Pelvic lipomatosis


General Considerations

  • Rare disease characterized by an excess deposition of fat in the pelvis surrounding the bladder and rectum
  • Most common in African-Americans (66%) with an overwhelming male predominance (94%)
  • Cause is not known but, it has been linked to obesity
  • Most patients are 20-50 years of age

Clinical Findings

  • From compression on the bladder (more common) and rectum< >FrequencyNocturia
  • Dysuria
  • Constipation
  • Ribbon-like stools
  • Lower extremity swelling
  • Suprapubic pain and fullness
  • Low back pain

Imaging Findings

  • Increased lucency in the pelvis on conventional radiography due to fat deposition
  • Inverted teardrop-shaped bladder (pear-shaped bladder)
  • Ureters may be dilated and may be medially or laterally displaced distally
  • Hydronephrosis, usually bilaterally
  • The rectum is elongated and symmetrically compressed
  • Rectum may be displaced cephalad (tower rectum)
  • Increased distance between seminal vesicles and posterior bladder wall
  • CT shows tissue surrounding bladder/rectum to be that of fat (-40 to -100 Hounsfield units)

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