Endoscopic Resection of a Large Colonic Lipoma Simulating a Tumor Revealed by Hemorrhage: A Case Report and Literature Review

Lipomas of the colon are benign tumors of the digestive tract. They are usually asymptomatic, and often discovered incidentally during a colonoscopy. However, lipomas larger than 2 cm may present with abdominal pain, bowel changes, and rectal bleeding. They may mimic cancer, depending on multiple factors including tumor size, location, and complications, which often makes preoperative diagnosis difficult. In this report, we discuss the case of a 34-year-old woman who presented with paroxysmal abdominal pain in the left iliac fossa withmoderate hematochezia that had been evolving for six months. The patient denied melena or hematemesis, and she had no significant medical history. Colonoscopy revealed a large polyp of over 5 cm located 40 cm from the anal margin. She underwent endoscopic resection without complications. The histological examination confirmed the lipomatous nature. An accurate preoperative diagnosis of lipomas is necessary.It can often be difficult to choose between endoscopic and surgical treatment. The choice of treatment depends on the size and location of the tumor and complications. Endoscopic resection may obviate the need for surgery and can potentially reduce surgical morbidity. We aimed to report and discuss the management of this patient who underwent endoscopic resection for a large mass with a definitive pathology of colonic lipoma.