A case of submucosal lipoma in the descending colon resected by endoscopic submucosal dissection (ESD)

We report the case of a 55-year-old man with a 50-mm submucosal lipoma in the descending colon. Colonoscopy revealed a smooth, yellowish submucosal tumor consistent with a lipoma, which had increased in size compared to findings from 6 years prior. Considering the risk of intussusception, ESD was performed using the ClutchCutter® to ensure optimal visualization of the incision site and surrounding muscular layer. The tumor was successfully resected without complications. Histopathological examination revealed mature adipocytes with fibrous septa, with no atypical cells, consistent with a benign lipoma. A follow-up colonoscopy conducted one year after the procedure showed only a post-treatment scar with no findings of recurrence. This case highlights the effectiveness and safety of ESD as a minimally invasive approach for large colonic lipomas that might otherwise necessitate surgical resection.