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Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma. Case Rep Surg 2017; 2016:3519606. [PMID: 28044120 PMCID: PMC5164886 DOI: 10.1155/2016/3519606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/14/2016] [Indexed: 12/04/2022] Open
Abstract
Introduction. Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions). Colonic intussusception is even rarer, particularly when caused by lipomas. Case Presentation. A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm) was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. Conclusion. Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%); since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.
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Ivekovic H, Rustemovic N, Brkic T, Ostojic R, Monkemuller K. Endoscopic ligation ("Loop-And-Let-Go") is effective treatment for large colonic lipomas: a prospective validation study. BMC Gastroenterol 2014; 14:122. [PMID: 25005025 PMCID: PMC4099390 DOI: 10.1186/1471-230x-14-122] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 07/02/2014] [Indexed: 12/30/2022] Open
Abstract
Background Colonic lipomas (CL) are rare benign adipose tumours usually found incidentally during colonoscopy. Endoscopic resection of symptomatic large CL remains controversial, since significant rates of perforation have been reported. In recent years, a novel technique for removal of large CL has been described, consisting of looping and ligating the lipoma with a nylon snare. The aim of our study was to evaluate the safety and efficacy of the “loop and let go” technique for large colon lipomas in a large case series. Methods Consecutive patients referred to our institution for colonoscopy were eligible for the study. The diagnosis of CL was confirmed endoscopically by “pillow” and “naked fat” signs. Following diagnosis, lipomas were looped and ligated by endoloop. Follow-up colonoscopies were scheduled at 1- and 3-months interval. Results A total of 11 patients with large CL were enrolled in study. The indications for the colonoscopy included altered bowel habits (7 patients, 64%), screening for colorectal neoplasm (3 pts, 27%) and lower gastrointestinal bleeding (1 pts, 9%). The median lesion size was 3 cm (range 2,5-6 cm). Lesions were located at the hepatic flexure in 4 patients (36%), cecum and ascending colon (4 pts, 36%), rectosigmoid (2 pts, 18%) and transverse colon (1 pts, 9%). There were no immediate and late complications. On follow-up (median follow-up time 11,9 months, range 8–24), there was one small residual lipoma (<1 cm). Conclusion The results of this study confirm that “loop-and-let-go” technique is safe and efficacious treatment of large colonic lipomas.
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Affiliation(s)
- Hrvoje Ivekovic
- Department of Gastroenterology and Hepatology, University Hospital Centre Zagreb, Zagreb, Croatia.
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Abstract
Lipomas are the tumors of mature lipocytes with its occurrence most often on the torso, neck, upper thighs, upper arms, and armpits, but they can occur almost anywhere in the body. They are the rare tumors of intestine, more frequently located in large intestine compared to small intestine. We present the case of a 58-year-old post-menopausal lady presenting with rectal bleeding and utero-vaginal prolapse. The prolapsing mass was excised, and histopathological examination diagnosed the lesion to be a lipoma.
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Affiliation(s)
- P Krishnan
- Department of Surgical Gastroenterology, Sree Narayana Institute of Medical Sciences, Ernakulam, Kerala, India
| | - S Adlekha
- Department of Pathology, Sree Narayana Institute of Medical Sciences, Ernakulam, Kerala, India
| | - T Chadha
- Department of Microbiology, Sree Narayana Institute of Medical Sciences, Ernakulam, Kerala, India
| | - Ak Babu
- Department of Dermatology and Venereology, Sunrise Hospital, Ernakulam, Kerala, India
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Kim GW, Kwon CI, Song SH, Jin SM, Kim KH, Moon JH, Hong SP, Park PW. Endoscopic resection of giant colonic lipoma: case series with partial resection. Clin Endosc 2013; 46:586-90. [PMID: 24143327 PMCID: PMC3797950 DOI: 10.5946/ce.2013.46.5.586] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 10/06/2012] [Accepted: 10/11/2012] [Indexed: 12/15/2022] Open
Abstract
Colonic lipoma, a very rare form of benign tumor, is typically detected incidentally in asymptomatic patients. The size of lipoma is reported variously from 2 mm to 30 cm, with higher likelihood of symptoms as the size is bigger. Cases with symptom or bigger lesion are surgically resected in principle; endoscopic resection, which has developed recently with groundbreaking advance of endoscopic excision technology, is being used more often but with rare report of success due to high chance of complications such as bowel perforation or bleeding. The authors report here, together with a literature review, our experiences of three cases of giant colonic lipomas showing complete remission after aggressive unroofing technique, at certain intervals, using snare catheter at the origin of the lipoma so that the remaining lipoma could be drained out of the exposed surface spontaneously, in order to reduce complications.
