Giant Colonic Lipoma Causing Intussusception: A Rare Case Report and Literature Review

Abstract Colonic lipomas are rare, benign tumors of adipose tissue that typically remain clinically silent. However, large lipomas usually cause symptoms, including intussusception, obstruction, and bleeding. We present a case of a 78-year-old man with previously treated non-Hodgkin lymphoma who developed colo-colic intussusception secondary to a giant colonic lipoma. Contrast-enhanced computed tomography was suggestive of colo-colic intussusception, and emergency surgery confirmed a 30 × 8 cm pedunculated mass arising from the splenic flexure, with descending colon intussuscepting into the sigmoid colon along with the lesion. An adjacent small, 4 × 3 cm, similar lesion was also observed at the same site. The patient underwent a successful left hemicolectomy with anterior resection and transverse end colostomy, with an uneventful postoperative recovery. Histopathologic examination confirmed a submucosal lipoma measuring 15 × 9 × 6 cm. This case is notable for the exceptional size of the lipoma, the rare location at the splenic flexure, and the complex presentation and surgical management required. It emphasizes the necessity of including colonic fatty tumors in diagnostic considerations for elderly individuals presenting with abdominal discomfort and rectal hemorrhage, especially those with a history of prior malignant disease, while highlighting the diagnostic complexities and operative decision-making in similar presentations.