Clinical History: A 44-yr-old male patient with a case of chronic renal failure was referred to for CT scan of the abdomen and cystogram. On examination, the clinician found a mass in the pelvis.Figure 1: Axial Images showing excessive fat deposition in pelvis around urinary bladder and pelvis causing external compression.
Figure 2: Axial post contrast Images showing excessive fat deposition in pelvis around urinary bladder and pelvis causing external compression.
Figure 5Figures 3, 4, 5: Image from Cystogram shows bilateral compression of the urinary bladder. There is increased lucency in the pelvis from excess fat deposition displacing the small bowel loops superiorly.Imaging Findings:Contrast CT scan: Excessive deposition of fat is seen in pelvis on CT scan. Elongated elevated urinary bladder is seen. The rectum is elongated and compressed externally.On Cystogram: Elongated elevated urinary bladder is seen (Pear-shaped bladder). Ureteric Reflux is seen on left side.Diagnosis: Pelvic lipomatosisDiscussion:Rare non-malignant disease characterized by an excess deposition of fat in the pelvis surrounding the bladder and rectum. Cause is not known.Differential Diagnosis:• Hypertrophy of the iliopsoas muscles• Retroperitoneal fibrosis. • Pelvic abscess• Pelvic hematomaTreatment: Symptomatic treatment; Rarely, surgical diversion of the urinary tract for severe obstructive symptoms.Complications:1-Urteral Obstruction.2-IVC obstruction.Sikander Ali Khan, MD, consultant radiologist, Royal Commisson Medical Center, Saudi Arabia