Preperitoneal Fat Protrusion along the Round Ligament Mimicking As an Inguinal Lipomatous Mass in a 17-Year-Old Female Child: A Rare Case Report

Bhaisare S and Meshram M

Published on: 2025-08-23

Abstract

In female patients, fat protrusion along the round ligament through the deep inguinal ring is rare and may clinically and radiologically mimic a lipomatous mass or incarcerated hernia. These lesions are often misdiagnosed due to the absence of a true hernial sac or tumour capsule and may only be definitively identified during surgical exploration.

We describe a 17 year old girl presented with a painless left inguinal swelling for 1 year. On physical examination a solitary 6x4 cm in size, soft, non-tender, non-reducible mass felt at left inguinal region slightly extending into left labia majora. Cough impulse was absent. Ultrasound examination revealed a hyperechoic fat density lesion along the round ligament, with no evidence of bowel or peritoneal sac.

Patient was admitted; all routine blood investigations were done. Preanesthetic check-up was done. Patient was planned for surgery. Intraoperatively, preperitoneal fat was identified protruding through the deep inguinal ring following the course of the round ligament. No discrete lipoma capsule or peritoneal sac was present. The fat was excised; remaining contents were put back through deep ring and posterior inguinal wall was reinforced. Post- operative course was uneventful. Patient was discharged on postoperative day 3. Patient was followed up after 7 days, at 1 month and 3 months. No recurrence was noted. Histopathology added our intraoperative diagnosis of mature adipose tissue continuous with preperitoneal fat, without encapsulation or neoplastic features.