Paracaval lipoma: Case study and literature review

Area of Science:

• Radiology
• Abdominal Imaging
• Vascular Imaging

Background:

• Paracaval lipoma is a benign condition involving fatty tissue accumulation around the intrahepatic inferior vena cava (IVC).
• It is an infrequent finding on abdominal computed tomography (CT) scans.
• The etiology is speculated to involve negative thoracic pressure during inspiration affecting the IVC.

Observation:

• A 51-year-old male presented with abdominal pain, distension, jaundice, and ascites.
• Abdominal and pelvic CT without contrast revealed incidental fat deposition around the caudate lobe.
• The fat deposition exhibited a juxtacaval distribution, consistent with paracaval lipoma.

Findings:

• The CT findings were characteristic of a paracaval lipoma.
• This benign finding was incidentally discovered during the workup for the patient's symptoms.
• The imaging demonstrated fat surrounding the intrahepatic portion of the IVC.

Implications:

• Accurate identification of paracaval lipoma on CT is crucial to avoid misinterpretation.
• Misdiagnosis can lead to unnecessary investigations for conditions like IVC thrombus or malignancy.
• Distinguishing paracaval lipoma prevents costly and potentially invasive patient workups.