PMC7381990_01
T2-weighted MRI at 15-week gestation demonstrates large homogeneous fat-containing mass which measured 28 x 14 x 6 cm with mass effects of the bowel. A minimal amount of intralesional fluid is noted; no irregular septa are identified, consistent with a simple lipoma.
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Magnetic Resonance Imaging (MRI) showed a large mass in her left retroperitoneal space measuring 28 x 14 x 6 cm compressing her bowel (Figure 1).
Fluorescence in situ hybridization (FISH) analysis was performed using a dual-color MDM2/CEN 12 probe set to detect gene amplification. MDM2 amplifications (neon green) are frequently detected in well-differentiated liposarcoma. (a) No MDM2 gene amplification is identified by FISH analysis in our patient; (b) amplification of the MDM2 gene in a well-differentiated liposarcoma (fluorescence in situ hybridization, FISH).
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Gene amplification studies were performed on the biopsy specimen using fluorescence in situ hybridization (FISH) and showed no evidence for malignancy (Figure 2).
Very large (>25 cm) fatty tumor that was noted in the abdominal cavity to be entirely covered by retroperitoneum and arising from the left pelvic sidewall.
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Ten weeks postpartum, the patient underwent exploratory laparotomy with resection of the left pelvic fatty tumor (Figure 3).
(a) Mature adipocytes that vary little in size from one another. Thin fibrous septa are seen separating the lobules. (b) The adipocyte nucleus is bland, small, and compressed against the periphery of the cell by the large fat vacuole. (c) Area of fat necrosis with foamy histiocytes surrounding and reacting to damaged adipocytes.
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Frozen section pathology slides confirmed the diagnosis of a retroperitoneal lipoma (Figure 4).