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A Case of Submucous Lipoma of the Colon Associated with Acute Intussusception, and Complicated Cancer of the Rectum Y. Katayama 1 , H. Takada 1 , M. Arimori 1 , S. Matsumoto 1 , M. Yamada 1 , T. Kimura 1 1Department of Surgery, Tokyo Second National Hospital pp.411-417
Published Date 1978/3/25
DOI https://doi.org/10.11477/mf.1403107256
  • Abstract
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 A 67-year-old female was admitted to our hospital with complaints of severe abdominal pain and no bowel movements for three days. She had a past history of the right radical mastectomy for breast cancer at the age of 62. Emergency operation, performed on the second hospital day, revealed an acute intussusception of the transeverse colon, which was surgically removed. There was no other lesion noticed in the abdominal cavity at that time. In the resected loop of the colon, measuring 49 cm in length, a pedunculated and superficially necrotic tumor measuring 7 by 5.5 by 4.5 cm was found which was compatible with the tip of the intussusceptum. The cut surface of the tumor was lobulated and diffusely hemorrhagic. Histological examination revealed a submucous adult lipoma of the colon. She passed uneventful postoperative course. Postoperative barium enema revealed no stricture at the anastomosis, but a small filling defect was discovered near the rectosigmoid junction. Anterior resection of the rectum was done. A polypoid tumor measuring 3.5 by 3 cm histologically showed well-differentiated adenocarcinoma tubulare focally infiltrating to the muscular layer without metastasis. After operation, she had good recovery with no troublesome episode.

 The lipoma of the gastrointestinal tract is an uncommon tumor. The sites of the lipomas in the order of frequency are large intestine, small intestine and stomach in previous reports of the United States. However, the reported cases of the gastric lipomas in Japan are more frequent than those of the large bowel. It seems likely that this fact may reflect the wide use of the upper gastrointestinal examination in this country.

 Some of the lipomas of the large intestine were found incidentally during the operation for carcinoma of the large intestine. But in our case, the lipoma associated with intussusception manifested severe signs and symptoms, and the cancer of the rectum was incidentally found by postoperative barium enema. A case like this has not been reported previously in the literature so far as we reviewed.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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