A 72-year-old man presented with fatigue for two months. Laboratory evaluation revealed a microcytic anemia (Hg 10.7g/dL). A lower gastrointestinal endoscopy was then requested which showed in the cecum a well-delineated soft lobulated yellowish mobile mass measuring about 5cm (Fig. 1). The mass was pedunculated, with a short but thick stalk. After careful evaluation, a decision was made to remove the polypoid lesion. An endoloop was placed around the mass (Fig. 1), followed by en bloc resection with a large cautery snare. Hemostasis was also ensured by placing three clips on the resection area (Fig. 2). The specimen was retrieved and sent to pathology. Histological examination confirmed a submucosal lipoma of the cecum, with 5cm×2.5cm×2cm and no evidence of dysplasia (Fig. 3). There were no adverse events after the procedure, and the patient has done well thereafter.
Colonic lipomas are uncommon benign lesions (incidence between 0.2 and 4.4%).1 They are usually asymptomatic and found incidentally, however when large (>4cm) may produce symptoms (bleeding, obstruction, invagination).1,2 Although some authors consider surgery for large lipomas,3 recent case series using endoscopic treatment reported high effectiveness with low rate of complications.2 In our case, a large colonic lipoma was safely removed using a ligate-and-resect technique.
Conflicts of interestNone declared.
