Pediatric Mesenteric Lipoma: Case Report and Narrative Literature Review

Introduction: Lipomas are among the most encountered neoplasms in clinical practice, occurring mainly in adults between the fourth and sixth decades of life. Deep-seated lipomas in children are found in the thorax, chest wall, mediastinum, pleura, pelvis, retroperitoneum, and paratesticular area. Herein, we present a case of a three-year-old child with a giant mesenteric lipoma, along with a review of the literature on mesenteric lipomas in childhood. Case presentation: A three-year-old male toddler was referred to our hospital for severe, intermittent abdominal pain. Imaging studies at admission revealed a fat lesion occupying most of the peritoneal cavity and dislocating adjacent structures. An urgent laparotomy was performed. A giant lipoma arising from the mesentery and leading to the torsion of the mesenteric radix was confirmed and completely excised alongside an adherent small tract of jejunum. The child recovered uneventfully and is still being followed-up with no signs of recurrence. Discussion: Lipomas of the mesentery in children are very rare, and they are reported to be more common among children younger than three years of age. Mesenteric lipomas appeared to be more frequent in males than females. Even though they might be asymptomatic, voluminous lipomas can also create a lead point for intermittent torsion of the mass causing ischemia and infarction. Abdominal pain was the most frequent symptom, and the ileum was the tract of bowel more frequently involved by the tumor. Laparotomy was reported to be the preferable approach to safely remove this abdominal mass, especially in case of huge dimensions.