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CC BY 4.0 · Journal of Coloproctology 2024; 44(S 01): S1-S138
DOI: 10.1055/s-0045-1808823
Temas Gerais Dentro da Especialidade
General Topics Within the Specialty
ID – 137793
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GIANT LIPOMA OF THE TRANSVERSE COLON WITH PROGRESSION TO INTUSSUSCEPTION: A CASE REPORT

Carlos Ramon Mendes
1   Hospital Cardiopulmonar Salvador, Salvador, Brasil
,
Joana Carolina Saraiva de Paula Pessoa
1   Hospital Cardiopulmonar Salvador, Salvador, Brasil
,
Tassia Mendes Franco
1   Hospital Cardiopulmonar Salvador, Salvador, Brasil
,
Ticiana Assemany Cruz
2   Medical Student, Centro Universitário Dom Pedro II, em Salvador Bahia, Salvador, BA, Brasil
,
Bruno Franco de Oliveira Santos
3   Medical Student, Escola Bahiana de Medicina e Saúde Pública, em Salvador Bahia, Salvador, BA, Brasil
,
Leticia Sandes Bittencourt de Carvalho Melo
3   Medical Student, Escola Bahiana de Medicina e Saúde Pública, em Salvador Bahia, Salvador, BA, Brasil
,
Lorena Boureau Pereira
2   Medical Student, Centro Universitário Dom Pedro II, em Salvador Bahia, Salvador, BA, Brasil
,
Julyana Costa Neiva
4   General Surgery Resident at Hospital Irmã Dulce, em Salvador Bahia, Salvador, BA, Brasil
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    Case Report This is a 56-year-old female patient with a history of abdominal pain. An endoscopic examination revealed a subepithelial lesion approximately 8 cm in size located in the transverse colon. Biopsies were performed, revealing a chronic inflammatory process associated with focal ulceration and adipose tissue with areas of steatonecrosis. The patient was scheduled for elective surgery but developed intense anal pain and the evacuation of a mass. Abdominal tomography showed signs of left colon-colon intussusception secondary to a lipoma. The patient underwent emergency partial colectomy in September 2023. Histopathology of the surgical specimen revealed a segment of the colon with intussusception secondary to a colon lipoma measuring 9.2 × 5.8 × 4.4 cm, located in the submucosa, with a yellowish and shiny surface. Additionally, thirteen reactive mesocolic lymph nodes were identified, the largest measuring 0.6 cm. The patient had a good postoperative recovery and continues with outpatient follow-up.

    Discussion Giant colonic lipomas are benign, non-epithelial tumors typically located in the submucosa of the large intestine. They are more common in the cecum and right colon, with an increased incidence after the age of 50. Lipomas smaller than 2 cm are usually asymptomatic, but larger ones produce symptoms in more than 75% of cases, including colicky abdominal pain, palpable abdominal masses, changes in bowel habits, and weight loss. Obstructive signs can also occur when pedunculated, leading to intussusception. Intussusception is a frequent complication of this neoplasm and is defined as the telescoping of one segment of the intestine into an adjacent one. It is usually associated with pathological lesions of the intestinal wall and can cause obstruction and, sometimes, ischemia. The diagnosis of colonic lipoma is made through clinical examination, colonoscopy, and imaging studies, and the treatment is surgical.

    Conclusion This case highlights the importance of monitoring and intervening in patients with giant colonic lipomas, given the alarming signs and symptoms associated with them and their potential complications.


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    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    25 April 2025

    © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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