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Diagnostic challenge of a huge omental tumor: A case report
Hadeel Helmi1, Sondos Al Odman2, Khayal Alkhayal1
1Colorectal Research Chair, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Introduction:
Omental lipomas are rare tumors that are often asymptomatic. They may produce vague abdominal complaints. Radiological diagnosis may be challenging. We report a large omental tumor with pre-operative diagnostic ambiguity due to suspicious radiological appearance.
Case Presentation:
A 61-year-old man presented to the emergency department with abdominal pain. Upon investigation, computed tomography and magnetic resonance imaging showed a large predominantly fatty omental tumor that was suspicious of liposarcoma. The patient underwent laparotomy with excision of a huge 5706-g tumor. The final diagnosis of lipoma was made histopathologically.
Discussion:
Although most omental lipomas are diagnosed by cross sectional imaging, radiological features may be confused with that of a liposarcoma. Pre-operative biopsy confirmation can be considered but is associated with the risk of complications and seeding. Surgical excision serves as a diagnostic and therapeutic modality, and can be achieved by open or laparoscopic approaches guided by tumor size.
Conclusion:
Omental lipomas are rare and most commonly asymptomatic until achieving a sizable mass. In such cases, the diagnosis can be challenging due to the possible confusion with liposarcoma, which may affect the management plan.
