Genital prolapse with rectal lipoma: a case report and literature review

Abstract

A 58-year-old postmenopausal woman presented with mass prolapsing per vagina hematochezia, tenesmus, constipation and loss of appetite of six months duration. On general examination patient was thin built with pallor. Abdominal examination was unremarkable. Speculum examination showed second degree uterovaginal prolapse, cystocele and rectocele. Vaginal examination showed uterus atrophic retroverted and fornices free. Recto vaginal examination showed mass in rectum/rectovaginal septum with atrophic perineal body per rectal examination revealed a soft swelling in the anterior wall of rectum measuring approximately 3x3 cm, 6 cm above the anal verge, with smooth surface and the overlying mucosa was free. She underwent colonoscopy which showed a submucous mass in the rectum of size 3 cm x 3 cm at about 6 cm from the anal verge. Contrast enhanced CT scan of the abdomen revealed rectal submucosal soft tissue mass suggestive of lipoma of size 3 cm x 3 cm (Figure 1). She underwent vaginal hysterectomy with pelvic floor repair. This was followed by transanal delivery of the rectal lipoma (Figure 2).Overlying mucosa was incised and lipoma was excised. The macroscopic appearance was suggestive of lipoma. Histological examination confirmed the diagnosis of lipoma.

Submucosal Lipoma of the Rectum Presenting as Rectal Prolapse and Appearing as Adenomatous Polyp on Confocal Laser Endomicroscopy: a Case Report and Literature Review

“…Preoperative diagnosis is usually missed, with most being presumed to be adenomas or carcinoma [8,9]. GI lipomas become clinically significant as they are likely to be confused with carcinomas, especially in symptomatic lesions, resulting in extensive surgeries that may result in higher rates of mortality and morbidity [10].…”