A 4-cm lipoma of the transverse colon causing colonic intussusception: A case report and literature review

Abstract

Colonic lipomas are rare benign tumors. Colonic intussusception is an uncommon complication of colonic lipoma. The current study presents an unusual case of a 4-cm symptomatic lipoma of the transverse colon causing colonic intussusception. A 65-year-old female was admitted to Wenzhou Central Hospital (Wenzhou, Zhejiang, China) with intermittent pain in the left abdomen that had been present for two weeks. Colonoscopy revealed a 4×5-cm intraluminal spherical mass with erosional mucosa 60 cm above the anal verge, indicating the presence of a malignant gastrointestinal stromal tumor. Contrast-enhanced computed tomography revealed a well-defined fatty tissue mass of 4 cm in diameter in the distal transverse colon proximal to the splenic flexure, with intussusception. The patient underwent segmental resection of the transverse colon and intraoperative frozen sections were obtained. The intraoperative frozen sections revealed a submucosal lipoma of the transverse colon and thus, a conclusive diagnosis was achieved. The patient was followed up for one year and 10 months following the segmental resection of the transverse colon, with a good prognosis. This study may increase clinical awareness with regard to colonic lipomas. Furthermore, open surgery combined with use of intraoperative frozen sections should be recommended for large symptomatic colonic lipomas accompanied by colonic intussusception, thus avoiding unnecessary radical resection and improving patient prognosis.

Colonic intussusception caused by an ulcerating lipoma in an adult: A rare case report and literature review

“…Colonic lipomas are benign submucosal tumors composed of mature adipose tissue and were first reported by Bauer in 1757 [2,3]. After reviewing the literature for the most recent cases (Table 1) [1][2][3][4][5][6][7][8][9][10][11][12][13], we concluded that most lipomas range in size from 2 mm to 30 cm and that the majority of patients are between 50 and 70 y of age, with a female predominance. Colonic lipomas are typically asymptomatic or minimally symptomatic when less than 2.0 cm in size, and they are usually detected during endoscopy, surgery, or autopsy.…”

“…Magnetic Resonance Imaging (MRI) is particularly suited to detecting fatty lesions because signal intensity characteristics typical for adipose tissue are evident on T1-weighted and fat-suppressed images. However, MRI is seldom used for detecting and studying intestinal neoplastic lesions [1][2]13,14].…”

“…Lipomas are the most common non-epithelial neoplasms of the gastrointestinal tract and can be found in any part of the gut [1][2][3]. Colonic lipomas are benign submucosal tumors composed of mature adipose tissue and were first reported by Bauer in 1757 [2,3].…”

“…The most common position of colonic lipoma is the right hemicolon, followed by the descending and transverse colon. Although the majority of colonic lipomas are small and asymptomatic, some cause symptoms such as abdominal pain, diarrhea, bowel obstruction and intussusception [1,2]. Here, we present a case report of a giant colonic lipoma causing ascending-colonic intussusception and discuss the role of imaging modalities for diagnosing neoplasms to assess the clinical behavior of lipomas when symptomatic.…”

Recurrent colonic intussusception due to a lipoma of the transverse colon at the background of congenital dolichocolon and chronic constipation

“…Due to the fact that this pathology is uncommon, it is difficult to diagnose such conditions. Differentiation with malignancies in cases with large lipomas is impossible before surgery and diagnosis verification can be made after histopathology 4 5. We present a rare case of recurrent colonic intussusception due to a lipoma of the transverse colon at the background of congenital dolichocolon and chronic constipation.…”