Giant Colonic Lipoma Remains a Surgeon's Domain: A Report of Two Cases

Colonic lipomas are rare benign submucosal tumors that are mostly asymptomatic. With increasing size, they may develop symptoms and complications. The acute presentation may be intestinal obstruction secondary to intussusception or gastrointestinal bleeding. The chronic presentation may be subtle and mimic a colonic malignancy. Symptoms include altered bowel habits, abdominal pain, lower gastrointestinal bleeding, and weight loss. Diagnostic evaluation includes advanced imaging such as Computed Tomography, Magnetic Resonance Imaging, and Endoscopy. With the advent of endoscopic submucosal dissection techniques, the therapeutic capabilities of endoscopy have expanded over the decade. However, surgical interventions were reserved for large, symptomatic lipomas, and resection varies from segmental colonic resection to hemicolectomy. Size and clinical presentation determine the therapeutic approach. We, with this, report two cases of giant colonic lipoma in the right colon causing a colo-colic intussusception.