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Kumar S, Harisankar AG, Singh R, Kumar A, Kumar B, Mandal M. Lipoma of the gastrointestinal tract: a tertiary care centre experience. Ann R Coll Surg Engl 2024; 106:401-406. [PMID: 37823391 PMCID: PMC11060862 DOI: 10.1308/rcsann.2023.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 10/13/2023] Open
Abstract
INTRODUCTION Gastrointestinal (GI) lipomas are rare; however, they are frequent enough to be considered in the differential diagnosis of gut tumours. Here, we present our experience with GI lipomas managed at our institute over the last three years. METHODS This is a retrospective cohort study of patients with GI lipomas managed between January, 2020 and April, 2023 at a tertiary care centre. Clinical presentation, location, and details of surgical procedure were analysed. RESULTS Ten patients were included, six of whom had lipoma in the colon, one in the stomach, and one each in the duodenum, jejunum, and ileum. The mean age at the time of presentation was 48.8 years (range, 19-77 years), and strong male preponderance (4:1) was noted. Preoperative diagnosis of lipoma on cross-sectional imaging was possible in all patients. All patients were symptomatic and were managed surgically. CONCLUSIONS While GI lipomas are generally considered to be indolent and benign tumours, they can potentially lead to severe complications. The utilisation of computed tomography and magnetic resonance imaging has brought about a significant transformation in diagnosing this condition, enabling preoperative identification in most cases. The surgery offers a definitive treatment with minimal risk of postoperative complications.
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Affiliation(s)
- S Kumar
- Indira Gandhi Institute of Medical Sciences, India
| | | | - R Singh
- Indira Gandhi Institute of Medical Sciences, India
| | - A Kumar
- BIG Apollo Spectra Hospitals, India
| | - B Kumar
- Sri Krishna Medical College and Hospital, India
| | - M Mandal
- Indira Gandhi Institute of Medical Sciences, India
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2
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Tang Y, Zhang L, Ni X, Gao S, Yin J, Chen L, Zhu Z. Endoscopic submucosal dissection of a rare antral mass: gastric fibrolipoma. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2023; 115:588-589. [PMID: 36926908 DOI: 10.17235/reed.2023.9581/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
A 60-year-old man was hospitalized with upper abdominal pain for 2-month duration. He had no previous history of symptoms related to his upper gastrointestinal tract. Physical examination was unremarkable. A semicircular round mass with smooth surface was found at the gastric antrum measuring 2.0 × 2.0-cm by gastroscopy. Endoscopic ultrasound (EUS) demonstrated a heterogeneous hyperechoic mass originated from the submucosal layer. Abdominal computed tomography (CT) revealed a fat-density mass with internal mixed density at the gastric antrum. His complete blood test, liver, renal, coagulation function and tumor markers were within reference values. Endoscopic submucosal dissection (ESD) was performed. Postoperative histopathology examination revealed the tumor was composed of closely arranged proliferating mature adipocytes with consistent size and shape. Collagen fiber hyperplasia between adipocytes was found in focal area. The patient was diagnosed as gastric fibrolipoma. He was discharged home uneventful and no symptoms was found in 12 months follow-up.
