INTRODUCTION: Pelvic lipomatosis is a rare beningn disorder characterized by deposition of mature fat tissue in the pelvic cavity and absence of delimitation by a capsule.
Computed tomography (CT), (Figure 1) showed bilateral hydrouretronephrosis with pear shaped bladder, non-encapsulated fatty mass surrounding urinary bladder symmetrically, with an attenuation similar to that of subcutaneous fat suggesting extensive pelvic lipomatosis.
DISCUSSION: Pelvic lipomatosis is a benign overgrowth of adipose tissue with small amount of inflammatory and fibrotic components found especially in the perivesical and perirectal spaces.
Pelvic lipomatosis usually causes progressive obstructive uropathy by obstructing the ureters.
It is important to highlight the relevant role of CT urography in the demonstration of the typical presentation of pear-shaped bladder, which is generally accepted as a valuable characteristic indicative of pelvic lipomatosis (7), besides hydronephrosis due vesicoureteral obstruction.
5) Lymphangiopathy is the most useful method that distinguishes pelvic lipomatosis from lipoplastic lymphadenopathy.
14) Ultrasonic assisted lipectomy and re-implantation of ureters have been employed successfully in cases of obstructive pelvic lipomatosis.
CONCLUSION: We report a rare case of pelvic lipomatosis with bilateral hydroureteronephrosis and symptomatic epigastric hernia.
Image characteristics of computer tomography urography in pelvic lipomatosis.
Pelvic lipomatosis associated with proliferative cystitis: Case report and review of the Japanese literature.