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Affiliation(s)
- Gun Woo Kim
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Lee KJ, Kim GH, Park DY, Shin NR, Lee BE, Ryu DY, Kim DU, Song GA. Endoscopic resection of gastrointestinal lipomas: a single-center experience. Surg Endosc 2013; 28:185-92. [PMID: 23996333 DOI: 10.1007/s00464-013-3151-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 07/22/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gastrointestinal (GI) lipomas are benign, slow-growing subepithelial tumors. Most lipomas are detected incidentally at endoscopy, but they can cause GI bleeding, abdominal pain, intestinal obstruction, and intussusception, particularly if they are larger than 2 cm in diameter. The aim of this study was to investigate the efficacy, safety, and long-term prognosis of endoscopic treatment of GI lipomas. METHODS A total of 28 GI lipomas treated endoscopically from January 2005 to June 2012 were retrospectively reviewed. Endoscopic treatment was performed by four methods: the unroofing technique, endoscopic mucosal resection (EMR), EMR after precutting (EMR-P), and endoscopic submucosal dissection (ESD). RESULTS Of 28 GI lipomas, 5 were located in the stomach, 2 in the duodenum, and 21 in the colon. Thirteen lipomas were <2 cm in diameter (small lipoma), and the other 15 were ≥2 cm (large lipoma). The unroofing technique was performed in 2 cases, EMR in 17 cases, EMR-P in 4 cases, and ESD in 5 cases. En bloc resection was performed with 21 lesions (75 %), and endoscopic complete resection was achieved with 26 lesions (93 %). Incomplete resection occurred in the 2 cases treated by the unroofing technique. On pathologic examination, complete resection was achieved with 21 lesions (75 %). Delayed bleeding was observed in one patient. There were no serious complications such as perforation or post-procedural stricture. During the mean follow-up period of 19 months (range 2-91 months), no recurrence was observed. CONCLUSIONS Endoscopic treatment appears to be a safe and effective treatment for GI lipomas, including large lipomas (≥2 cm in diameter).
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Affiliation(s)
- Kwang Jae Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 1-10, Ami-dong, Seo-gu, Pusan, 602-739, Korea
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Böler DE, Baca B, Uras C. Laparoscopic resection of colonic lipomas: When and why? AMERICAN JOURNAL OF CASE REPORTS 2013; 14:270-5. [PMID: 23901354 PMCID: PMC3726236 DOI: 10.12659/ajcr.889247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 05/06/2013] [Indexed: 01/04/2023]
Abstract
PATIENT Male, >60 FINAL DIAGNOSIS: Colonic lipoma Symptoms: Rectal bleeding • abdominal pain • fatique • abdominal distention MEDICATION - Clinical Procedure: Laparoscopic resection Specialty: General surgery. OBJECTIVE We aimed to review and discuss the clinical picture and management of 4 patients who underwent laparoscopic colonic resection with a definitive pathology of colonic lipoma. BACKGROUND Colonic lipomas are rare benign nonepithelial tumors of the colon. They begin to be symptomatic when they reach a certain size, although the presentation can vary. Different endoscopic and surgical treatment strategies have been reported in the literature. CASE REPORTS Four male patients who underwent laparoscopic colonic resection and had definitive diagnosis of colonic lipoma were included in this report. All patients were over 60 years old. The first case presented with massive rectal bleeding. Obstructive symptoms and intermittent bleeding were prominent in the second and third cases. Abdominal pain and discomfort was present in the forth case. In the first 2 cases, abdominal CTs were suggestive of colonic lipoma and laparoscopic ileocecal resection was performed. However, malignancy could not be ruled out in the other 2 cases due to large size and heterogeneous appearance of the lesions and inconclusive endoscopic biopsies consisted of ulcer with exudate and inflammatory cells. Laparoscopic left and right hemicolectomy was performed in the third and forth cases, respectively. There were no complications in any patients. CONCLUSIONS Laparoscopic resection can be the first choice in treatment of colonic lipomas with various presentations. Wider resections should be considered in cases with uncertain diagnosis.
