BACKGROUND Since fat does not transmit electrical energy well,delayed perforation and postpolypectomy syndrome due to electrical thermal injury are concerns in the endoscopic removal of colonic lipoma.The endoscopic s...BACKGROUND Since fat does not transmit electrical energy well,delayed perforation and postpolypectomy syndrome due to electrical thermal injury are concerns in the endoscopic removal of colonic lipoma.The endoscopic submucosal dissection(ESD)technique concentrates electrical energy conducts to the submucosa,not the adipose tissue.This helps to minimize electrical thermal injury,especially in the case of large colonic lipomas.In rare cases,such as colonic lipomas accompanied by mucosal lesions,it is difficult for endoscopists to decide how to safely remove them.CASE SUMMARY A 78-year-old man underwent colonoscopy for colorectal cancer screening.During colonoscopy,a yellowish submucosal tumor with positive cushion sign was observed in the ascending colon measuring about 4.5 cm.A nodular mucosal lesion of about 2.5 cm was observed on the mucosal surface of the lipoma.The lipoma was so large that it occupied much of the inside of the colon,making it difficult to see the entire laterally spreading tumor(LST)at once.The LST was confined to the surface of the lipoma,which had a semipedunculated shape with a wide neck.The margin of the LST was not observed at the neck of the lipoma.ESD was performed and the colonic lipoma with the LST was successfully removed without complications.After 3 d of hospitalization,the patient was discharged without any symptoms.The final pathology report showed that the lesion consisted of submucosal lipoma and tubulovillous adenoma with lowgrade dysplasia.CONCLUSION ESD is effective and safe for treating a large colonic lipoma with an LST by minimizing electrical thermal injury.展开更多
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 ...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.展开更多
Colonic lipoma is a well-documented benign neoplasia, endoscopicaUy 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 p...Colonic lipoma is a well-documented benign neoplasia, endoscopicaUy 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 laparoscopicaUy performed for a presumptive diagnosis of a cecal adenocarcinoma, but histological examination revealed a colonic lipoma with overlying mucosal ulceration.展开更多
文摘BACKGROUND Since fat does not transmit electrical energy well,delayed perforation and postpolypectomy syndrome due to electrical thermal injury are concerns in the endoscopic removal of colonic lipoma.The endoscopic submucosal dissection(ESD)technique concentrates electrical energy conducts to the submucosa,not the adipose tissue.This helps to minimize electrical thermal injury,especially in the case of large colonic lipomas.In rare cases,such as colonic lipomas accompanied by mucosal lesions,it is difficult for endoscopists to decide how to safely remove them.CASE SUMMARY A 78-year-old man underwent colonoscopy for colorectal cancer screening.During colonoscopy,a yellowish submucosal tumor with positive cushion sign was observed in the ascending colon measuring about 4.5 cm.A nodular mucosal lesion of about 2.5 cm was observed on the mucosal surface of the lipoma.The lipoma was so large that it occupied much of the inside of the colon,making it difficult to see the entire laterally spreading tumor(LST)at once.The LST was confined to the surface of the lipoma,which had a semipedunculated shape with a wide neck.The margin of the LST was not observed at the neck of the lipoma.ESD was performed and the colonic lipoma with the LST was successfully removed without complications.After 3 d of hospitalization,the patient was discharged without any symptoms.The final pathology report showed that the lesion consisted of submucosal lipoma and tubulovillous adenoma with lowgrade dysplasia.CONCLUSION ESD is effective and safe for treating a large colonic lipoma with an LST by minimizing electrical thermal injury.
文摘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.
文摘Colonic lipoma is a well-documented benign neoplasia, endoscopicaUy 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 laparoscopicaUy performed for a presumptive diagnosis of a cecal adenocarcinoma, but histological examination revealed a colonic lipoma with overlying mucosal ulceration.