Giant Intra-Abdominal Lipoma- An Enigma

Abstract

A 59-year-old gentleman presented with the chief complaint of generalised abdominal distension for the last 2 years. It had achieved an uncomfortable size, which was disturbing his day-today activities. It was not associated with any pain, obstructive or compressive symptoms and no history of lowgrade fever, night sweats and anorexia or weight loss. Patient's nutritional status was good, had mild pallor and bilateral pedal oedema. On examination, the abdomen was found to be hugely distended with an inverted umbilicus (girth 160 cm). No venous engorgement or pigmentation were noted. A diffuse firm lump was palpated in all quadrants of the abdomen, nontender, non-mobile, no organomegaly and no evidence of ascites. Routine investigations were within normal limits. CT scan and USG revealed a lobulated mass with predominantly fat content and areas of soft tissue occupying most of the abdomen. It had fine septations, tiny calcifications measuring 39.4 by 36.9 by 29.1 cm (Fig. 1, 2).