Gastrointestinal lipoma

• 3rd most common benign tumor of small bowel
• Usually assymptomatic, but can serve as lead point for itussusseption
• can be seen in the colon, classically in the region of the cecum
• Pathogneumonic features – rare malignant transformation liposarcoma – suspect with soft tissue component

Examples of lipomas in transverse colon and ileocecal

Example of an ileal lipoma with ileocolic intussusseption
Duke DDX solitary Mucosal/Submucosal Mass
Benign

• Mucosal -> adenoma(60% tubular, 40% villous)
• Submucosal
• GIST – commonest benign SB tumor, jej>ileum
• Lipoma – ileum>jej, may intussuscept or bleed
• Hemangioma
• Neurofibroma

Malignant

• Adenoarcinoma – usu prox., risk with Spure, Crohn, Peutz-Jegher
• Lymphoma – commonest malig. SB tumor, ileum>jej>duo, associated with aneurysmal dilitation/LAD
• GIST – second most common site, stomach 1st
• Carcinoid – angulation/kinking from messenteric desmoplastic rx., calcify, syndrome suggests liver mets
• Sarcoma

Mets – hematogenous(melanoma, lung, breast), peritoneal(ovary, uterus, GI)