Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2020; 8(16): 3548-3552
Published online Aug 26, 2020. doi: 10.12998/wjcc.v8.i16.3548
Pelvic lipomatosis and renal transplantation: A case report
Jie Zhao, Ying-Xin Fu, Gang Feng, Chun-Bai Mo
Jie Zhao, Ying-Xin Fu, Gang Feng, Chun-Bai Mo, Department of Kidney Transplant, Tianjin First Central Hospital, Tianjin 300192, China
Author contributions: Zhao J summarized the clinical data, and drafted the manuscript; Fu YX contributed to the conception of the study; Mo CB and Feng G performed the operation.
Supported by National Natural Science Foundation of China, No. 81970654.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ying-Xin Fu, MD, PhD, Chief Doctor, Surgeon, Department of Kidney Transplant, Tianjin First Central Hospital, No. 24 Fukang Road, Nankai District, Tianjin 300192, China. fuyingxintj@163.com
Received: April 6, 2020
Peer-review started: April 6, 2020
First decision: April 24, 2020
Revised: May 1, 2020
Accepted: July 16, 2020
Article in press: July 16, 2020
Published online: August 26, 2020
Abstract
BACKGROUND

Pelvic lipomatosis is a rare disease of unknown etiology, characterized by the overgrowth of pelvic adipose tissue that causes compression of the urinary tract including the bladder and ureters, rectum and blood vessels. The patient may progressively develop obstructive uropathy which could subsequently lead to renal failure. At present, there are no reports of renal transplantation due to uremia caused by pelvic lipomatosis. The ideal management of patients with pelvic lipomatosis after renal transplantation is not yet well-established due to the lack of literature and follow-up data.

CASE SUMMARY

We report a 37-year-old male patient with pelvic lipomatosis who received a successful living donor renal transplantation on July 22, 2015. The operation was complicated as the iliac vessels and bladder were wrapped entirely in excessive abnormal fat. The external iliac artery and vein were located using ultrasonographic guidance. The adipose tissue around the right bladder was removed as far as possible, and the graft ureter was reimplanted into the bladder, using the Lich-Gregoir technique. At 22 mo after transplantation, graft percutaneous nephrostomy was performed under ultrasonographic guidance for urinary diversion due to hydronephrosis of the graft kidney. Follow-up at four years showed that the renal allograft function was stable.

CONCLUSION

When patients with pelvic lipomatosis develop renal failure, renal transplantation could be a feasible treatment strategy.

Keywords: Pelvic lipomatosis, Kidney transplantation, Uremia, Hydronephrosis, Bladder, Urinary obstruction, Case report

Core tip: We describe a patient with pelvic lipomatosis who underwent renal transplantation due to uremia. Such patients may progressively develop obstructive uropathy which can subsequently lead to renal failure. At present, there are no reports of renal transplantation due to uremia caused by pelvic lipomatosis. The ideal management of patients with pelvic lipomatosis after renal transplantation is not yet well-established due to the lack of literature and follow-up data.