University of Texas Rio Grande Valley at Doctors Hospital at Renaissance Edinburg, TX, United States
Nghia Nguyen, DO, MS1, Juan Castano, MD1, Grigoriy Rapoport, MD2, Ans Albustamy, MD1, Asif Zamir, MD, FACG1 1University of Texas Rio Grande Valley at Doctors Hospital at Renaissance, Edinburg, TX; 2University of Texas Rio Grande Valley at Doctor's Hospital at Renaissance, Edinburg, TX
Introduction: Intestinal lipomas are benign submucosal tumors found in the colon, arising from adipose connective tissue. Their incidence is reported to be between 0.035 and 4.4%. While adenomatous polyps are the most common benign tumor of the large intestine, their involvement within the same lesion as a lipoma is rare. The following is a case of a patient with an adenomatous polyp overlying a colonic lipoma, resected during colonoscopy.
Case Description/Methods: A 71-year-old man with a medical history of hiatal hernia, gastroparesis, hypertension and type 2 diabetes mellitus, was referred to our clinic for surveillance colonoscopy. The patient reported symptoms of chronic regurgitation and reflux and denied any other complaints. His medications included amlodipine, atorvastatin, metformin and insulin. Family medical history was significant for colon cancer in two maternal uncles. Colonoscopy revealed a flat polyp about 2 cm in diameter overlying a large lipoma in the hepatic flexure region. The polyp was resected using snare cautery and 2 endoclips were were placed at the site of polypectomy. Fatty tissue was observed at the polypectomy site. There were no adverse events after the procedure. Histological examination of the polyp revealed tubular adenoma, negative for high-grade dysplasia or malignancy.
Discussion: Adenomatous polyps are the most common benign tumors found in the colon, followed by lipomas. Finding both in a single lesion however is rare. There is only one similar reported case of colonic lipoma with adenomatous polyp and in that case the polyp was also resected during endoscopy. The majority of intestinal lipomas are located in the large intestine but these lesions can be found anywhere within the digestive tract. Lipomas are usually asymptomatic and are often found incidentally during colonoscopy or autopsy. However, lipomas that are larger than 2 cm carry a higher risk of ulceration and bleeding. In rare instances, colonic lipomas can cause bowel obstruction and intussusception, in which case urgent surgical intervention is required. Finally, it is also important to distinguish between lipoma and liposarcoma, which is malignant and requires a different management approach.
Figure: a. Adenomatous polyp about 2 cm in diameter overlying a large lipoma in the hepatic flexure region. b. Status post resection using snare cautery
Disclosures: Nghia Nguyen indicated no relevant financial relationships. Juan Castano indicated no relevant financial relationships. Grigoriy Rapoport indicated no relevant financial relationships. Ans Albustamy indicated no relevant financial relationships. Asif Zamir indicated no relevant financial relationships.
Nghia Nguyen, DO, MS1, Juan Castano, MD1, Grigoriy Rapoport, MD2, Ans Albustamy, MD1, Asif Zamir, MD, FACG1. P2284 - A Rare Case of Adenomatous Polyp Overlying a Colonic Lipoma, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.
