Large Cecal Lipoma With Overlying Ulceration Simulating Malignancy: A Case Report and Review of Relevant Literature

Abstract

Elmer This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

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

“…In the descending order of prevalence, the other locations include the transverse colon, descending colon, sigmoid colon with rectum being the rarest site of occurrence. They have also being reported in the small intestine, stomach and esophagus [12]. These lesions have been found to occur most frequently in the 5th to 6th decade, with a slight female preponderance.…”

“…Moreover, most of these lesions remain asymptomatic, only to be discovered incidentally during a colonoscopy, surgery or autopsy. Less than one-fourth of colonic lipomas have been reported to be symptomatic [12]. However, lesions larger than 2 cm may present in varied ways including abdominal pain, changes in bowel habit, intussusception, weight loss, anemia, GI bleed and prolapse.…”

“…The etiology has not been clearly understood, although chronic inflammation may contribute to the development of these lesions due to abnormal intestinal motility, resulting in separation of the mucosa from the deeper submucosa and subsequent adipose tissue deposition in the separated tissue space [12].…”

“…However, preoperative diagnosis is often difficult, with most lesions being diagnosed during laparotomy and definitively by histopathology. Moreover, these lesions are often misdiagnosed to be adenomas or carcinomas on white light endoscopy, especially in presence of surface ulceration or necrotic areas [12]. CLE is a novel method for diagnosing GI lesions that provides real time high resolution imaging at approximately thousand fold magnifications with a resolution of about 1 micron, which enables visualization of mucosa and lamina propria as well as individual cells.…”

“…This reiterates the importance of histopathology for the diagnosis of GI lesions over novel "virtual microscopy" techniques. 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].…”