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      Cecal lipoma with subclinical appendicitis: A case report

      case-report

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          Abstract

          BACKGROUND

          Colonic lipomas are rare, slow-growing benign tumors. Colonic lipomas are generally asymptomatic and are found incidentally. Although cases of cecal lipoma have been sporadically reported in the literature, the disease has not been systematically reviewed.

          CASE SUMMARY

          We present a 44-year-old man who underwent a routine physical check-up during which colonoscopic examination revealed an asymptomatic 1.5-cm cecal mass at the appendiceal orifice. Laparoscopic exploration was performed that also demonstrated a congested and erythematous appendix. En bloc resection of both the cecum and vermiform appendix was performed because of the suspicion of malignancy. Histopathological examination revealed a cecal lipoma composed of mature adipose tissue, and the appendix showed subclinical inflammation. Our procedures and findings were discussed, along with relevant English literature that was retrieved from the PubMed database from 2000 to 2017. Twenty-six cases, including ours, were reported. Consistent with the findings of the literature, it is difficult to obtain a definitive diagnosis by colonoscopic biopsy.

          CONCLUSION

          Surgery remains the treatment of choice for this condition. Intraoperative frozen pathological sectioning helped the surgeon decide the extent of surgery, and radical surgery was avoided. Excision of benign lesions occupying the appendiceal orifice may be indicated for the prevention of later development of acute appendicitis. The prognosis is generally good, with only one of the 26 reported patients complicated with acute appendicitis, who subsequently succumbed due to severe comorbidities and sepsis.

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          Most cited references12

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          Lipomas of the large bowel.

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            Large colonic lipomas.

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              Giant submucosal lipoma of the cecum: report of a case and review of literature.

              Lipoma of the colon is a relatively rare benign tumor. A case with intermittent subacute colon obstruction due to a giant lipoma of the cecum is reported. A 51-year-old woman presented with intermittent, abdominal crampy pain in the right upper and lower quadrants, accompanied by alternative episodes of diarrhea and constipation. She had had similar symptoms over the last three months. A double-contrast barium enema showed a large (approx. 7 cm in diameter) polypoid mass occluding the lumen of the cecum and the ascending colon. Colonoscopy revealed a submucosal mass suspected of benign tumor but too large for endoscopic resection. Surgery revealed a hard elongated mass in the right colon, which telescoped into the transverse colon and caused colo-colonic intussusception. Right hemicolectomy was performed and pathology documented a mature, submucosal lipoma of the cecum. Six years after the surgery, the patient has not showed any of the previous symptoms. Along with a review of the literature, the incidence, diagnosis complications and treatment of colonic lipomas are discussed.
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                Author and article information

                Contributors
                Journal
                World J Clin Cases
                WJCC
                World Journal of Clinical Cases
                Baishideng Publishing Group Inc
                2307-8960
                26 January 2019
                26 January 2019
                : 7
                : 2
                : 209-214
                Affiliations
                Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung City 82445, Taiwan
                Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung City 82445, Taiwan. ed109633@ 123456edah.org.tw
                Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung City 82445, Taiwan
                Department of Pathology, E-Da Cancer Hospital, I-Shou University, Kaohsiung City 82445, Taiwan
                Author notes

                Author contributions: Tsai KJ drafted the manuscript; Tai YS reviewed the literature; Hung CM revised the article critically; Su YC analyzed and interpreted the histopathological samples; all authors read and approved the final manuscript.

                Corresponding author: Yun-Sheng Tai, MD, Chief Doctor, Department of Surgery, E-Da Hospital, I-Shou University, No. 1 Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan. ed109633@ 123456edah.org.tw

                Telephone: +886-7-6150011 Fax: +886-7-6150982

                Article
                jWJCC.v7.i2.pg209
                10.12998/wjcc.v7.i2.209
                6354092
                f6944be8-df70-4a25-a32c-a70fe1241159
                ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                : 31 August 2018
                : 23 December 2018
                : 29 December 2018
                Categories
                Case Report

                cecal lipoma,appendicitis,intussusception,case report
                cecal lipoma, appendicitis, intussusception, case report

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