Lipoma of the Cecum

• Uncommon tumors, but second in prevalence to adenomas for colonic tumors
• Tend to occur more frequently in older females
• Usually asymptomatic
• When symptomatic, can produce:
• Pain
• Diarrhea
• Rectal bleeding-if surface ulcerates
• Constipation
• Almost all are submucosal
• Most are located on the right side (40%), but about 20% are in the sigmoid
• In the small bowel, lipomas are more common proximally (duodenum)
  
  
• Imaging findings
  
  
• Usually less than 4 cm in size
• Smooth, sharply defined hemispheric mass
• Typically produces either right-angle or slightly obtuse angle as the lesion meets lumen of bowel
• Rarely pedunculated
• Squeeze-sign = deformity due to softness and compressibility of these lesions
• Contour may be altered by peristalsis
• Ulceration is rare
• CT may demonstrate fatty nature of lesion, especially if they are large enough for accurate density measurements
• May intussuscept
• Do not undergo malignant transformation 

 
Cecal Lipoma. Axial CT image of right lower quadrant shows a large, lobulated filling defect in the cecum with well-circumscribed margins. The lower image demonstrates a negative Hounsfield values (-85HU)
consistent with fat. The lesion represents a lipoma of the cecum.