Pelvic lipomatosis (also known as pelvic fibrolipomatosis) represents excessive deposition of fat in pelvis due to overgrowth of adipose cells leading to compression of pelvic organs.
The condition usually presents in patients 20-50 years of age. The condition is predominantly (2/3 of cases) seen in African-Americans.
Patients usually present with features of compression of genitourinary system, vascular system and lower gastrointestinal tract. These are dysuria, hematuria, urgency, urinary incontinence, constipation.
Findings are non-specific and non-diagnostic with areas of lucency around the bladder.
Pear shaped or inverted teardrop bladder with dilated ureter.
CT findings are diagnostic with areas of symmetric fat density in the pelvic region. Pear shaped bladder can be seen.
Similar to CT findings with hyperintensity noted on T1 in areas containing fat and iso to hyperintensity noted on T2W imaging.
The differential is mainly that of inflammatory conditions resulting in fatty infiltration or other fatty masses.