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Affiliation(s)
- Deniz Eren Böler
- Department of General Surgery, Acıbadem University Medical Faculty, İstanbul, Turkey
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Ongom PA, Wabinga H, Lukande RL. A 'giant' intraluminal lipoma presenting with intussusception in an adult: a case report. J Med Case Rep 2012; 6:370. [PMID: 23107601 PMCID: PMC3512482 DOI: 10.1186/1752-1947-6-370] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 09/26/2012] [Indexed: 11/16/2022] Open
Abstract
Introduction Intussusception is an uncommon cause of intestinal obstruction in adults. It usually presents with typical features of intestinal obstruction, and is associated with the presence of a ‘lead point’ for the invaginated portion. This ‘lead point’ is rarely an intraluminal, submucosal lipoma. Case presentation We describe the case of a 64-year-old African-Ugandan woman of Bantu ethnicity who presented with features of intestinal obstruction secondary to intussusception. She was treated operatively. A left colocolonic invagination was found with the interssusceptum having a giant polyp. A left hemicolectomy was performed. A histopathological examination revealed a polypoid, submucosal lipoma. Conclusions In resource-rich countries, most cases of colonic intraluminal polyps are detected through colonoscopy during routine medical check-ups. With limited resources in our region, many tumors present as intestinal obstructions secondary to intussusception. Even then, most are associated with adenomas and malignancies. Rarely are polypoid, submucosal lipomas found. In our patient’s case a polyp of 9.5cm at its widest dimension is of particular interest. A lesson to learn is that the differential diagnosis for intussusceptions in resource-poor countries should be broadened to include submucosal lipomas.
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Affiliation(s)
- Peter A Ongom
- Department of Surgery, Colorectal Surgery Unit, School of Medicine, Makerere College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda.
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Lee CS, Lee MJ, Kim KL, Kim YS, Baik GH, Kim JB, Kim DJ, Han SH. A case of giant lipoma causing chronic recurrent intussusception of the colon. Clin Endosc 2012; 45:165-8. [PMID: 22866259 PMCID: PMC3401622 DOI: 10.5946/ce.2012.45.2.165] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 03/19/2012] [Accepted: 03/22/2012] [Indexed: 11/18/2022] Open
Abstract
Colonic lipomas, which often occur in elderly women, usually have small size and occur mainly in the cecum and ascending colon. Most colonic lipomas are asymptomatic and identified incidentally at the time of endoscopy or surgery. However, they may cause symptoms such as bleeding, obstruction or intussusception as their size increases. Intermittent episodes of intussusception are uncommon but may be caused by large pedunculated lipoma. In a 68-year-old woman suffering intermittent abdominal pain, 5.5×4.5×3.8-cm huge mass was found by colonoscopy at proximal ascending colon, which was intussuscepted to proximal transverse colon on abdominal computed tomography. Segmental right colonic resection was conducted. We report a case of symptomatic giant pedunculated colonic lipoma causing intussusception requiring surgical intervention, with a successful recovery after surgery.
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Affiliation(s)
- Chang Seob Lee
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
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Mantzoros I, Raptis D, Pramateftakis MG, Kanellos D, Psomas S, Makrantonakis A, Tsachalis T, Angelopoulos S. Colonic lipomas: our experience in diagnosis and treatment. Tech Coloproctol 2012; 15 Suppl 1:S71-3. [PMID: 21887571 DOI: 10.1007/s10151-011-0736-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIM The aim of this study is to present our experience in colonic lipomas. PATIENTS AND METHODS We present 4 patients (1 male, 3 females) of mean age 65.5 years (range, 61-72 years) treated for single colonic lipomas. The diameters of the lesions were 4.5, 4, 3.5 and 2.5 cm, respectively. In 3 cases, colonic lipomas were located within the cecum, while in one patient within the descending colon, proximally to the splenic flexure. RESULTS Lipomas of diameter greater than 3 cm caused nonspecific symptoms. Lipomas of higher diameter were removed laparoscopically with colotomy; in two cases, the patients underwent open hemicolectomy, because of the suspicion of malignancy, while the smallest lesion was resected endoscopically, using a bipolar snare. All patients recovered without complications and remain healthy with no signs of recurrence. CONCLUSION In cases of ulcerated lipomas, greater than 3 cm of diameter, surgical resection is recommended.
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Affiliation(s)
- I Mantzoros
- Surgical Department, European Medical Center, Macedonias 2 str, 55535 Pilea, Thessaloniki, Greece
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Geraci G, Pisello F, Arnone E, Sciuto A, Modica G, Sciumè C. Endoscopic Resection of a Large Colonic Lipoma: Case Report and Review of Literature. Case Rep Gastroenterol 2010; 4:6-11. [PMID: 21103220 PMCID: PMC2988890 DOI: 10.1159/000260053] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Colonic lipomas are uncommon, benign, submucosal adipose tumors that are usually asymptomatic. Large lipomas can cause symptoms such as constipation, abdominal pain, rectal bleeding and intussusception. We report the case of a 60-year-old man with a history of lower abdominal pain and pseudoobstructive symptoms. Colonoscopy revealed a large polypoid sessile lesion in the sigma. We used a standardized technique of polypectomy, preceded by submucosal injection of dilute 5 ml polygelin with epinephrine 1:10,000 solution, to fully resect large colonic lipomas. The lipoma size was 3.5 cm. No bleeding or perforation developed. Histology showed the polyp to be a submucosul lipoma. On follow-up, there was no residual lesion. Colonic lipomas larger than 2 cm can be safely and efficaciously removed using electrosurgical snare polypectomy technique. The technique of submucosal injection before resection and using an electrocautery snare appears to be safe and reduces the risk of perforation reported in the literature.
