Colorectal lipomas: anatomoclinical study of 29 cases

• Published in: Revista da Associação Médica Brasileira (1992) Vol. 43; no. 4; pp. 319 - 325
• Main Authors: Bromberg, S H, Zampieri, J C, Cavalcanti, L A, Waisberg, J, Barreto, E, de Godoy, A C
• Format: Magazine Article
• Language: Portuguese
• Published: Brazil 01.10.1997
• Subjects: Adult; Aged; Aged, 80 and over; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - therapy; Female; Humans; Lipoma - diagnosis; Lipoma - therapy; Male; Middle Aged; Retrospective Studies
• ISSN: 0104-4230

To evaluate the incidence of colorectal lipomas, its diagnostic methodology and therapeutic management. The reviewed necropsies performed in a six years period and the patients' records from colorectal lipomas cases treated up to 1965 until 1993 were studied enhancing the clinical presentation, their diagnosis and therapy. The 29 cases of submucosal intestinal lipomas were disposed in three groups. The first group with ten patients lipomas were detected at necropsies. The second group with 11 symptomatic patients and group three with 8 asymptomatic patients which lipomas were discovered accidentally in surgical specimens resected due to neoplasm or in the course of diagnostical procedure. 0.56% of patients who were submitted to necropsy disclosed colorectal lipomas situated preferentially in right colon and in female. Enterourhage was the most often symptom (54.5%) in the group two, followed by cramp abdominal pain. Intussusception appeared in three patients (27.3%). Contrary to the medical literature, the symptomatic lipomas were preferentially situated in left colon and its mean size was 6.1 cm. The diagnosis were performed through opaque enema and more recently by colofibroscopy and CT scan. Resections were performed in all patients: five were enlarged, three were local and other three were endoscopic resections. Multiple lipomas were detected in 30% of patients who were submitted to necropsy and in 25% of asymptomatic group. In both groups no tumor was larger than 2.0 cm of diameter. Colorectal lipomas are rare in both clinical presentation and necropsy. Before the advent of CT scan and colofibroscopy the majority of the patients were submitted to wide resections, in the assumption of malignancy. Afterwards the endoscopic polipectomy and local resection became our preferential management.