Giant submucosal lipoma located in the descending colon: a case report and review of the literature

Abstract

Colonic lipoma is an uncommon tumor of the gastrointestinal tract. Most cases are asymptomatic, with a small tumor size, and do not need any special treatment. However, we encountered one patient with a giant submucosal lipoma, with a maximum diameter of 8.5 cm, which exhibited symptoms such as intermittent lower abdominal pain, changes in bowel habits with passage of fresh blood and mucus per rectum, abdominal distension, anorexia and weight loss. Unfortunately, the possibility of colonic malignancy could not be precluded and left hemicolectomy was planned. The exact diagnosis of this special case was accomplished by intraoperative pathology. In the end, local resection was performed instead of left hemicolectomy. To the best of our knowledge, colonic lipoma exceeding 8 cm in diameter has not been previously reported. We, therefore, present this case and discuss age and sex factors, clinical and histopathological findings, diagnostic methods and treatment by reviewing the available literature, to serve as a reminder that colonic lipoma can also exist in patients with significant symptoms. In addition, intraoperative pathology should be investigated in those doubtful cases, so as to guide the exact diagnosis and treatment plan.

Figure 1

Colonoscopy showed a yellowish, spherical, polypoid lesion, with a lot of inflammatory necrotic tissue and numerous areas of ulceration on its surface, which arose from the lateral wall of the colon. The lesion almost obstructed the whole lumen.

Figure 2

Histopathology showed that the lesion was located in the submucosa, of adipose origin, and was complicated with necrotic tissue and granulation on its surface (HE, × 100).

Figure 3

Histopathology showed the numerous fibra intervals in the adipose tissue (HE, × 200).