Clinical evaluation of submucosal colonic lipomas: decision making

Abstract

Even lipomas are the most common mesenchymal benign tumors of the gastrointestinal tract, symptomatic colonic presentation is rare. Herein, we evaluated four patients suffering from various size of colonic lipomas and approached by different therapeutic modalities.

Figure 1

Computed tomography (CT) scan showing a regular contoured 4 cm x 3 cm lesion with fatty density localised in midportion of ascending colon causing a luminal narrowing defect (A), double contrast barium enema showing a filling defect of the protruded polipoid lesion at the hepatic flexura of colon (B), and appearance of the colonic submucosal lipoma during the operation (C).

Figure 2

A mass lesion located in the hepatic flexura causing filling defect shown by double contrast enema (A), resected biopsy specimen showing a submucosal benign lipoma composed of mature lipocytes by hematoxylin and eosin staining (B) (x 400).

Figure 3

Colonoscopic appearance of a broad- based giant mass acquiring spontaneous hemorrhagic areas and obstructing more than 75% of the lumen of sigmoid colon (A); abdominal computed tomography scans showing the diffuse thickening of sigmoid colon wall, invagination and a distal intraluminal giant mass with fat density with a size of approximately 6 cm x 7 cm (B); macroscopic appearance of the giant sigmoid colon lipoma (C).