Large, Ulcerated Lipoma of the Hepatic Flexure Causing Intestinal Obstruction: A Case Report
Location
Suwanee, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
Colonic lipomas are rare benign tumors of the gastrointestinal tract, typically asymptomatic when small but capable of causing significant complications when large. We present the case of a 62-year-old female who presented with two months of postprandial abdominal pain unresponsive to empiric treatment for suspected diverticulitis. CT imaging revealed a 5 cm fat-containing mass in the proximal transverse colon, and colonoscopy confirmed a large, ulcerated submucosal lesion in the hepatic flexure; biopsies ruled out malignancy, including gastrointestinal stromal tumor. Although she was referred for surgical evaluation, she did not follow up. She later developed acute intestinal obstruction requiring emergent right hemicolectomy, and final pathology confirmed a large benign colonic lipoma causing intussusception. This case highlights the diagnostic and management challenges posed by large colonic lipomas, which are rare, benign adipose tumors and the second most common benign colonic lesion after polyps, including adenomatous and hyperplastic subtypes. Although typically asymptomatic and submucosal in origin, lipomas larger than 4 cm can cause abdominal pain, bleeding, obstruction, or intussusception—an uncommon condition in adults that is more often associated with malignancy. Imaging, particularly CT, is highly sensitive for detecting fat-density tumors. Still, large or ulcerated lipomas may closely mimic colorectal carcinoma, making histopathology essential for definitive diagnosis and exclusion of malignancies such as GISTs. Management depends on tumor size and symptoms, with smaller lesions treated endoscopically and larger or complicated lipomas requiring surgical resection. Complete excision generally results in an excellent prognosis with minimal risk of recurrence.
Embargo Period
5-15-2026
Large, Ulcerated Lipoma of the Hepatic Flexure Causing Intestinal Obstruction: A Case Report
Suwanee, GA
Colonic lipomas are rare benign tumors of the gastrointestinal tract, typically asymptomatic when small but capable of causing significant complications when large. We present the case of a 62-year-old female who presented with two months of postprandial abdominal pain unresponsive to empiric treatment for suspected diverticulitis. CT imaging revealed a 5 cm fat-containing mass in the proximal transverse colon, and colonoscopy confirmed a large, ulcerated submucosal lesion in the hepatic flexure; biopsies ruled out malignancy, including gastrointestinal stromal tumor. Although she was referred for surgical evaluation, she did not follow up. She later developed acute intestinal obstruction requiring emergent right hemicolectomy, and final pathology confirmed a large benign colonic lipoma causing intussusception. This case highlights the diagnostic and management challenges posed by large colonic lipomas, which are rare, benign adipose tumors and the second most common benign colonic lesion after polyps, including adenomatous and hyperplastic subtypes. Although typically asymptomatic and submucosal in origin, lipomas larger than 4 cm can cause abdominal pain, bleeding, obstruction, or intussusception—an uncommon condition in adults that is more often associated with malignancy. Imaging, particularly CT, is highly sensitive for detecting fat-density tumors. Still, large or ulcerated lipomas may closely mimic colorectal carcinoma, making histopathology essential for definitive diagnosis and exclusion of malignancies such as GISTs. Management depends on tumor size and symptoms, with smaller lesions treated endoscopically and larger or complicated lipomas requiring surgical resection. Complete excision generally results in an excellent prognosis with minimal risk of recurrence.