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Affiliation(s)
- Girolamo Geraci
- Section of General and Thoracic Surgery, Division of Surgical Endoscopy, University of Palermo School of Medicine, Palermo, Italy
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Lazaraki G, Tragiannidis D, Xirou P, Nakos A, Pilpilidis I, Katsos I. Endoscopic resection of giant lipoma mimicking colonic neoplasm initially presenting with massive haemorrhage: a case report. CASES JOURNAL 2009; 2:6462. [PMID: 20181161 DOI: 10.1186/1757-1626-0002-0000006462] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Accepted: 02/05/2009] [Indexed: 11/10/2022]
Abstract
Lipomas of the colon are benign tumors that rarely occur. Their size ranges from 2 mm to several cm. They are usually asymptomatic but occasionally they present with clinical manifestations depending on tumor size, localization and complications, which often lead to diagnostic difficulty. A 40-year-old man presented with massive rectal haemorrhage. During colonoscopy a giant polyp of over 50 mm in its bigger diameter, with a thick stalk of 2 cm, located in the transverse colon, was revealed. Endoscopic resection was performed with success. Histologic examination demonstrated a giant lipoma. In this report discussion over endoscopic resection of colonic lipomas mimicking neoplasms is also performed.
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Affiliation(s)
- Georgia Lazaraki
- Department of Gastrointestinal Oncology, Theagenion Cancer Hospital, Al. Simeonidi 2 str, 54007, Thessaloniki, Greece.
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Lazaraki G, Tragiannidis D, Xirou P, Nakos A, Pilpilidis I, Katsos I. Endoscopic resection of giant lipoma mimicking colonic neoplasm initially presenting with massive haemorrhage: a case report. CASES JOURNAL 2009. [PMID: 20181161 PMCID: PMC2827102 DOI: 10.1186/1757-1626-2-6462] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Lipomas of the colon are benign tumors that rarely occur. Their size ranges from 2 mm to several cm. They are usually asymptomatic but occasionally they present with clinical manifestations depending on tumor size, localization and complications, which often lead to diagnostic difficulty. A 40-year-old man presented with massive rectal haemorrhage. During colonoscopy a giant polyp of over 50 mm in its bigger diameter, with a thick stalk of 2 cm, located in the transverse colon, was revealed. Endoscopic resection was performed with success. Histologic examination demonstrated a giant lipoma. In this report discussion over endoscopic resection of colonic lipomas mimicking neoplasms is also performed.
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Affiliation(s)
- Georgia Lazaraki
- Department of Gastrointestinal Oncology, Theagenion Cancer Hospital, Al. Simeonidi 2 str, 54007, Thessaloniki, Greece.
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Jovanović I, Pavlović A, Popović D, Pavlov M. Endoscopically removed giant submucosal lipoma. VOJNOSANIT PREGL 2007; 64:417-20. [PMID: 17687948 DOI: 10.2298/vsp0706417j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although uncommon, giant submucosal colon lipomas merit attention as they are often presented with dramatic clinical features such as bleeding, acute bowel obstruction, perforation and sometimes may be mistaken for malignancy. There is a great debate in the literature as to how to treat them. CASE REPORT A patient, 67-year old, was admitted to the Clinic due to a constipation over the last several months, increasing abdominal pain mainly localized in the left lower quadrant accompanied by nausea, vomiting and abdominal distension. Physical examination was unremarkable and the results of the detailed laboratory tests and carcinoembryonic antigen remained within normal limits. Colonoscopy revealed a large 10 cm long, and 4 to 5 cm in diameter, mobile lesion in his sigmoid colon. Conventional endoscopic ultrasound revealed 5 cm hyperechoic lesion of the colonic wall. Twenty MHz mini-probe examination showed that lesion was limited to the submucosa. Since polyp appeared too large for a single transaction, it was removed piecemeal. Once the largest portion of the polyp has been resected, it was relatively easy to place the opened snare loop around portions of the residual polyp. Endoscopic resection was carried out safely without complications. Histological examination revealed the common typical histological features of lipoma elsewhere. The patient remained stable and eventually discharged home. Four weeks later he suffered no recurrent symptoms. CONCLUSION Colonic lipomas can be endoscopically removed safely eliminating unnecessary surgery.
