A case of multiple colonic lipomas treated with ESD and endoscopic unroofing

[Introduction] Endoscopic treatment of colonic tumors has been advanced recently. We applied endoscopic submucosal dissection (ESD) and endoscopic unroofing (EU) to a patient with multiple colonic lipomas. [Case] A 62 year old woman was referred to our department for her colonic submucosal tumors found during screening colonoscopy. She had no particular past or familial medical history. Colonoscopy showed two submucosal tumors with 5 and 2.5cm in diameter in the ascending colon and transverse colon, respectively. Both surfaces of the tumors were smooth and yellowish, and their cushion signs were positive (Fig. 1). Based on these findings, multiple colonic lipomas in the ascending colon and transverse colon were diagnosed. Colonic lipomas, larger than 3.0cm, are resected by ESD in our institution because of possible intestinal invagination. Those cause bleeding, melena, or abdominal pain are also treated. Therefore, ESD was intended for the ascending colon.