Giant retroperitoneal lipoma resulting in femoral hernia: A case report

Retroperitoneal lipomas are relatively rare and have nonspecific clinical manifestations. Although only a few cases presenting as inguinal hernias have been reported, no case of herniating through the femoral canal has been reported to our knowledge. Herein we report an extremely rare case of giant retroperitoneal lipoma presented as femoral hernia.

A 38-year-old woman was referred to our department with a complaint of right inguinal bulging that began four years earlier and was suspected to be a lipoma or liposarcoma. Although she was asymptomatic and continued following up via computed tomography (CT) scan, she noticed gradual bladder control loss, for which she decided to undergo surgery. During surgery, the retroperitoneal tumor extended to the thigh through the dorsal side of the inguinal ligament. Although we could separate the tumor from the surrounding structures, the defect of the inguinal tissue was extensive because of the tumor's size, and two types of meshes were used to repair the defect. As a result of histopathological examination, the tumor was identified as a lipoma. After the surgery, the patient remains without femoral hernia and no evidence of local recurrence.

Retroperitoneal lipomas are rare and can have different clinical manifestations. Surgery is the only treatment for giant lipomas. For extensive tissue defects, a suitable mesh should be selected to prevent postoperative herniation.

Retroperitoneal lipomas sometimes grow to the groin area, and complete resection and repair of the defect are important on surgery.