Successful endoscopic submucosal dissection of colorectal lipoma with an overlying adenoma

A Colonic Lipoma Causing Obstruction: A Case Report and Review of Literature

Colonic lipomas are rare benign lesions of the gastrointestinal tract. They are asymptomatic in the majority of cases. This report aims to present a case involving a 65-year-old female patient reporting rectal bleeding, loss of appetite, and alteration in bowel habits. First, she was submitted to colonoscopy which revealed a sizable ulcerative polypoid lesion in the descending colon, displaying histological characteristics consistent with a hyperplastic polyp and devoid of malignancy indications. An abdominal computed tomography followed which showed diffuse thickening of the colonic wall in the descending colon, resulting in nearly complete luminal obstruction and also a submucosal lipoma measuring 2.6 centimeters at the same location. Laparoscopic intervention ensued, and following a conclusive intraoperative diagnosis of a submucosal lipoma via frozen biopsy, a successful laparoscopic segmental resection of the descending colon with primary anastomosis was executed. Additionally, a comprehensive review of contemporary literature is provided to enhance the understanding of the management approaches applied in analogous cases since established treatment guidelines for colonic lipomas are currently lacking.