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Spontaneous peeled ileal giant lipoma caused by lower gastrointestinal bleeding: A case report.
Medicine (Baltimore). 2017 Dec; 96(51):e9253.M

Abstract

RATIONALE

Gastrointestinal subepithelial tumors (SETs) with endoscopic features such as ulceration, a red color change, a peeled mucosal layer, and spontaneous bleeding could have malignant potential. However, we encountered a case of a lipoma that presented features different from the generally known features of gastrointestinal SETs. Therefore, we report an interesting rare case of a terminal ileal giant lipoma with a unique feature of spontaneous peeled ulceration on the surface on endoscopy that caused gastrointestinal bleeding.

PATIENT

An 82-year-old woman with a 1-week history of abdominal pain and hematochezia presented to our hospital.

DIAGNOSES

Ileocolonoscopy revealed a SET with a peeled surface and erythematous and ulcerative mucosal changes as well as exposed a submucosal mass at the terminal ileum. Macroscopically, the lesion appeared as a yellowish pedunculated polypoid mass measuring 3 × 2 cm with a peeled mucosal ulceration. Histopathological findings revealed a submucosal lipoma of the terminal ileum.

INTERVENTION

We thought that the endoscopic finding indicated malignant SETs or those with malignant potential rather than benign SETs. Therefore, the patient underwent an elective laparoscopic ileocecectomy.

LESSONS

We encountered a lipoma that did not present with the typical features of gastrointestinal SETs. Our findings suggest that clinicians should consider that benign SETs in the terminal ileum may present with various endoscopic findings similar to those of malignant SETs, which can cause fatal symptoms and signs.

Authors+Show Affiliations

Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon.Department of Internal Medicine, Central Hospital, Siheung-si, Gyeonggi-do.Department of Internal Medicine, Catholic Kwandong University International St. Mary's Hospital.Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon.Department of Surgery.Department of Radiology.Department of Nuclear Medicine.Department of Pathology, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

29390483

Citation

Kim, Jung Ho, et al. "Spontaneous Peeled Ileal Giant Lipoma Caused By Lower Gastrointestinal Bleeding: a Case Report." Medicine, vol. 96, no. 51, 2017, pp. e9253.
Kim JH, Yoon HH, Jeong SH, et al. Spontaneous peeled ileal giant lipoma caused by lower gastrointestinal bleeding: A case report. Medicine (Baltimore). 2017;96(51):e9253.
Kim, J. H., Yoon, H. H., Jeong, S. H., Woo, H. S., Lee, W. S., Choi, S. J., Kim, S. G., Ha, S. Y., & Kwon, K. A. (2017). Spontaneous peeled ileal giant lipoma caused by lower gastrointestinal bleeding: A case report. Medicine, 96(51), e9253. https://doi.org/10.1097/MD.0000000000009253
Kim JH, et al. Spontaneous Peeled Ileal Giant Lipoma Caused By Lower Gastrointestinal Bleeding: a Case Report. Medicine (Baltimore). 2017;96(51):e9253. PubMed PMID: 29390483.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spontaneous peeled ileal giant lipoma caused by lower gastrointestinal bleeding: A case report. AU - Kim,Jung Ho, AU - Yoon,Hyun Hwa, AU - Jeong,Seok Hoo, AU - Woo,Hyun Sun, AU - Lee,Won-Suk, AU - Choi,Seung Joon, AU - Kim,Seog Gyun, AU - Ha,Seung Yeon, AU - Kwon,Kwang An, PY - 2018/2/3/entrez PY - 2018/2/3/pubmed PY - 2018/2/15/medline SP - e9253 EP - e9253 JF - Medicine JO - Medicine (Baltimore) VL - 96 IS - 51 N2 - RATIONALE: Gastrointestinal subepithelial tumors (SETs) with endoscopic features such as ulceration, a red color change, a peeled mucosal layer, and spontaneous bleeding could have malignant potential. However, we encountered a case of a lipoma that presented features different from the generally known features of gastrointestinal SETs. Therefore, we report an interesting rare case of a terminal ileal giant lipoma with a unique feature of spontaneous peeled ulceration on the surface on endoscopy that caused gastrointestinal bleeding. PATIENT: An 82-year-old woman with a 1-week history of abdominal pain and hematochezia presented to our hospital. DIAGNOSES: Ileocolonoscopy revealed a SET with a peeled surface and erythematous and ulcerative mucosal changes as well as exposed a submucosal mass at the terminal ileum. Macroscopically, the lesion appeared as a yellowish pedunculated polypoid mass measuring 3 × 2 cm with a peeled mucosal ulceration. Histopathological findings revealed a submucosal lipoma of the terminal ileum. INTERVENTION: We thought that the endoscopic finding indicated malignant SETs or those with malignant potential rather than benign SETs. Therefore, the patient underwent an elective laparoscopic ileocecectomy. LESSONS: We encountered a lipoma that did not present with the typical features of gastrointestinal SETs. Our findings suggest that clinicians should consider that benign SETs in the terminal ileum may present with various endoscopic findings similar to those of malignant SETs, which can cause fatal symptoms and signs. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/29390483/Spontaneous_peeled_ileal_giant_lipoma_caused_by_lower_gastrointestinal_bleeding:_A_case_report_ L2 - http://dx.doi.org/10.1097/MD.0000000000009253 DB - PRIME DP - Unbound Medicine ER -