Solitary lipoma of ileocaecal valve mimicking Crohn's disease: A case report of a challenging diagnosis for a rare benign tumor of the intestinal tract.

Abstract

Symptomatic ileocaecal lipomas is a fascinating disease, it represents a distinctive subtype of bowel lipomas for two main reasons: it is so rare that its exact incidence is unknown, second its clinical and radiological features are so unspecific that it remains a challenging diagnosis. In terms of treatment surgical resection is indicated when doubting malignant origin, or in case of symptomatic lipomas. Through anatomopathological findings, diagnosis can be confirmed. We herein report a case of an obstructive lipoma of the ileocaecal valve mimicking Crohn's disease, presented as a case of small bowel obstruction evolving for days without clinical, biological, or radiological signs of severity. After overcoming the acute phase, a series of clinical and radiological findings were in favor of inflammatory origin whereas endoscopic investigations showed a fibrotic stenosed ileocaecal valve. The patient underwent ileocaecal resection with primary anastomosis. Anatomopathological reports confirmed the diagnosis of lipoma without any signs of malignancy. No complications were observed. Symptomatic ileocaecal lipoma is a rare pathology, with unspecific signs in clinical examination and radiological features. Surgical management is not common practice. It is reserved for symptomatic tumors, or when in doubt of malignant origin. Amongst benign tumors, ileocaecal lipomas are a rare entity. Due to its misleading symptoms, achieving a positive diagnosis can be challenging. The main problem of these tumors is their differential diagnosis with Crohn's disease, like our case, therefore leading to surgical resection to confirm or infirm malignancy.