BACKGROUND: Primary solid tumors of the greater omentum are extremely rare. Lipomas, leiomyomas, fibromas, and neurofibromas have been described as benign tumors of the greater omentum, but angiofibrolipomas have not. CLINICAL CASE: We present the case of a 39-year-old male with a 3-day evolution of right lower quadrant abdominal pain associated with nausea and vomiting. McBurney, Psoas, Obturator and Markle signs were all positive. Laboratory analysis revealed leukocytosis and bandemia. Abdominal ultrasound showed free fluid and an undefined mass suggestive of complicated acute appendicitis. Emergency midline laparotomy demonstrated a tumor of the greater omentum with areas of ischemia, necrosis and hemorrhage. Histological exam revealed angiofibrolipoma of the greater omentum. CONCLUSIONS: Angiofibrolipoma of the greater omentum may present as a surgical emergency due to torsion. When a tumor of the omentum is found during surgery, complete excision is the treatment of choice when a definitive histology result is received.
BACKGROUND:Primary solid tumors of the greater omentum are extremely rare. Lipomas, leiomyomas, fibromas, and neurofibromas have been described as benign tumors of the greater omentum, but angiofibrolipomas have not. CLINICAL CASE: We present the case of a 39-year-old male with a 3-day evolution of right lower quadrant abdominal pain associated with nausea and vomiting. McBurney, Psoas, Obturator and Markle signs were all positive. Laboratory analysis revealed leukocytosis and bandemia. Abdominal ultrasound showed free fluid and an undefined mass suggestive of complicated acute appendicitis. Emergency midline laparotomy demonstrated a tumor of the greater omentum with areas of ischemia, necrosis and hemorrhage. Histological exam revealed angiofibrolipoma of the greater omentum. CONCLUSIONS: Angiofibrolipoma of the greater omentum may present as a surgical emergency due to torsion. When a tumor of the omentum is found during surgery, complete excision is the treatment of choice when a definitive histology result is received.