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Falciform Ligament Lipoma: A Rare Cause of Chronic Epigastric Pain
Takamune Yamaguchi1, Takashi Kokudo2, Henri Vuilleumier3
1Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Introduction:
Lipomas of the falciform ligament are exceptionally rare benign tumors, with only 9 cases reported in the literature since 1983. These lesions can present with chronic abdominal pain and pose significant diagnostic challenges due to their rarity and overlap with other pathological entities.
Case Presentation:
We report a case of a 49-year-old female presenting with chronic epigastric pain radiating to the right hypochondrium. MRI revealed a large fatty mass measuring 9 × 2.7 × 8.5 cm in the falciform ligament region. The patient underwent successful laparoscopic excision with histopathological confirmation of a benign lipoma. Negative MDM2 immunostaining excluded liposarcoma, and negative HMB-45, smooth muscle actin, and melan-A immunostaining excluded perivascular epithelioid cell tumor (PEComa).
Conclusions:
Although exceptionally rare, falciform ligament lipoma should be considered in the differential diagnosis of chronic epigastric pain alongside other falciform ligament pathologies, including PEComas and liposarcomas. Complete laparoscopic excision represents the treatment of choice with excellent outcomes, although diagnostic laparoscopy may be required for anatomical localization.
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