Sheep in Wolf's Clothing: Pedunculated Colonic Lipoma with Overlying Hyperplastic and Ulcerated Epithelium

Abstract

Introduction: Lipomas are the most common non-epithelial benign tumors of the gastrointestinal tract with a reported incidence in the colon of 0.2-4.4%. These lesions are usually asymptomatic with a typical endoscopic finding of a smooth, slightly yellow, circular, polyp that is sessile in most cases, covered with normal colonic mucosa.

Areas covered: There are rare reported cases of alterations of the overlying mucosa such as hyperplasia, atrophy, adenomatous changes, and necrosis.

Expert commentary: We report a rare case of pedunculated colonic lipoma of the transverse colon covered with hyperplastic and ulcerated epithelium easily misdiagnosed as an adenomatous lesion.

Keywords: Colonoscopy; Endoscopic mucosal resection; Hyperplasia; Lipoma.