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Affiliation(s)
- Yuxuan Tang
- Gastroenterology, Yangzhou University/Northern Jiangsu People's Hospital Affiliated to Yangzhou
| | - Li Zhang
- Gastroenterology, Yangzhou University/Northern Jiangsu People's Hospital Affiliated to Yangzhou,
| | - Xiufan Ni
- Gastroenterology, Yangzhou University/Northern Jiangsu People's Hospital Affiliated to Yangzhou,
| | - Sujun Gao
- Gastroenterology, Yangzhou University/Northern Jiangsu People's Hospital Affiliated to Yangzhou,
| | - Jian Yin
- Gastroenterology, Yangzhou University/Northern Jiangsu People's Hospital Affiliated to Yangzhou,
| | - Lei Chen
- Gastroenterology, Yangzhou University/Northern Jiangsu People's Hospital Affiliated to Yangzhou,
| | - Zhen Zhu
- Gastroenterology, Yangzhou University/Northern Jiangsu People's Hospital Affiliated to Yangzhou, China
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3
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Sun J, Kang W, Zeng Z, Zhang Z, Wang X. Rare localization of angiolipoma in the gastrointestinal tract: a case series. J Int Med Res 2021; 48:300060520938589. [PMID: 32972286 PMCID: PMC7522849 DOI: 10.1177/0300060520938589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective Angiolipoma is a benign tumor that rarely occurs in the gastrointestinal (GI) tract. This case series was performed to increase clinicians’ understanding of the diagnosis and management of GI angiolipoma. Methods We evaluated the clinical presentations, diagnoses, and treatments of 3 patients with angiolipoma in the upper GI tract in our hospital and 27 cases reported in the literature. Results Among all 30 cases of GI angiolipoma, 2 originated in the esophagus, 4 in the stomach, 2 in the duodenum, 1 in the jejunum, 7 in the ileum, 1 in the cecum, 9 in the colon, 2 in the rectum, and 2 in both the duodenum and colon. Conclusion Angiolipoma of the GI tract may be more likely to occur in middle-aged and elderly men and be located in the ileum and colon. The clinical manifestations generally involve upper GI hemorrhage and lower GI pain and obstruction. Computed tomography and endoscopy may be effective diagnostic techniques, but postoperative histopathologic examination is still the gold standard. The management of angiolipoma in the GI tract depends on the size and type of lesion. Most cases in the present series were managed by complete surgical resection, after which no recurrence was found.
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Affiliation(s)
| | - Weiming Kang
- Wei-Ming Kang, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, No. 1 Shuaifuyuan Street, Dongcheng District, Beijing 100730, China.
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Yeo SM, Lee JK, Kim HS, Park CG, Jung JK, Kim DJ, Chung YJ, Ryu HJ. Gastric Angiolipoma Resected with Endoscopic Submucosal Dissection. Clin Endosc 2021; 54:432-435. [PMID: 33715342 PMCID: PMC8182249 DOI: 10.5946/ce.2020.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 12/07/2020] [Indexed: 11/14/2022] Open
Abstract
Angiolipoma is a benign fatty neoplasm that has components of proliferating blood vessels. These types of lesions commonly occur in the subcutaneous tissue of the limbs and trunk. Angiolipoma in the gastrointestinal tract is extremely rare, and the final diagnosis generally depends on histological examination of the excised biopsy. In most previously reported cases, the lesions were diagnosed and treated with surgical management. In this study, we report a case of gastric angiolipoma of approximately 4 cm in size that was diagnosed and treated with endoscopic submucosal dissection.
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Affiliation(s)
- Sang Myung Yeo
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jae Kwang Lee
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Hyun Soo Kim
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Chang Geun Park
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jae Kwon Jung
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Dae Jin Kim
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Yun Jin Chung
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Han Jun Ryu
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
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5
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Cure HW, Gómez D, Pedraza M, Bulicie HC, Cabrera LF, Gil LPG, Acevedo D, Cabrera L, Moreno V, Mendoza A. Laparoscopic management of gastric liposarcoma: A case report and review of the literature. Int J Surg Case Rep 2020; 73:268-270. [PMID: 32721886 PMCID: PMC7388163 DOI: 10.1016/j.ijscr.2020.07.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/03/2020] [Accepted: 07/13/2020] [Indexed: 01/08/2023] Open
Abstract
Soft tissue tumors are characterized by frequent somatic chromosomal rearrangements. Symptoms include epigastric pain, nausea, anorexia, and gastrointestinal bleeding. Gastric liposarcoma is the least common sarcoma of the gastrointestinal tract. CT and pathological analysis of resected specimens enable diagnosis. The gold standard of treatment is surgery with radical resection of the tumor.
Introduction Liposarcoma is one of the most common mesenchymal neoplasms in adults. Predominant locations are the retroperitoneum and limbs, it rarely occurs in the gastrointestinal tract. Gastric liposarcoma is extremely rare, with fewer than 30 cases reported around the world. Presentation of case Here we present the case of a 70-year-old female patient who was diagnosed with gastric liposarcoma and managed with laparoscopic surgical resection. The patient is currently being followed up and is alive without recurrence 12 months after the operation. Discussion Gastric liposarcoma approach requires proper diagnosis with computed tomography and endoscopy, in order to develop an adequate surgical plan. Laparoscopic en-bloc resection and gastrointestinal reconstruction is the ideal management in this type of patient. Conclusion Gastric liposarcoma is an extremely rare entity, his management consists of wide en-bloc resection with a gastrointestinal reconstruction.
