Torsion of a giant mesocolic lipoma in a child with Bannayan-Riley-Ruvalcaba syndrome

Pediatr Radiol. 2015 Mar;45(3):449-52. doi: 10.1007/s00247-014-3083-0. Epub 2014 Jul 10.

Abstract

A 6-year-old boy with Bannayan-Riley-Ruvalcaba syndrome (BRRS) presented to the emergency department with periumbilical abdominal pain for 12 h. A contrast-enhanced abdominal and pelvis CT examination revealed significant interval change in the size and appearance of a previously seen hypoattenuating right mesocolic fatty mass suggestive for lipoma, first observed 5 months prior. This lesion demonstrated new enhancing internal septations, a thickened capsule, interval development of adjacent mesenteric fat stranding and engorgement of the mesenteric vessels. Given the short follow-up interval and acute clinical presentation, imaging findings were suggestive for torsion. We present this case for the unusual imaging findings as well as to highlight the differential diagnosis for abdominal fat containing lesions by imaging in patients with BRRS and other hamartomatous syndromes.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnostic imaging
  • Abdominal Pain / etiology
  • Abdominal Pain / surgery
  • Child
  • Contrast Media
  • Diagnosis, Differential
  • Hamartoma Syndrome, Multiple / complications*
  • Hamartoma Syndrome, Multiple / diagnostic imaging
  • Hamartoma Syndrome, Multiple / surgery
  • Humans
  • Intestinal Volvulus / complications*
  • Intestinal Volvulus / diagnostic imaging*
  • Intestinal Volvulus / surgery
  • Lipoma / complications
  • Lipoma / diagnostic imaging*
  • Lipoma / surgery
  • Male
  • Mesocolon / diagnostic imaging
  • Mesocolon / surgery
  • Peritoneal Neoplasms / complications*
  • Peritoneal Neoplasms / diagnostic imaging*
  • Peritoneal Neoplasms / surgery
  • Radiographic Image Enhancement
  • Tomography, X-Ray Computed

Substances

  • Contrast Media