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Affiliation(s)
- Ivan Jovanović
- Clinical Center of Serbia, Clinic of Gastroenterology and Hepatology, Belgrade, Serbia.
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Katsinelos P, Chatzimavroudis G, Zavos C, Pilpilidis I, Lazaraki G, Papaziogas B, Paroutoglou G, Kountouras J, Paikos D. Cecal lipoma with pseudomalignant features: A case report and review of the literature. World J Gastroenterol 2007; 13:2510-3. [PMID: 17552037 PMCID: PMC4146772 DOI: 10.3748/wjg.v13.i17.2510] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Colonic lipoma is a well-documented benign neoplasia, endoscopically appearing as a smooth round yellowish polyp with a thick stalk or broad-based attachment. We describe a 63-year old woman with persistent abdominal pain, in whom colonoscopy revealed a cecal mass with malignant features. Based on the colonoscopy findings, right hemicolectomy was laparoscopically performed for a presumptive diagnosis of a cecal adenocarcinoma, but histological examination revealed a colonic lipoma with overlying mucosal ulceration.
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Affiliation(s)
- Panagiotis Katsinelos
- Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, 54635, Thessaloniki, Greece.
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Yu HG, Ding YM, Tan S, Luo HS, Yu JP. A safe and efficient strategy for endoscopic resection of large, gastrointestinal lipoma. Surg Endosc 2006; 21:265-9. [PMID: 17122972 DOI: 10.1007/s00464-006-0059-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2006] [Accepted: 04/27/2006] [Indexed: 12/18/2022]
Abstract
BACKGROUND Gastrointestinal (GI) lipomas are benign, slowly growing, submucosal tumors, which may cause gastrointestinal bleeding, anemia, intussusception, and bowel obstruction. The aim of this study is to explore the safe and effective strategy for endoscopic removal of large GI lipomas. METHODS During last 10 years, fifteen large and symptomatic GI lipomas were resected under endoscopy in our hospital. In them, two large lipomas with small stalk (< 2 m in diameter) were resected by polypectomy; ten large lipomas with base size greater than 2 cm in diameter were removed using a "subtotal resection." Three other large lipomas with small stalk (< 2 m in diameter) were resected by multistep resection. Endoscopic ultrasonography (EUS) and miniprobe endoscopic ultrasound were performed in six cases from January 2000 to July 2004 to confirm that those lesions were lipomas that were superficial to the muscularis propria. RESULTS All 15 lesions were successfully removed and were histopathologically confirmed to be lipomas. No severe complications, such as perforation or hemorrhage, developed after endoscopic removal. No recurrence was observed after 1-8 years follow-up endoscopic examination. CONCLUSIONS Various, large GI lipomas can be removed safely by electrosurgical snare resection under endoscopy following the guidance of the present therapeutic strategy.
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Affiliation(s)
- H-G Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Jiefang Road 238, 430060, Wuhan, People's Republic of China.
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Tascilar O, Cakmak GK, Gün BD, Uçan BH, Balbaloglu H, Cesur A, Emre AU, Comert M, Erdem LO, Aydemir S. Clinical evaluation of submucosal colonic lipomas: Decision making. World J Gastroenterol 2006; 12:5075-7. [PMID: 16937511 PMCID: PMC4087418 DOI: 10.3748/wjg.v12.i31.5075] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Even lipomas are the most common mesenchymal benign tumors of the gastrointestinal tract, symptomatic colonic presentation is rare. Herein, we evaluated four patients suffering from various size of colonic lipomas and approached by different therapeutic modalities.
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Affiliation(s)
- Oge Tascilar
- Department of Surgery, Zonguldak Karaelmas University, Kozlu-Zonguldak 67600, Turkey
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17
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Affiliation(s)
- Shree J Krishnan
- Department of Internal Medicine, St. Joseph Mercy Hospital, Ann Arbor, Michigan, USA
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Abstract
Colon lipoma is remarkably rare in clinical practice. We reported a case of ascending colon lipoma in an 83-year-old woman. She was asymptomatic with a lipoma of 35 mm×30 mm×24 mm in size which was found by routine colonoscopy. Right hemicolectomy was performed uneventfully. The diagnosis was made by histological examination. Reviewing the literature and combining with our experience, we discussed the clinical features, diagnosis and treatment of this uncommon disease.
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Affiliation(s)
- Hong Zhang
- Department of General Surgery, The Second Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.
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