[Giant pelvic lipoma mimicking a liposarcoma]

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Giant lipomas (GL) are rare, ubiquitous tumors, with pelvic lipomas being exceptionally uncommon, fewer than 10 cases reported.
• Differentiating pelvic lipomas from lipoma-like well-differentiated liposarcoma is a critical diagnostic challenge.

Observation:

• A 50-year-old female presented with a 3-month history of pelvic discomfort and a palpable mass in the left ischiorectal fossa.
• Abdominopelvic CT revealed a large (10x18 cm), homogeneous, hypodense, presacral lipomatous mass.
• MRI demonstrated a hyperintense lesion on T1 and T2-weighted images, extending to the second sacral vertebra.

Findings:

• Surgical resection via abdominoperineal approach was successfully performed without tumor capsule rupture.
• Anatomopathological examination confirmed the diagnosis of a giant pelvic lipoma.

Implications:

• This case contributes to the limited literature on giant presacral pelvic lipomas.
• Accurate radiological assessment and histopathological confirmation are crucial for managing these rare pelvic masses.
• Surgical intervention is the definitive treatment for symptomatic giant pelvic lipomas.