Incidental giant mesenteric lipoma: A case report

Lipomas are common benign fatty tumors, but their occurrence in the mesentery is exceedingly rare. While usually asymptomatic and underreported, they may grow to a considerable size and cause obstruction, volvulus, abdominal pain, or discomfort. We report the case of a 63-year-old Arab female who presented with a 10-day history of intermittent right upper quadrant abdominal pain radiating to the back, worsened by cold exposure and meals, along with months of mild constipation and progressive distension. Clinical examination showed mild, nontender abdominal distension, and imaging revealed a 2 cm gallstone, a gallbladder polyp or sludge, and a large intra-abdominal mass. Contrast-enhanced CT (Computed Tomography) confirmed a well-defined, encapsulated mesenteric lipoma measuring 28.5 × 17 × 6.5 cm. The patient underwent simultaneous cholecystectomy and mass excision, and histopathology confirmed chronic cholecystitis and a benign mesenteric lipoma. This case underscores the importance of considering mesenteric lipomas in the differential diagnosis of vague abdominal complaints and highlights the critical role of radiological assessment in guiding definitive surgical management.