title: Torsion of a giant mesocolic lipoma in a child with Bannayan-Riley-Ruvalcaba syndrome.
abstract: A 6-year-old boy with Bannayan-Riley-Ruvalcaba syndrome (BRRS) presented to the emergency department with periumbilical abdominal pain for 12 h. A contrast-enhanced abdominal and pelvis CT examination revealed significant interval change in the size and appearance of a previously seen hypoattenuating right mesocolic fatty mass suggestive for lipoma, first observed 5 months prior. This lesion demonstrated new enhancing internal septations, a thickened capsule, interval development of adjacent mesenteric fat stranding and engorgement of the mesenteric vessels. Given the short follow-up interval and acute clinical presentation, imaging findings were suggestive for torsion. We present this case for the unusual imaging findings as well as to highlight the differential diagnosis for abdominal fat containing lesions by imaging in patients with BRRS and other hamartomatous syndromes.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Laguna
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Iyer
authors.forename: Erin R
authors.initials: ER
authors.lastname: Rudzinski
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Roybal
authors.forename: A Luana
authors.initials: AL
authors.lastname: Stanescu
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002648:Child; D003287:Contrast Media; D003937:Diagnosis, Differential; D006223:Hamartoma Syndrome, Multiple / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D045822:Intestinal Volvulus / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D008067:Lipoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008646:Mesocolon / Q000000981:diagnostic imaging / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media