A 52-year-old man was seen at the hospital because of massive melena at defecation. On digital examination of the rectum a movable elastic hard mass was palpated. A rectal carcinoma was suspected. Barium enema and rectoscopy revealed a hemi-circumference and gently rising torous lesion about 50cm distant from the anal verge, and its center involved a shallow ulcerative lesion and erosion. From biopsy findings a diagnosis of inflammatory epithelium was made, but a sigmoidal cancer was strongly suspected. Laparotomy was carried out. During surgery a tumor of hen's egg size was palpated in the sigmoid colon but no serosa invasion was noted. It was determined as P0H0N0 (n0)S0(s0) and sigmoidectomy R2 was carried out. Resected specimen revealed a 6×5cm torous lesion of Yamada's type I accompanying by an ulcerative lesion in the mucosa. Histopathologically it was diagnosed as submucosal lipoma of the large intestine.
This paper describes a relatively rare resected case of lipoma of the large intestine presenting with melena, with a review of the literature.