Colonic lipoma mimicking malignancy and presenting as an intussusception: A rare case report

Abstract

Introduction and importance: Lipomas of the gastrointestinal tract are a rare entity compared to the more common tumors of the gut, such as adenomatous polyps and carcinomas. They were first described by Bauer in 1757. Gastrointestinal lipomas can grow in all segments of the gut, with the highest frequency in the colon. In this case report, we present a rare case of gastrointestinal lipoma mimicking colonic malignancy and causing intussusception, necessitating emergent surgery. This paper highlights the potential diagnostic challenges and therapeutic interventions associated with GI lipomas.

Case presentation: A 28-year-old female presented with symptoms of abdominal pain, weight loss, vomiting, and changes in bowel habits. Initially, she received a misdiagnosis of Irritable Bowel Syndrome. Subsequent investigations indicated the possibility of colonic malignancy. During the intra-operative biopsy, it was ultimately discovered that she had a colonic lipoma.

Clinical discussion: CT revealed an abdominal mass and an intussusception, indicating the need for surgical intervention. A laparoscopic procedure was performed to remove the mass, which alleviated the symptoms. Subsequently, a histological examination confirmed the mass to be a lipoma.

Conclusion: Differentiating a gastrointestinal lipoma from malignancy is crucial, and careful investigation is necessary to determine if a local excision can be performed instead of a wide excision.

Keywords: Case report; Gastrointestinal lipomas; Intussusception; Surgery.

Fig. 1

(a) and (b): Lobules of lipocytes with eccentric nuclei consistent with histology of lipoma (4×, 10×).

Fig. 2

CT imaging with contrast showing concentric mass in left hemiabdomen with “bowel within bowel” appearance.

Fig. 3

Intraoperative sections.