An Unusual Diagnosis in a Patient with Suspected Colorectal Cancer

A 78-year-old female was referred to a gastroenterology appointment due to recurrent lower abdominal pain, anorexia, and significant ( ∼ 10%) weight loss over the last 3 months. Abdominal computed tomography (CT) showed a 4-cm hypodense lobulated lesion, with an eccentric solid component, in the ascending colon ( Fig. 1 ). In colonoscopy, a large broad-based ulcerated mass, with necrotic and fatty tissue exposed in the ulcerated area, was documented in the ascending colon ( Fig. 2 a, b). First, this lesion was misinterpreted as an ulcerated and necrotic colonic adenocarcinoma, but biopsies were negative for malignancy. Colonoscopy was repeated and the hypothesis of a large ulcerated colonic lipoma was considered. Received: March 14, 2017 Accepted after revision: May 18, 2017 Published online: August 4, 2017