Peer Reviewed Open Access Research Journal
International Journal of Medical Laboratory Research (IJMLR)
"IJMLR invites articles for the Vol 8, Issue 2, August 2023. click to submit manuscript
ENCAPSULTED FAT NECROSIS OF THE MESENETRY: SURGICAL INTERVENTION BY INQUSITIVE OBSTRETRICIAN LEADING TO NEWER INSIGHTS FOR THE PATHOLOGIST!
Nidha Gaffoor, Archana Shetty, Nirupama M, Supriya TR
ABSTRACT: Lesions of the mesentery encompass a wide variety of neoplastic and non-neoplastic entities. Being a metabolically active tissue, it is often subject to trauma and ischemia, which in turn can give rise to encapsulated masses. Encapsulated fat necrosis is one such nodular lesion which is often encountered by radiologists. It presents clinically with nonspecific abdominal symptoms, and many a times is discovered incidentally when imaging is done for other obvious pathologies. Though the lesion is known to shrink over time, surgical resection is often done to rule out other mimics, liposarcoma being the closest. Encapsulated mesenteric fat necrosis is a rare lesion and more so uncommonly found in association with pregnancy. Vascular hypoperfusion can be one of the hypotheses, although fetal role cannot be ruled out, especially in obese gravid females.
We wish to document one such lesion detected intraoperatively, picked up incidentally suspecting to be a mesenteric cyst in a gravid obese female without history of trauma or predisposing factors, who underwent caesarian section at an institute in rural set up. The case also describes histopathological features of this interesting lesion for the pathologists.
Key words: Fat necrosis, histopathology, liposarcoma, lipoma, Mesenteric cyst
Devos H, Goethals L, Belsack D, De Brucker Y, Allemeersch GJ, Ilsen B, Vandenbroucke F, de Mey J. Fat misbehaving in the abdominal cavity: a pictorial essay. Polish journal of radiology. 2020;85: e32.
Kamaya A, Federle MP, Desser TS. Imaging manifestations of abdominal fat necrosis and its mimics. Radiographics. 2011;31(7):2021-2034.
Patil AR, Nandikoor S, Jagannath P, Bansal A. Not Just Fat: Imaging in Abdominal Fat Pathology. Journal of Gastrointestinal and Abdominal Radiology. 2021;4(01):049-57.
De Kock I, Delrue L. Encapsulated mesenteric fat necrosis. Journal of the Belgian Society of Radiology. 2016;100(1):53.
Mitrovic M, Velickovic D, Micev M, Sljukic V, Djuric P, Tadic B, Skrobic O, Djokic Kovac J. Encapsulated Omental Necrosis as an Unexpected Postoperative Finding: A Case Report. Medicina. 2021;57(9):865.
Watanabe J, Osaki T, Tatebe S, Goto K, Endo K, Nakamura S, Hirooka Y. Encapsulated fat necrosis mimicking abdominal liposarcoma: A case report and literature review. Clin Case Rep. 2020; 8:2255–2258.
Lourenço AL, Lopes Dias J, Marques J, Bernardino V. A Very Rare Case of Mass-Like Mesenteric Fat Necrosis in a Patient with Antiphospholipid Syndrome. GE Port J Gastroenterol. 2021;28(2):139-143.
Oh HB, Arab N, Teo L, Lieske B. Snapshot in surgery: intraperitoneal encapsulated fat necrosis. Clinical case reports. 2015;3(2):131.
To cite this article:
Gaffoor N, Shetty A, Nirupama M, Supriya TR. Encapsulated fat necrosis of the mesentery: surgical intervention by inquisitive obstretician leading to newer insights for the pathologist. Int. J. Med. Lab. Res. 2022; 7, 1:49-52 http://doi.org/10.35503/IJMLR.2022.77