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Endoscopic submucosal dissection of a large colonic lipoma: Report of two cases. A colonic lipoma is a very rare benign tumor that is usually asymptomatic and is found incidentally by colonoscopy. Patients with a large colonic lipoma may present with symptoms such as abdominal pain, bleeding, and colonic obstruction or intussusceptions. We report two patients with large colonic lipomas and symptoms. Standard endoscopic submucosal dissection (ESD) was performed to remove the lipomas instead of conventional surgical bowel resection. No complications were observed during or after the procedure. The tumors were resected en bloc, and the patients were discharged 2 d after ESD with a regular diet. The results indicate that ESD can be applied as safe and effective treatment for a large colonic lipoma.