Giant symptomatic gastric lipoma

A case report and literature review

Julia R. Amundson, David Straus, Basem Azab, Sandy Liu, Monica T. Garcia Buitrago, Danny Yakoub

Research output: Contribution to journalArticle

Abstract

Introduction: Lipomas are uncommon tumors of the gastrointestinal tract; gastric lipomas account for <1% of all gastric tumors encountered (Nickloes and Sutphin [1]). Giant gastric lipomas, defined as ≥10 cm, are exceedingly rare with only 6 cases reported since 1980 (Cappell et al., Termos et al., Singh et al., Ramaraj et al., Rao et al., Priyadarshi et al., Neto et al. [3–9]). We hereby present a case of a giant gastric lipoma that became symptomatic seven years after its initial identification and was excised preserving gastric continuity. Case presentation: Our patient is a 58-year-old African American male with a 3 cm gastric mass incidentally found on CT in 2010. In September of 2017, the patient presented with severe epigastric pain, nausea, and vomiting. Abdominal CT scan revealed an increase in size of the patient's gastric lesion to 7.2 × 10.3 × 7.3 cm. He underwent an exploratory laparotomy with transverse anterior gastrotomy and primary closure. Pathologic examination revealed a 12 cm submucosal, well-circumscribed, non-encapsulated mass comprised of mature adipose tissue without atypia or mitotic figures, consistent with lipoma. Discussion: The majority of gastric lipomas are asymptomatic, identified on CT scan as round/ovoid masses with low attenuation and homogenous appearance, measuring −80 to −120 Hounsfield units. These findings are nearly pathognomonic. Due to the benign nature of gastric lipomas, circumferential excision with a clear margin of normal tissue is adequate for symptomatic resection. This is the second report of giant gastric lipoma excised with continuity preserving partial gastrectomy, avoiding gastrojejunostomy complications. Conclusion: Fatty tumors are rare in the gastrointestinal tract, yet lipomas must be on the differential when masses are found with Hounsfield units similar to peripheral fat.

Original languageEnglish (US)
Pages (from-to)313-317
Number of pages5
JournalInternational Journal of Surgery Case Reports
Volume51
DOIs
StatePublished - Jan 1 2018

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Lipoma
Stomach
Gastrointestinal Tract
Gastric Bypass
Gastrectomy
African Americans
Laparotomy
Nausea
Vomiting
Adipose Tissue
Neoplasms
Fats
Pain

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Giant symptomatic gastric lipoma : A case report and literature review. / Amundson, Julia R.; Straus, David; Azab, Basem; Liu, Sandy; Garcia Buitrago, Monica T.; Yakoub, Danny.

In: International Journal of Surgery Case Reports, Vol. 51, 01.01.2018, p. 313-317.

Research output: Contribution to journalArticle

Amundson, Julia R. ; Straus, David ; Azab, Basem ; Liu, Sandy ; Garcia Buitrago, Monica T. ; Yakoub, Danny. / Giant symptomatic gastric lipoma : A case report and literature review. In: International Journal of Surgery Case Reports. 2018 ; Vol. 51. pp. 313-317.
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