“Giant” lipoma of the sigmoid colon: spontaneous expulsion 12 days after failure of endoscopic resection. Report of a case and review of the literature

Abstract

Background: Lipomas of the colon are benign tumors which
occur rarely. Their size ranges from 2 mm to several cm. They
are usually asymptomatic but occasionally they present with
clinical manifestations depending on tumor size, localization
and complications, which often lead to diagnostic difficulty.
Patient-Methods: A 78-year-old man presented with a
6-month history of multiple episodes of crampy abdominal
pain due to a lipoma of 40 mm x 30 mm x 24 mm located in
the sigmoid. Endoscopic resection was performed without
success. We report here for the first time, lipoma self-expulsion
with the feces 12 days after the endoscopic resection
attempt. In this report a review of the literature regarding
clinical features, diagnosis and treatment of this uncommon
disease is also performed. Conclusion: Surgery remains the
main therapeutic option, especially for large colonic lipomas,
however endoscopic removal would be preferable over surgical
excision if it can be done safely.