Case Report: Giant Colonic Lipoma, a Rare Benign Tumor Mimicking Malignancy

<b>Background and Clinical Significance:</b> Colonic lipomas are benign tumors composed of adipose tissue, frequently asymptomatic and found incidentally on routine surveillance. Most lesions are smaller than 2 cm in diameter, while giant lipomas are characterized as over 4 cm. Giant colonic lipomas, though rare, may present with obstructive symptoms, gastrointestinal bleeding or intussusception and can mimic malignant lesions on imaging and endoscopic examination. Historically, the resection of these lesions has been limited to those that are larger or symptomatic. Recent observations indicate that lipomas may retain growth potential and can become symptomatic over time, though being inconsequential initially. Surgical resection is favored over endoscopic excision for lipomas above 2 cm to mitigate risks including haemorrhages and perforations. <b>Case Presentation</b>: We report a case of a 38-year-old female who exhibited non-specific gastrointestinal symptoms with a high suspicion of malignancy based on imaging and endoscopy but was ultimately diagnosed with a benign giant colonic lipoma. <b>Conclusions:</b> This case presents the challenges in diagnosing giant colonic lipomas, which, in certain cases, can mimic malignant lesions. Histopathological analysis remains the gold standard for confirming the diagnosis, especially in cases with atypical features.