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Pedunculated Lipoma Arising from Terminal Ileum, Report of a Case K. Ushio 1 , M. Sasagawa 1 , T. Yamada 1 , K. Hojo 2 , S. Yoshida 3 , T. Hirota 4 , H. Ichikawa 5 1Department of Diagnostic Radiology, National Cancer Center Hospital 2Department of Internal Medicine, National Cancer Center Hospital 3Department of Surgery, National Cancer Center Hospital 4Department of Pathology, National Cancer Center Hospital pp.993-1001
Published Date 1982/9/25
DOI https://doi.org/10.11477/mf.1403108814
  • Abstract
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 A 59-year-old man was admitted on June 30, 1980, with a history of abdominal pain, vomiting and melena. On physical examination, the abdomen was soft and there was no tenderness, or enlarged visceral palpable mass. Routine laboratory investigation did not reveal any abnormal findings except positive hemooccult reaction in feces. Upper gastrointestinal examination did not indicate any organic lesions. However, barium enema study disclosed a tumor near the ileocecal valve. Flexible fiberoptic colonoscopy revealed the tumor as a pedunculated polypoid lesion with lobulated head, hyperemic surface and central ulceration covered with yellowish white substance at the apex. The polypoid mass moved freely and was displaced behind the ileocecal valve with peristaltic wave and air pressure. Specimens taken from the surface of the tumor showed superficial erosion with inflammatory cell infiltration and fibrinous exudate. It was difficult to diagnose the tumor as a submucosal tumor before operation.

 At laparotomy performed on July 9, 1980, the tumor was found in the cecum with slight ileocecal intussu-sception, which was reduced without difficulty by pres-sure, and was also detected to be pedunculated with a pedicle which originated at the wall of the terminal ileum. The tumor was removed. The cut surface was homogenous and yellowish. Pathological examination revealed a pedunculated mass which proved to be a submucosal tumor composed of mature adipose tissue with focal superficial erosion and submucosal fibrosis of surrounding mucosa.

 The postoperative coures was uneventful and the patient was discharged on 29th day after operation.


Copyright © 1982, 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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