Abstract
The purpose of the study was to investigate and review the multimodality imaging findings of gastric lipomas. Seven patients with gastric lipomas identified by CT imaging at a single institution between 2003 and 2017 were retrospectively evaluated. Patient demographics, clinical presentation, non-invasive imaging, endoscopic, and pathological findings were recorded.The most common location for gastric lipoma was the gastric antrum (3/7). The mean lipoma size was 2.7 cm ± 0.8 cm. Six out of seven lipomas demonstrated homogenous fat attenuation with mean Hounsfield units (HU) between −80 and −120. A single lipoma measuring −50 HU demonstrated soft tissue septations. In addition to routine CT and MRI, gastric lipomas were diagnosed on the low-dose CT protocols such as coronary calcium scoring, renal stone, and positron emission tomography-CT (PET-CT). Our CT findings corroborate those reported previously. Soft tissue septations visualized in one lesion likely represented post-biopsy changes, adding this etiology to a differential which previously included only ulceration. Cases characterized by MRI are rare in the literature, and our study provides one such example. To our knowledge this study represents the first documentation of gastric lipomas on PET-CT and other low-dose CT imaging protocols.
Highlights
Gastric lipomas are rare tumors, comprising of only 1–3% of benign stomach tumors.[1]
Gastric lipomas are rare with an incidence of 0.029% on autopsy,[4] and represent 3% of benign gastric masses.[5]
5% of alimentary tract lipomas occur in the stomach, the second rarest location after the esophagus.[5]
Summary
Gastric lipomas are rare tumors, comprising of only 1–3% of benign stomach tumors.[1] Most gastric lipomas are found incidentally; larger tumors can be symptomatic.[2] Imaging findings of gastric lipomas are similar to those of more common extra gastric lipomas: Typically well circumscribed oval lesions with homogenous fat density. Management of symptomatic lipomas is traditionally endoscopic excision in small lesions with larger lesions undergoing surgery, this is debated.[3] we present findings in a series of seven patients with gastric lipomas identified incidentally on cross-sectional imaging. Three of these lipomas were visualized using low-dose CT protocols previously undocumented in the literature, highlighting the potential utility of low-dose CT as a means of follow-up imaging of gastric lipomas. We present a case of gastric lipoma visualized on MRI, adding another example to the few documented in the literature
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