Giant pelvic lipoma mimicking a liposarcoma

Giant lipoma (GL) is a rare ubiquitous tumor. Pelvic lipoma is rare with less than 10 cases reported in the literature. The main differential diagnosis is lipoma-like well differentiated liposarcoma. We report the case of a 50-year old female patient, with a 3-month history of pelvic discomfort, presenting with a mass in the left ischiorectal fossa. Abdominopelvic CT scan showed presacral hypodense homogeneous lipomatous mass measuring 10x18 cm. MRI showed hyperintense lesion on T1 and T2 -weighted images with fine partition walls reaching the 2nd sacral vertebra. Total abdominoperineal resection was performed without rupture of tumor capsule. Anatomo-pathological examination confirmed the diagnosis of GL. This study aims to report a new case of giant presacral pelvic lipoma which extends into the left ischiorectal fossa.