Retroperitoneal Dumbbell-Shaped Lipoma: Laparoscopy-Assisted Hybrid Surgical Approach.

Abstract

Retroperitoneal lipomas are benign tumors but are rarely seen extending into the femoral canal. A 43-year-old woman presented with a painless, progressively enlarging swelling in her right upper thigh. Imaging revealed a well-defined, fat-density, dumbbell-shaped mass measuring 17 cm, arising from the retroperitoneum and extending into the anterior thigh through the femoral canal. A trucut biopsy confirmed a lipoma. She underwent a successful laparoscopy-assisted open excision. Laparoscopic dissection facilitated mobilization of the intra-abdominal component, while a small groin incision allowed removal of the mass through the femoral canal. Histopathology confirmed a benign lipoma. As no defects were identified in the inguinal or femoral regions, mesh reinforcement was not required. Lipomas are common in subcutaneous tissue, but retroperitoneal lipomas extending through the femoral canal are rare and may mimic incarcerated hernias, complicating diagnosis. While open excision remains the standard treatment, the hybrid laparoscopic approach in this case provided a less invasive, precise, and safe method for complete tumor removal, resulting in an uneventful recovery. This case highlights a rare retroperitoneal dumbbell-shaped lipoma passing through the femoral canal and demonstrates the feasibility and advantages of a laparoscopy-assisted hybrid surgical approach.