Paracaval lipoma

Case contributed by Yahya Baba
Diagnosis certain


Right upper quadrant pain with a history of choledocholithiasis.

Patient Data

Age: 75 years
Gender: Male
  • there is a paracaval fat seeming to invaginate into the medial intrahepatic segment of the inferior vena cava, in keeping with paracaval lipoma

  • mild gallbladder distension with diffuse thickening of the gallbladder wall, pericholecystic free fluid and fat-stranding. Several partially-obstructive gallstones located in the neck of the gallbladder and in the cystic duct, in keeping with acute calcular cholecystitis

  • the portal and hepatic veins are normal


Paracaval lesion demonstrating hyperintense T1 and T2 signals without a drop on out-of-phase imaging. However, there is a drop of signal on T1 dixon water images.

Case Discussion

Paracaval lipomas are not that uncommon and are reported to be seen in up to 0.5% of CT examinations 1.

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