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27 November 2019 : Case report  USA

Unilateral Giant Vulvar Lipoma with Fat Necrosis Not Visualized on Magnetic Resonance Imaging (MRI)

Challenging differential diagnosis, Rare disease, Clinical situation which can not be reproduced for ethical reasons

Shuang Li1ABEF, Terry Haag1AB, Jeannie McWhorter1BDE, Li Ge2DE, Steve J. Carlan3BDEF*

DOI: 10.12659/AJCR.918976

Am J Case Rep 2019; 20:1760-1764

Abstract

BACKGROUND: A subcutaneous lipoma is a benign tumor comprised of mature adipocytes. Clinically it presents as a soft, freely moveable, doughy mass that is typically painless and slow growing. Lipomas containing fat necrosis and corresponding palpable nodular elements are rare and suggest an alternative diagnosis. Lipomas in the vulvar region are rare and giant vulvar lipomas with palpable fat necrosis are unreported.

CASE REPORT: A 25-year-old patient presented with a 4-year history of an enlarging right vulvar mass with multiple small (<1 cm) firm nodules within the tumor. A pelvic MRI (magnetic resonance imaging) did not visualize the nodules but histopathologic examination revealed a benign lipoma containing fat necrosis and discrete areas of calcium deposition.

CONCLUSIONS: Fat necrosis can occur in vulvar lipomas and present with intratumor nodularity. MRI imaging, clinical findings and histology may be discordant.

Keywords: Fat Necrosis, Lipoma, Vulvar Diseases, Adult, Diagnosis, Differential, Magnetic Resonance Imaging

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923