Clinical evaluation of submucosal colonic lipomas: Decision making

Taşçılar, Öge; Çakmak, Güldeniz Karadeniz; Gün, Banu Doğan; Uçan, Bülent Hamdi; Balbaloglu, Hakan; Cesur, Ali; Emre, Arif; Comert, Mustafa; Erdem, Lütfü Oktay; Aydemır, Selim

doi:10.3748/wjg.v12.i31.5075

Cited by 32 publications

(39 citation statements)

References 10 publications

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“…Although submucosal lipomas represent the second most common benign tumour of the colon,1 , 2 they remain rare and are usually detected incidentally at colonoscopy, surgery or autopsy 3. They can cause complications, including bleeding, abdominal pain, bowel obstruction or intussusception.…”

Section: Introductionmentioning

confidence: 99%

A colonic submucosal lipoma presenting with recurrent intestinal obstruction attacks

Boyce

Khor²

2009

Case Reports

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Colonic submucosal lipomas are rare benign tumours of the colon, which may be discovered incidentally at colonoscopy, through imaging such as CT or at autopsy. These tumours can cause complications such as bleeding, intussusception and bowel obstruction. We describe the case of a patient in whom a small submucosal lipoma was identified at the time of colonoscopy and who did not receive follow-up treatment. The patient presented 1 year later with intussusception and obstruction resulting from this polyp and required urgent surgery. With the increasing use of colonoscopy and CT, such lesions are likely to be discovered more often. As complications can ensue, guidelines should be developed to advise on the management of such polyps in order to prevent consequent complications.

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Section: Introductionmentioning

confidence: 99%

A colonic submucosal lipoma presenting with recurrent intestinal obstruction attacks

Boyce

Khor²

2009

Case Reports

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“…14 If the preoperative diagnosis of colonic lipoma can be made correctly, the extent of surgery may be appropriately limited. 15 In our case, although the length of the tumour was >13 cm, surgery as simple excision without resection was well performed. As a result, although colonic lipomas are rare and benign mesenchymal tumours, improper preoperative diagnosis may cause huge unnecessary abdominal surgery.…”

Section: Discussionmentioning

confidence: 52%

Giant Intraperitoneal Lipoma of the Cecum

Atahan¹,

Üreyen²,

Gür³

et al. 2011

Kolon Rektum Hast Derg

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Giant Intraperitoneal Lipoma of the CecumAnahtar Kelimeler: ‹ntraperitoneal lipom, Çekum, Benign ABSTRACT Colonic lipomas are uncommon, benign, submucosal adipose tumors that are usually asymptomatic. Colonic lipomas usually occur in cecum and ascending colon. These lesions are usually detected incidentally. Large colonic lipomas can be mistaken for malignancy, which may result in extensive surgical operations. We report a large size cecal lipoma in a 64-year-old man, who presented with abdominal pain. The patient underwent laparatomy and excision, the lesion was diagnosed as an intraperitoneal cecal lipoma.

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“…[5] However, large tumors may be mistaken for more serious lesions due to variable presentations and rare occurrences. [2,3] CT scan and MR are preferred in this setup because of typical imaging characteristics for fatty tissue, but are not confirmatory. [9] Barium enema can identify the colonic mass as smooth and radiolucent with change in size and shape due to peristalsis (squeeze sign).…”

Section: Discussionmentioning

confidence: 99%

“…[9] Barium enema can identify the colonic mass as smooth and radiolucent with change in size and shape due to peristalsis (squeeze sign). [3,5] Colonoscopy is an important tool for diagnosis. Colonic lipomas less than 2 cm in diameter also can be removed by this process.…”

Section: Discussionmentioning

confidence: 99%

“…However, larger tumors may produce symptoms varying from alteration in bowel habits, rectal bleeding, abdominal pain to acute or subacute obstuctions. [2,3] Preoperative diagnosis of these tumors is often difficult. Even with available sophisticated imaging techniques such as computed tomography (CT) scan and magnetic resonance imaging (MRI), definitive diagnosis is only possible based on histopathological evaluation.…”

Section: Introductionmentioning

confidence: 99%

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Submucosal colonic lipoma presenting with acute abdomen due to intestinal obstruction

Mondal¹,

Sengupta²,

Mallick³

et al. 2012

J Acad Med Sci

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A 42-year-old male patient presented with features of acute abdomen characterized by vomiting, abdominal distension, pain, and constipation. There was past history of a similar episode 4months back, which was treated conservatively. On examination, the abdomen was found to be tense, distended with evidence of hyperperistalsis. Ultrasonography failed to detect any mass/ tumor. A decision of explorative laparotomy was taken as no improvement occurred after conservative therapy.On exploration, dilated small and large bowel loops up to the splenic flexure were found. There was a hard, irregular mass at the splenic flexure; no evidence of local or distantdissemination of the disease was found. A presumptive diagnosis of colonic carcinoma was made and standard left hemicolectomy with end-to-end anastomosis was performed. The patient recovered uneventfully. Histopathological FindingsSpecimen of colostomy with growth was subjected to histopathological evaluation. Gross examination showed a large (4.0 cm × 3.5 cm × 2.0 cm), pedunculated, soft to firm globular mass in the splenic flexure with focal ulcerations [ Figure 1].Microscopically, the tumor was present in the submucosa and the overlying mucosa showed focal ulceration. The tumor was composed of mature adipocytes separated by fibrous septa. Nuclear atypia, mitosis, and lipoblast were absent. Congestion and mild infiltration of inflammatory cells were also noted within the tumor [ Figure 2.]. Thus, a final diagnosis of well-differentiated lipoma was rendered.Colonic lipomas are uncommon neoplasms. These tumors rarely produce symptoms. However, we encountered a middle-aged man presenting with features of acute intestinal obstruction. On laparotomy, a hard, irregular mass was identified at splenic flexure. Histological evaluation proved the mass to be a submucosal lipoma. We are presenting this case along with relevant discussions to underscore the fact that colonic lipomas can present as acute abdomen. ABsTRACTAccess this article online Quick Response Code: Website:www.e-jams.org

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Clinical evaluation of submucosal colonic lipomas: Decision making

Abstract: Even lipomas are the most common mesenchymal benign tumors of the gastrointestinal tract, symptomatic colonic presentation is rare. Herein, we evaluated four patients suffering from various size of colonic lipomas and approached by different therapeutic modalities.

Cited by 32 publications

References 10 publications

A colonic submucosal lipoma presenting with recurrent intestinal obstruction attacks

A colonic submucosal lipoma presenting with recurrent intestinal obstruction attacks

Giant Intraperitoneal Lipoma of the Cecum

Submucosal colonic lipoma presenting with acute abdomen due to intestinal obstruction

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