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.

Diagnostic value and potential clinical significance of duodenal lipoma based on computed tomography imaging data

“…[10] Some studies have demonstrated that duodenal lipomas can occur in any part of the duodenum, of which the descending part is the most common, accounting for approximately 60% of the cases. [11] Among the 57 patients in this study, 33 duodenal lipomas were located in the descending part of the duodenum, accounting for approximately 58%, which was consistent with the findings of a previous report. Duodenal lipoma is more common in middle-aged and elderly individuals, and there is no significant difference in the incidence between men and women.…”

“…Although the pathogenesis of gastrointestinal lipoma remains unclear, [4] it may be related to the combined effect of inflammatory stimulation and fat accumulation, and/or abnormal secretion of gonadal hormones in the anterior pituitary [10] . Some studies have demonstrated that duodenal lipomas can occur in any part of the duodenum, of which the descending part is the most common, accounting for approximately 60% of the cases [11] . Among the 57 patients in this study, 33 duodenal lipomas were located in the descending part of the duodenum, accounting for approximately 58%, which was consistent with the findings of a previous report.…”

Symptomatic colonic lipomas: Report of two cases and a review of the literature

“…The decision whether to remove lipomas and which method is the best option either endoscopically or surgically remains controversial. 7 The general agreement is that colon lipomas <2.0 cm in diameter are more accessible for endoscopic treatment. 3 Endoscopic removal is not suggested for lesions >2.0 cm due to the high risk of complications, such as bleeding and perforation.…”

“…3 Endoscopic removal is not suggested for lesions >2.0 cm due to the high risk of complications, such as bleeding and perforation. 7…”

“…3,5,10 Recently, laparoscopic procedures and minimal laparotomy approach were reported as an alternative to conventional laparotomy used in removal of large CLs. 7,9 Both approaches involve shorter operation times, less postoperative pain, shorter duration of ileus, and quicker recovery. 9,11…”