Pedunculated lipoma of the colon: risks of endoscopic removal

Endoscopic removal of pedunculated submucosal lipomas of the colon has been considered safe and effective. I have reported a case of large submucosal lipoma of the descending colon, in which serosal invagination resulted in the formation of a "pseudopedicle." Endoscopic polypectomy in such a case would have resulted in colonic perforation. Caution should be exercised in endoscopic removal of large lipomas, even when a pedicle is present.