Submucosal Cecal Lipoma Mimicking Malignancy in a 51-Year-Old Man: A Diagnostic Challenge in Routine Colonoscopy

BACKGROUND Benign submucosal tumors of the large bowel include lipomas and smooth muscle tumors, which can be a diagnostic challenge since they appear as nodules or masses on colonoscopy. This report describes the case of a 51-year-old man with a submucosal lipoma of the cecum diagnosed as an incidental finding during routine colonoscopy. CASE REPORT On April 29, 2024, a 51-year-old male patient was found during colonoscopy to have a submucosal mass in the cecum, with surface ulceration, raising suspicion of malignancy. However, endoscopic biopsy showed no evidence of malignant components. For further evaluation and treatment, the patient underwent laparoscopic right hemicolectomy on May 7, 2024. Postoperative pathology results confirmed that the submucosal mass in the cecum was a lipoma. CONCLUSIONS Even though modern gastrointestinal endoscopy has made significant advancements, the diagnosis of a benign or malignant nature in some gastrointestinal submucosal masses remains a challenge in clinical practice today. It is worth noting that benign submucosal masses of the cecum can also present with various colonoscopy findings that look like malignant tumors, with or without symptoms.