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Case Reports
. 2022 Nov-Dec;27(6):768-770.
doi: 10.4103/jiaps.jiaps_33_22. Epub 2022 Nov 14.

Rectal Lipoma in a 4-Year-Old Boy Presenting with Anal Prolapse

Papouis S George  1 , Athanasios G Pegios  1 , Ioannis Ch Georgakis  1 , Maria I Petridou  1 , Christos M Limas  2
Affiliations
Case Reports

Rectal Lipoma in a 4-Year-Old Boy Presenting with Anal Prolapse

Papouis S George et al. J Indian Assoc Pediatr Surg. 2022 Nov-Dec.

Abstract

Colonic lipomas, even though rare, are the most common intramural tumor and the second-most common benign tumor of the colon after adenomatous polyps. We present the case of a 4-year-old boy with a large rectal lipoma causing anal prolapse, bleeding, and constipation, to discuss differential diagnostic problems and the proper management. A 4-year-old boy presented with symptoms of anal prolapse and constipation. Anal prolapse was accompanied by a tumor that occasionally was bleeding. Computed tomography was performed to determine the origin of the tumor and its relations with the surrounding tissues. Excision of the mass was performed through retraction through the anus and the anal wall was closed with sutures. Histopathological findings revealed a submucosal lipoma of a 5 cm diameter, with the erosions of the overlying mucosa. The patient was discharged after 3 days with no postoperative complications. Colonic lipomas, even though rare, are the second-most common benign tumor of the colon. Essential reasons for the resection are the potential complications, such as abdominal pain, change in bowel pattern, bleeding, obstruction, intussusception, perforation, and rarely transformation into a liposarcoma. Resection is performed endoscopically if the tumor is <2 cm in diameter and has a narrow base that allows safe ligation. Otherwise, the open procedure should be considered. In our case, prolapse of the mass through the anal canal allowed the transanal resection.

Keywords: Lipoma; prolapse; rectal; transanal.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Rectal tumor in MRI (coronary). MRI: Magnetic resonance imaging
Figure 2
Figure 2
Rectal tumor in MRI (sagittal). MRI: Magnetic resonance imaging
Figure 3
Figure 3
Prolapse of the tumor with maneuvers
Figure 4
Figure 4
Excision using an ultrasound scissor
See this image and copyright information in PMC

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