Management Options of Giant Colonic Lipomas

Large bowel obstruction caused by a submucosal colonic lipoma: not all lipomas are trouble free

“…Although lipomas have no malignant potential, excluding the underlying malignancy can be challenging without surgical resection. CT is considered the best diagnostic modality with intussusception presenting with the classic target sign 2,5,6 . Colonoscopy allows direct lesion visualization, which can reveal the ‘pillow sign’ (pressing the forceps on the lipoma leads to pillowing) and the “bare fat” mark (leakage of fat after endoscopic biopsy) 1 .…”

“…CT is considered the best diagnostic modality with intussusception presenting with the classic target sign. 2,5,6 Colonoscopy allows direct lesion visualization, which can reveal the 'pillow sign' (pressing the forceps on the lipoma leads to pillowing) and the "bare fat" mark (leakage of fat after endoscopic biopsy). Surgical resection is generally recommended for lipomas with a diameter >2 cm.…”