ENCAPSULATED FAT NECROSIS OF THE MESENTERY: SURGICAL INTERVENTION BY INQUISITIVE OBSTRETRICIAN LEADING TO NEWER INSIGHTS FOR THE PATHOLOGIST

Abstract

Lesions of the mesentery encompass a wide variety of neoplastic and non-neoplastic entities. Being a metabolically active tissue, it is often subject to trauma and ischemia, which in turn can give rise to encapsulated masses. Encapsulated fat necrosis is one such nodular lesion which is often encountered by radiologists. It presents clinically with nonspecific abdominal symptoms, and many a times is discovered incidentally when imaging is done for other obvious pathologies. Though the lesion is known to shrink over time, surgical resection is often done to rule out other mimics, liposarcoma being the closest. Encapsulated mesenteric fat necrosis is a rare lesion and more so uncommonly found in association with pregnancy. Vascular hypoperfusion can be one of the hypotheses, although fetal role cannot be ruled out, especially in obese gravid females. We wish to document one such lesion detected intraoperatively, picked up incidentally suspecting to be a mesenteric cyst in a gravid obese female without history of trauma or predisposing factors, who underwent caesarian section at an institute in rural set up. The case also describes histopathological features of this interesting lesion for the pathologists.