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结直肠脂肪瘤的临床病理特征和处理:病例报告。

Clinicopathological features and management of colonic lipomas: Case reports.

机构信息

Department of General Surgery, Istanbul University Cerrahpasa - Cerrahpasa School of Medicine, Istanbul, Turkey.

Department of Pathology, Istanbul University Cerrahpasa - Cerrahpasa School of Medicine, Istanbul, Turkey.

出版信息

Medicine (Baltimore). 2022 Mar 11;101(10):e29004. doi: 10.1097/MD.0000000000029004.

Abstract

INTRODUCTION

Colonic lipomas are benign tumors of adipose tissue that are often asymptomatic, but they may present with rectal bleeding or obstructive symptoms. These tumors are unique in that they are rarely encountered within the gastrointestinal system and can mimic malignant tumors in appearance. Surgical resection and endoscopic removal of tumors have been shown to be successful in their management.

PATIENT CONCERNS

In this report, we present 3 cases of colonic lipomas, 2 of which are located in the cecum and the other within the sigmoid colon. The presenting symptoms of the patients included abdominal pain, constipation, and dyspepsia.

DIAGNOSIS

Patients typically presented with anemia and an elevated C-reactive protein count. Colonoscopic and computerized tomography findings were used for diagnosis.

INTERVENTIONS

Hemicolectomy was performed, depending on the localization, and the pathologic specimens were consistent with lipoma.

OUTCOMES

Surgical resection was curative in all patients. The postoperative period was uneventful in all patients and all patients are symptom-free and alive at 3 years follow-up.

CONCLUSION

Colonic lipomas are benign mesenchymal tumors of the gastrointestinal system with a male predominance and are observed within the fourth to sixth decades of life. Various genetic abnormalities have been reported and they have been linked to the formation of intussusception. The squeeze sign on radiological imaging, cushion sign and tenting sign in colonoscopy, and naked fat sign during pathologic examination is helpful towards reaching a diagnosis. Surgical resection is the treatment of choice but minimally invasive endoscopic approaches have also been shown to be successful.

摘要

简介

结肠脂肪瘤是一种良性脂肪组织肿瘤,通常无症状,但可能出现直肠出血或梗阻症状。这些肿瘤的独特之处在于它们在胃肠道中很少见,并且外观上可模拟恶性肿瘤。手术切除和内镜下切除肿瘤已被证明在其治疗中是成功的。

患者关注

在本报告中,我们介绍了 3 例结肠脂肪瘤病例,其中 2 例位于盲肠,另 1 例位于乙状结肠。患者的主要症状包括腹痛、便秘和消化不良。

诊断

患者通常表现为贫血和 C 反应蛋白升高。结肠镜和计算机断层扫描检查用于诊断。

干预措施

根据病变部位行半结肠切除术,病理标本符合脂肪瘤。

结果

所有患者的手术切除均为治愈性的。所有患者的术后均无并发症,所有患者在 3 年随访时均无症状且存活。

结论

结肠脂肪瘤是胃肠道的良性间叶肿瘤,男性多见,发病年龄在 40 至 60 岁之间。已报道了各种遗传异常,它们与肠套叠的形成有关。影像学检查的挤压征、结肠镜检查的垫状征和帐篷征以及病理检查的光裸脂肪征有助于做出诊断。手术切除是首选治疗方法,但微创内镜方法也已被证明是成功的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f3c/8913087/c468aec0ec18/medi-101-e29004-g001.jpg

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