title: Successful Endoscopic Submucosal Dissection of a Large Terminal Ileal Lipoma.
abstract: A 78-year-old woman who had recurrent right lower abdominal pain for about 1 year underwent computed tomography (CT) because of a follow-up observation 1 year after right breast cancer surgery. CT revealed a tumor in the colon. The patient was referred to our hospital for detailed examinations. An abdominal CT showed a low-density tumor of approximately 30 mm in the ascending colon, and the CT density inside the tumor was same as that of fatty tissues. A subsequent colonoscopy showed a submucosal tumor (SMT) in the proximal ascending colon developing from the terminal ileum. A colonoscopic ultrasonography revealed that the SMT was a high-echoic mass mainly localized in the submucosal layer. Based on the findings from CT, colonoscopy, and colonoscopic ultrasonography, the SMT was diagnosed as a pedunculated lipoma originating from the terminal ileum and treated with endoscopic submucosal dissection (ESD) because of recurrent abdominal pain. The 40-mm tumor was resected en bloc without complications. ESD may be more appropriate than polypectomy and surgery for removal of small intestinal tumors, because ESD allows direct visualization of the cutting line and exactly dissects the submucosal layers without damaging the muscular layers. ESD is a potentially useful treatment to remove intestinal lipomas.
authors.affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Hisatsugu
authors.initials: H
authors.lastname: Noda
authors.affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Naotaka
authors.initials: N
authors.lastname: Ogasawara
authors.affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tamura
authors.affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kondo
authors.affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Izawa
authors.affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Ebi
authors.affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Funaki
authors.affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Kunio
authors.initials: K
authors.lastname: Kasugai
keywords: Endoscopic submucosal dissection; Lipoma; Submucosal tumor