0.5 to 2 cm in diameter, were white to yellowish-white and elastic-firm. Histologically, the nodules had a dense fibrous capsule and contained necrotic mature fat tissue. In addition, three showed focal calcification. Blood vessels were rarely found within the capsule. These findings strongly suggest that history of abdominal operation, advanced age, sex, and poor blood supply to the nodule are causal to their development. Although only 18 cases have been reported previously, our six cases during but a 3-year period suggests that it may not be as rare as believed.