Intestinal lipomatosis in a 10-year-old girl

IntroductionLipomatosis involvement of the gastrointestinal tract is arare disorder, for which few cases have been reported inmedical literature [1, 2]. Benign tumors of the small bowelare relatively rare; lipomas are among the most commonones, with an incidence in autopsy ranging from 0.04% to4.5% [4]. We report a 10-year-old girl with lipomatosisinvolving small and large bowel.Case reportA 10-year-old girl was referred with a history of recurrentabdominal pain for the last 12 months. Pain was severe andgradually increasing in the right upper abdominal quadrant.She had no symptoms or signs of intestinal obstruction. Norelevant past medical or family history was reported.Results of a haematological examination, liver functiontest, urine analysis and stool occult blood test were allwithin normal ranges. Abdominal ultrasonography revealeda “target” mass (10×6 cm) in the right upper quadrant.Abdominal computed tomography demonstrated an 11.4×1.4×5.2 cm mass in the right hypochondrium, with fatdensity. At laparotomy, a large lipoma (10×15 cm) in themesenteric area of the right colon was resected (Fig. 1). Thecut section showed multiple submucous jejunal and ileallipomas, sized from 2 to 8 cm; ten of them were resected.Microscopic examination of the specimen showed manysmall-to-large tumors, composed of mature adipose tissueand thin fibrous septa, in the submucosal and serosa, withpreservation of muscularis propria. The postoperativeperiod was uneventful and the patient was completelysymptom free during 10 months of follow-up.DiscussionThe term lipomatosis has been used to describe thepresence of numerous circumscribed lipomas in theintestine [3, 4]. Lipomatosis of the small bowel was firstdescribed by Hellstrom in 1906, and is uncommon [4].Case reports of lipomas in isolated or scattered segmentsare most frequently encountered in the literature. The ileum