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[Pelvic lipomatosis. Diagnostic and therapeutic considerations apropos of 3 cases]
Soledad Buitrago Sivianes1, Miguel Tallada Buñuel, Francisco Javier Vicente Prados
1Servicio de Urología, Hospital Universitario Virgen de las Nieves, Granada, España.
Objective:
We report three cases of pelvic lipomatosis, and from them we discuss its diagnostic and therapeutic considerations.
Methods/Results:
Three patients, 71, 65 and 61 years old respectively, presented with irritative lower urinary tract symptoms. Intravenous pyelogram (IVP) and CT scan were performed as diagnostic procedures. After diagnosis an endoscopic evaluation including biopsies was performed to rule out tumours. All three underwent Bricker-Wallace II type urinary diversion resulting in good control of irritative symptoms. During follow-up one patient presented with an infiltrative bladder tumour.
Conclusion:
Pelvic lipomatosis is a rare disease; although traditionally has been considered benign it can result in urinary tract obstruction with severe physiopathological consequences. IVU and CT-scan are valuable to confirm the diagnosis. Lower urinary tract symptoms are controlled with urinary diversion without cystectomy but potential malignization of the bladder lesions should make us reconsider treatment.