Endoscopic resection of giant lipoma mimicking colonic neoplasm initially presenting with massive haemorrhage: a case report

Abstract

Lipomas of the colon are benign tumors that rarely occur. Their size ranges from 2 mm to several cm. They are usually asymptomatic but occasionally they present with clinical manifestations depending on tumor size, localization and complications, which often lead to diagnostic difficulty. A 40-year-old man presented with massive rectal haemorrhage. During colonoscopy a giant polyp of over 50 mm in its bigger diameter, with a thick stalk of 2 cm, located in the transverse colon, was revealed. Endoscopic resection was performed with success. Histologic examination demonstrated a giant lipoma. In this report discussion over endoscopic resection of colonic lipomas mimicking neoplasms is also performed.

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

“…The size of colonic lipomas ranges between 2 mm and 30 cm and may mimic colonic malignancies ( 13 ). The present case revealed that large colonic lipomas and malignant tumors may be difficult to differentiate prior to resection if only endoscopic observations are used.…”

Colonic lipomas an uncommon cause of intussusception in adult patients: report of three cases and literature review

“…Colonoscopy may show CLs in the form of a yellow elastic submucosal mass, but sometimes hemorrhage, necrosis, and mucosal ulceration may be seen 15 . (15) Regarding treatment, the general agreement is that CLs <2.0cm in diameter are accessible for endoscopic management, while this is not recommended for lesions >2.0cm due to the risk of complications 16 . (16) For those patients taken for surgical treatment, formal colectomy and limited colon resection are considered as adequate treatment modality, particularly in those cases with a confirmed preoperative diagnosis 17 .…”

“…(15) Regarding treatment, the general agreement is that CLs <2.0cm in diameter are accessible for endoscopic management, while this is not recommended for lesions >2.0cm due to the risk of complications 16 . (16) For those patients taken for surgical treatment, formal colectomy and limited colon resection are considered as adequate treatment modality, particularly in those cases with a confirmed preoperative diagnosis 17 . (17) According to Jiang et al, surgical intervention is appropriate when the lipoma is >4 cm in size; has associated intussusception and the patient is symptomatic, or when the lesion cannot be resected endoscopically 18 .…”

Submucosal Lipoma of the Rectum Presenting as Rectal Prolapse and Appearing as Adenomatous Polyp on Confocal Laser Endomicroscopy: a Case Report and Literature Review

“…Lipomas of the colon and rectum are rare GI neoplasms, though they are the second most common benign tumors after adenomatous polyps [1], and the commonest non-epithelial neoplasms. They comprise about 5% of all GI tract tumors [2], with an incidence ranging from 0.035% to 4.4% [3].…”

“…or laparoscopic methods [12]. However, endoscopic removal is preferable over surgical excision, provided the cases are selected carefully and the procedure performed by skilled endoscopists in centers of excellence [1].…”