Large colonic lipoma with a laterally spreading tumor treated by endoscopic submucosal dissection:A case report  

作　　者：Jun Yong Bae Hun Kyu Kim Yee Jin Kim Se Woong Kim Youngeun Lee Chang Beom Ryu Moon Sung Lee 

机构地区：[1]Internal Medicine and Digestive Disease Center,Seoul Medical Center,Seoul 02053,South Korea [2]Department of Pathology,Seoul Medical Center,Seoul 02053,South Korea [3]Internal Medicine and Digestive Disease Center and Research Institute,Soon Chun Hyang University of School of Medicine,Bucheon 14584,South Korea

出　　处：《World Journal of Clinical Cases》2023年第26期6194-6199,共6页世界临床病例杂志

摘　　要：BACKGROUND Since fat does not transmit electrical energy well,delayed perforation and postpolypectomy syndrome due to electrical thermal injury are concerns in the endoscopic removal of colonic lipoma.The endoscopic submucosal dissection(ESD)technique concentrates electrical energy conducts to the submucosa,not the adipose tissue.This helps to minimize electrical thermal injury,especially in the case of large colonic lipomas.In rare cases,such as colonic lipomas accompanied by mucosal lesions,it is difficult for endoscopists to decide how to safely remove them.CASE SUMMARY A 78-year-old man underwent colonoscopy for colorectal cancer screening.During colonoscopy,a yellowish submucosal tumor with positive cushion sign was observed in the ascending colon measuring about 4.5 cm.A nodular mucosal lesion of about 2.5 cm was observed on the mucosal surface of the lipoma.The lipoma was so large that it occupied much of the inside of the colon,making it difficult to see the entire laterally spreading tumor(LST)at once.The LST was confined to the surface of the lipoma,which had a semipedunculated shape with a wide neck.The margin of the LST was not observed at the neck of the lipoma.ESD was performed and the colonic lipoma with the LST was successfully removed without complications.After 3 d of hospitalization,the patient was discharged without any symptoms.The final pathology report showed that the lesion consisted of submucosal lipoma and tubulovillous adenoma with lowgrade dysplasia.CONCLUSION ESD is effective and safe for treating a large colonic lipoma with an LST by minimizing electrical thermal injury.

关 键 词：Colonic lipoma Endoscopic submucosal dissection Laterally spreading tumor Tubulovillous adenoma Electrical injury Case report 

分 类 号：R735.32[医药卫生—肿瘤]