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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
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Example of an ileal lipoma with ileocolic intussusseption
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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)

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