Abstract
BackgroundGastric lipomatosis is characterized by multiple gastric lipomas or a diffuse gastric infiltration of the submucosal or subserosal layer by the adipose tissue; diffuse-type gastric lipomatosis is an extremely rare condition. Here, we present the case of a patient with gastric lipomatosis treated by total gastrectomy.Case presentationA 54-year-old man diagnosed with gastric submucosal tumor in 2008 was referred to our hospital for further examination and treatment in September 2016. Upper gastrointestinal endoscopy revealed a submucosal tumor with an associated ulcer on the anterior wall of the lower body of the stomach. A compressing mass was observed on the anterior wall of the greater curvature and the posterior wall of the stomach. Following a biopsy of the submucosal tumor and ulcer, lipoma without malignancy was diagnosed by microscopy. A giant gastric lipoma was suspected because endoscopic ultrasound revealed a high-echoic lesion on the antral wall that extended to the stomach. Therefore, total gastrectomy was performed, and gastric lipomatosis was confirmed by a histological examination of the resected specimen.ConclusionsSurgical treatment is a highly effective treatment for symptomatic gastric lipomatosis with extensive involvement or multiple lipomas and can be used for patient diagnosis.
Highlights
Gastric lipomatosis is characterized by multiple gastric lipomas or a diffuse gastric infiltration of the submucosal or subserosal layer by the adipose tissue; diffuse-type gastric lipomatosis is an extremely rare condition
We present the case of a patient with suspected gastric lipoma associated with ulcer and bleeding who was treated by gastrectomy
Endoscopic ultrasound (EUS) confirmed a high-echoic submucosal lesion in the antral wall that extended to the stomach body (Fig. 2a), and computed tomography (CT) and magnetic resonance imaging confirmed a fat-containing mass spanning entire gastric walls of the stomach antrum and body, but excluding the lesser curvature, with a mass protruding on the anterior wall of the greater curvature (Figs. 2b, c and 3)
Summary
Gastrointestinal (GI) lipomatosis is characterized by multiple, small, and asymptomatic lipomas, which are one of the most common submucosal tumors (SMTs) of the GI tract [1, 2]. We present the case of a patient with suspected gastric lipoma associated with ulcer and bleeding who was treated by gastrectomy. A pathological examination of the resected specimen confirmed gastric lipomatosis. This is the first case of lipomatosis with ulcer and bleeding. Case presentation Our patient was a 54-year-old man who was originally diagnosed with a gastric SMT in 2008. He underwent an annual follow-up by upper GI endoscopy at another hospital but was referred to our hospital for further examination and treatment in September 2016, during which his main clinical symptoms were epigastric soreness, general malaise, and melena. At the latest follow-up, he was continuing to do well and showed no evidence of recurrence in other organs
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