Vulvoperineal lipoma

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Painless swelling of the right vulvoperineal region.

Patient Data

Age: 50 years
Gender: Female
mri

The MRI sequences demonstrate a well-encapsulated lobulated mass in the right vulvoperineal region of high signal on both T1WI/T2WI and attenuated on suppressed fat sat sequences. Multiple thin fibrous septations within (<2 mm) with minimal enhancement on postcontrast sequences.

Case Discussion

MRI features of a pelvic floor lipoma.

The main differential diagnosis should include:

  • normal adipose tissue: usually non encapsulated fatty mass, indistinguishable from the adjacent fatty tissue
  • liposarcoma
    • thick septa with enhancement
    • inhomogeneous attenuation, with significant amounts of soft-tissue within the fatty mass
    • poor definition of the adjacent structures or evidence of local invasion 

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