The radiographic finding of a "tear-shaped" bladder is indicative of an extraperitoneal pelvic mass, generally a neoplasm or blood following trauma. Recently, a benign condition has been recognized in male patients which radiographically simulates this picture. The entity, termed pelvic lipomatosis, consists of fat deposition around the bladder, prostate, and rectum, and can be diagnosed without resorting to surgical exploration. At least 15 cases have been described in the literature since 1958 under various nomenclatures.1-6 As the majority of these reports have appeared in the radiologic literature, it is our aim to report four new cases and a nineyear follow-up on a previously described case, and to emphasize the radiologic appearances in the differential diagnosis of an intrapelvic mass. We have observed these five patients within a three-year period. An increased awareness of this condition will most likely result in more frequent preoperative recognition, thus avoiding surgical exploration.
Becker JA, Weiss RM, Schiff M, Lytton B. Pelvic Lipomatosis: A Consideration in the Diagnosis of Intrapelvic Neoplasms. Arch Surg. 1970;100(1):94–96. doi:10.1001/archsurg.1970.01340190096022
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