Giant ascending colonic lipoma accompanied by intussusception

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Imaging

Background:

• Intussusception is a rare cause of bowel obstruction in adults.
• Submucosal lipomas are benign fatty tumors that can occur anywhere in the gastrointestinal tract.
• Colonic lipomas can present with vague abdominal symptoms or complications like intussusception.

Observation:

• A 49-year-old woman presented with abdominal pain and CT findings of intussusception.
• Imaging revealed a "Bulls eye" appearance and a 5.0 cm fat-density tumor in the hepatic flexure.
• Colonoscopy confirmed a cauliflower-like tumor, and laparoscopy identified an ascending colonic tumor.

Findings:

• Histopathology confirmed a 4.0 × 4.0 × 4.5 cm submucosal lipoma in the ascending colon.
• The lipoma served as the lead point for the intussusception.
• A radical right hemicolectomy was successfully performed.

Implications:

• This case underscores the need for thorough investigation of adult intussusception, including consideration of benign intraluminal masses.
• Submucosal lipomas, though rare, should be included in the differential diagnosis of colonic intussusception.
• Early diagnosis and surgical intervention are crucial for favorable outcomes in such cases.