Intestinal subocclusion due to colonic lipoma: a case report

Abstract

Colonic lipomas are rare benign tumors infrequently met in clinical practice. Most of them are asymptomatic making frequent their fortuitous discovery. The therapeutic approach to the fortuitous discovery of a lipoma is even less clear. The treatment depends essentially on the clinical picture, on the size of the lipoma and on its location. We report the case of a 31-year old woman, which sub-occlusive accidents events revealed a lipoma of the descending colon. The diagnosis was suspected on colonoscopy and segmental colectomy was performed. The diagnosis was confirmed by histological examination. We review the literature and discuss the clinical features, diagnosis and treatment of this uncommon disease.

Lipoma of the Colon: Should Asymptomatic Tumors be Treated?

“…Endoscopic removal for lesions bigger than 2.5 cm carries a significant risk of perforation and bleeding. 4 The two cases reported here demonstrate the varied presentations of these rare tumors in terms of age, site, and acuity of presentation. Our first patient had a lipoma in the sigmoid colon, which is an uncommon site and presented with intussusception, which is a known but a rare presentation of these tumors.…”

“…Colonoscopy can be helpful in making the diagnosis by showing a submucosal mass, which indents and tents during biopsy and yellow fat visible after biopsy, whereas CT scan may show a well-defined rounded mass with fat consistency. 4 However, in many cases, carcinoma of the colon is difficult to rule out with certainty because submucosal location of these tumors prevents accurate sampling of the mass during colonoscopy. Treatment options vary from observation for asymptomatic lesions to colotomy with lipectomy versus partial colectomy for large symptomatic lesions depending on the preoperative certainty of the diagnosis of a benign process.…”

Rectal lipoma in a 4-year-old boy presenting with anal prolapse

“…[ 3 4 5 ] Endoscopic resection is considered a safe approach if the lipoma has a diameter <2 cm and the pedicle is narrow. [ 5 6 ] In bigger lipomas, the endoscopic approach is feasible, but the risk of bleeding and perforation is reported high in the literature. [ 1 3 4 ] Surgical repair, both open and laparoscopic, is suggested in the literature when: the lipoma is sessile or has a diameter of more than 4 cm, there is a risk of malignancy, symptoms occur, and muscular layer or serosal attachment is present.…”

“…[ 1 3 4 5 ] These masses are mostly asymptomatic, but if they grow bigger than 2 cm in diameter symptoms may occur, such as rectal bleeding, intussusception, obstruction, or anal prolapse. [ 5 6 9 ]…”

Lipoma gigante de colon transverso, causa de dolor abdominal crónico. Presentación de caso

“…La localización de estos tumores en la mayoría de los casos es en la submucosa; por esta razón, es completamente intraluminal y tiene apariencia de grasa subcutánea. Este tipo de lesiones aparecen con la siguiente distribución: 61 % en el colon derecho, 15,4 % en el colon transverso, 20,1 % en el colon izquierdo y 3,4 % en el recto (3,6,7).…”