Journal of Laboratory Physicians
Home About us Ahead of print Current issue Back issues Subscribe Instructions Contact Login 
Wide layoutNarrow layoutPrint this page  Email this page Bookmark this page Small font size Default font size Increase font size 
 


 
LETTER TO EDITOR
Year : 2009  |  Volume : 1  |  Issue : 2  |  Page : 82-83 Table of Contents   

Submucous lipoma of sigmoid colon: A rare entity


Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati - 517 507, India

Date of Web Publication5-Feb-2010

Correspondence Address:
Kinnera Vijay Sreedhar Babu
Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati - 517 507
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2727.59706

Rights and Permissions

How to cite this article:
Sreedhar Babu KV, Chowhan AK, Yootla M, Reddy MK. Submucous lipoma of sigmoid colon: A rare entity. J Lab Physicians 2009;1:82-3

How to cite this URL:
Sreedhar Babu KV, Chowhan AK, Yootla M, Reddy MK. Submucous lipoma of sigmoid colon: A rare entity. J Lab Physicians [serial online] 2009 [cited 2018 Dec 11];1:82-3. Available from: http://www.jlponline.org/text.asp?2009/1/2/82/59706

Sir,

Lipoma of colon is a rare entity. So far to best of our knowledge, only 254 cases have been reported in the literature. [1] It may be asymptomatic to mildly symptomatic depending upon the size of the lesion (larger than 20 mm). [2] Though the diagnosis can be made easily at surgery or autopsy, but before that it may lead to many differential diagnostic problems, such as polypoidal carcinoma. We report a case of submucous lipoma sigmoid colon in a woman who underwent left hemicolectomy with clinical suspicion of malignancy.

A 45-year-old female presented with abdominal pain and constipation since 20 days. Abdominal examination has not revealed any organomegaly. As anorectal digital examination and proctoscopy have not revealed any significant findings, colonoscopy was then performed to find out a large polypoidal growth proximal to the sigmoid flexure nearly obstructing the lumen [Figure 1]. There is ulceration of the overlying mucosa, which has raised the clinical suspicion of polypoidal Adenocarcinoma of sigmoid colon. The patient subsequently underwent left hemicolectomy.

The resected segment of sigmoid colon (30 cm in length) has revealed the presence of a smooth, ovoid, slightly firm, polypoidal, submucous tumor of 45 x 35 x 30 mm 3 in size with mucosal surface ulceration; the cut surface of which is lobular, yellowish, and greasy [Figure 2].

Microscopy revealed lobules of adipocytes with little intervening fibro collagen, beneath the ulcerated mucosa and florid fibroblastic and vascular proliferation in the stalk of lesion. The smooth muscle fibres were pushed to the periphery forming a capsule along with fibrous tissue [Figure 3]. The diagnosis of submucous lipoma of colon was made.

Submucous lipomas of colon are extremely rare, with a reported incidence of approximately 0.26%, [3] described initially by Bauer in 1757. They are more frequently seen in the large than in the small intestine and are common in the right accounting for nearly 90% of the cases than in the left colon. The present case is a lipoma of the left colon which is a rare entity. The histogenesis of colonic lipoma is unclear. Majority of the patients are asymptomatic but some may experience abdominal pain, constipation, and malena. The episode of intussusception or intestinal obstruction can also be seen in the patients with a larger lipoma. [4] Sometimes they can also be the source of massive lower gastrointestinal bleeding. Most of the cases are diagnosed only after resection; however, occasionally the diagnosis can be made from a deeper biopsy, with the development of colonoscopy, barium enema, and computed tomography (CT) scan. Some characteristic findings of colon lipomas are useful in making diagnosis, even there is a case report that colon lipoma was correctly diagnosed by sonography. [5] If the preoperative diagnosis of colonic lipoma can be made with precision, extent of surgery may be appropriately limited and unnecessary hemicolectomies can be avoided.

 
   References Top

1.Hayes HT, Burr HB, Melton WT. Submucous lipoma of the colon. Review of the literature and report of four cases. Dis Colon Rectum 1960;3:145-8.  Back to cited text no. 1      
2.Rogy MA, Mirza D, Berlakovich G, Winkelbauer F, Rauhs R. Submucous large bowel lipomas - presentation and management. An 18 year study. Eur J surg 1991;157:51-5.  Back to cited text no. 2      
3.Notaro JR, Masser PA. Annular colon lipoma; a case report and review of the literature. Surgery 1991;110:570-2.  Back to cited text no. 3  [PUBMED]    
4.Kabaalioglu A, Gelen T, Aktan S, Kesici A, Bircan O, Lüleci E. Acute colonic obstruction caused by intussusception and extrusion of a sigmoid lipoma through the anus after barium enema. Abdom Imaging 1997;22:389-91.  Back to cited text no. 4      
5.Alkim C, Sasmaz N, Alkim H, Caglikulekci M, Turhan N. Sonographic findings in intussusception caused by a lipoma in the muscular layer of the colon. J Clin Ultrasound 2001;29:298-301.  Back to cited text no. 5      


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

Top
 
  Search
 
  
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed1897    
    Printed158    
    Emailed0    
    PDF Downloaded132    
    Comments [Add]    

Recommend this journal