Tuesday, August 11, 2009

Colon Lipoma


44 year old male presented to gastroenterology clinic complaining loose stools . Upper GI endoscopy was normal. Patient was referred for CT enteroclysis. The images revealed 4X3.5 cm well defined intralumnal fat attenuation lesion seen in the desecnding colon attached to the lateral wall. The findings are consistent with colonic lipoma.

Colon lipoma was described initially by Bauer in 1757. The incidence was estimated to be about 0.26%. colon lipoma constituted 0.3% of the cases treated for colorectal diseases and 1.8% of the cases of benign colorectal tumor during the same period. Elders are more likely to be involved. Most of the lesions were located at the right side of large bowel, accounting for nearly 90% of cases. The majority of colon lipomas presented as single while only 10% of cases were multiple. Most lipomas are submucosal while some are subserosal location. Some are sessile and some pedunculated. CT scan features of lipoma include well defined well capsulated fat attenuation lesion with not much enhancement are diagnostic of lipoma. MR shows hyperintense lesion on T1 and T2 W imagea and loss of signal in fat saturated images. Treatment is mainly by colonoscopic resection if the lesion is pedunculated and surgery if it is sessile.

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