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酷似恶性肿瘤并表现为肠套叠的结肠脂肪瘤:一例罕见病例报告。

Colonic lipoma mimicking malignancy and presenting as an intussusception: A rare case report.

作者信息

Niazi Shehryar Ahmed Khan, Raza Muhammad Salar, Mukhtar Muhammad Umer, Hassan Rameez, Nasir Muhammad Umar

机构信息

District Headquarter Hospital, Bhakkar, Pakistan.

Shaikh Zayed Medical Complex, Lahore, Pakistan.

出版信息

Int J Surg Case Rep. 2023 Aug;109:108611. doi: 10.1016/j.ijscr.2023.108611. Epub 2023 Aug 9.

Abstract

INTRODUCTION AND IMPORTANCE

Lipomas of the gastrointestinal tract are a rare entity compared to the more common tumors of the gut, such as adenomatous polyps and carcinomas. They were first described by Bauer in 1757. Gastrointestinal lipomas can grow in all segments of the gut, with the highest frequency in the colon. In this case report, we present a rare case of gastrointestinal lipoma mimicking colonic malignancy and causing intussusception, necessitating emergent surgery. This paper highlights the potential diagnostic challenges and therapeutic interventions associated with GI lipomas.

CASE PRESENTATION

A 28-year-old female presented with symptoms of abdominal pain, weight loss, vomiting, and changes in bowel habits. Initially, she received a misdiagnosis of Irritable Bowel Syndrome. Subsequent investigations indicated the possibility of colonic malignancy. During the intra-operative biopsy, it was ultimately discovered that she had a colonic lipoma.

CLINICAL DISCUSSION

CT revealed an abdominal mass and an intussusception, indicating the need for surgical intervention. A laparoscopic procedure was performed to remove the mass, which alleviated the symptoms. Subsequently, a histological examination confirmed the mass to be a lipoma.

CONCLUSION

Differentiating a gastrointestinal lipoma from malignancy is crucial, and careful investigation is necessary to determine if a local excision can be performed instead of a wide excision.

摘要

引言与重要性

与肠道中更常见的肿瘤(如腺瘤性息肉和癌)相比,胃肠道脂肪瘤是一种罕见的实体。它们于1757年首次由鲍尔描述。胃肠道脂肪瘤可在肠道的所有节段生长,在结肠中出现频率最高。在本病例报告中,我们呈现了一例罕见的胃肠道脂肪瘤,其酷似结肠恶性肿瘤并导致肠套叠,需要紧急手术。本文强调了与胃肠道脂肪瘤相关的潜在诊断挑战和治疗干预措施。

病例介绍

一名28岁女性出现腹痛、体重减轻、呕吐和排便习惯改变等症状。最初,她被误诊为肠易激综合征。后续检查提示有结肠恶性肿瘤的可能性。在术中活检时,最终发现她患有结肠脂肪瘤。

临床讨论

CT显示腹部有肿块和肠套叠,表明需要进行手术干预。进行了腹腔镜手术切除肿块,症状得到缓解。随后,组织学检查证实肿块为脂肪瘤。

结论

区分胃肠道脂肪瘤与恶性肿瘤至关重要,必须进行仔细检查以确定是否可行局部切除而非广泛切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce97/10425391/4c1ece0cb37c/gr1.jpg

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