Intraperitoneal lipoma: A case report

Lipoma is a very common benign tumor of diverse localization, formed by mature adipocyte cells without cyto-nuclear atypia. Intra-abdominal localization, particularly from omental origin, is uncommon and can present with diffuse abdominal pain, intestinal occlusion, or perforation.

We present the case of a 43-year-old man (BMI 24.8, normoglycemic, normal lipid profile) with right hypochondrial pain and a palpable abdominal mass. Contrast-enhanced CT and MRI revealed a fatty intraperitoneal mass measuring 14 cm in length, originating from the greater omentum. Fine needle aspiration cytology (FNAC) was not performed preoperatively due to the highly suggestive benign imaging features. Surgical exploration confirmed an 8 cm lipomatous mass adherent to the greater omentum, which was completely resected. Histopathological examination confirmed a lipoma without malignancy.

Omental lipomas represent a subset of intraperitoneal adipose tumors, primarily affecting adults aged 40-60. While both contrast-enhanced CT and MRI aid in diagnosis, MRI provides superior tissue characterization for fat-containing lesions. Histology remains essential to rule out liposarcoma, with core needle biopsy indicated for lesions with concerning features. Surgical removal with capsule preservation minimizes recurrence risk, which remains low (2-5 %) but warrants long-term surveillance.

Omental lipomas are uncommon, usually asymptomatic, and require imaging for diagnosis and surgery for definitive treatment. Surveillance imaging is recommended to monitor for recurrence.