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Affiliation(s)
- Hector W Cure
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel Gómez
- Department of General Surgery, Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Mauricio Pedraza
- Department of General Surgery, Universidad El Bosque, Bogotá, Colombia.
| | | | - Luis Felipe Cabrera
- Department of General Surgery, Universidad El Bosque, Bogotá, Colombia; Departament of Surgery José Félix Patiño, Fundación Santa Fe de Bogotá, Universidad de los Andes, Universidad El Bosque, Colombia
| | | | - David Acevedo
- Department of General Surgery, Universidad El Bosque, Bogotá, Colombia
| | - Laura Cabrera
- Department of General Surgery, Universidad El Bosque, Bogotá, Colombia
| | - Valery Moreno
- Department of General Surgery, Universidad El Bosque, Bogotá, Colombia
| | - Andrés Mendoza
- Department of General Surgery, Universidad El Bosque, Bogotá, Colombia
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6
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Lochman P, Rejchrt S, Páral J. Proximal Gastrectomy in a Case of Giant Gastric Liposarcoma and a 5-Year Follow-Up. Case Rep Oncol 2020; 13:617-620. [PMID: 32595472 PMCID: PMC7315206 DOI: 10.1159/000507477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 03/22/2020] [Indexed: 12/20/2022] Open
Abstract
Even though liposarcomas account for 10–20% of all mesenchymal malignancies, they are extremely rarely located in the stomach. We report the case of a female patient with gastric liposarcoma. CT revealed a giant hypoechogenic tumour subcardially on the posterior gastric wall. Endoscopic tumour resection by piecemeal technique was done, and a lipoma was confirmed on histopathological examination. A recurrent bleeding tumour was proven 6 weeks later. The patient underwent an open proximal gastrectomy with pyloroplasty, and liposarcoma was surprisingly revealed in the resected specimen, finally. Five years later, our patient had been without recurrence or any somatic difficulties. The CT finding of a submucosal fatty tumour with heterogeneous density within the gastric wall should raise the suspicion for liposarcoma. The goal is the surgical removal of the tumour with sufficient margins ensuring R0 resection.
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Affiliation(s)
- Petr Lochman
- Department of Field Surgery, Faculty of Military Health Science, University of Defence, Hradec Králové, Czechia.,Department of Surgery, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czechia
| | - Stanislav Rejchrt
- 2nd Department of Internal Medicine - Gastroenterology, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czechia
| | - Jiří Páral
- Department of Field Surgery, Faculty of Military Health Science, University of Defence, Hradec Králové, Czechia.,Department of Surgery, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czechia
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7
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Solano J, Herrera G, Cadena M, Cabrera LF, Isaac E, Pedraza M. Non surgical management for massive gastric lipomatosis. Int J Surg Case Rep 2019; 66:149-152. [PMID: 31846867 PMCID: PMC6920312 DOI: 10.1016/j.ijscr.2019.11.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/15/2019] [Accepted: 11/24/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Gastric lipomatosis (GL) is defined as a lipomatous lesion with diffuse infiltration of the submucosal layer by adipose tissue with multiple lesions and must be differentiated from gastrointestinal lipomas, which are solitary submucosal masses composed of well-differentiated adipose tissue surrounded by a fibrous capsule. GL are uncommon, represents 5 % of gastrointestinal tract lipomas and less than 1∼3 % of all gastric tumors. CASE PRESENTATION A 65-year-old woman, who underwent non-operatively approach by Gastric lipomatosis. Non-specific gastrointestinal symptoms and endoscopic examination ruled out the possibility of mucosal ulceration or bleeding. Endoscopic ultrasonography and abdominal CT that confirmed gastric lipomatosis. DISCUSSION Gastric lipomas are usually small, solitary and asymptomatic, and are hence often detected incidentally, surgical management in asymptomatic patients still be a in debate. CONCLUSION Non operative management in massive gastic lipomatosis is appropiate when the patient is asymptomatic without mucosal ulceration, regardless of the amount of gastric lipomas. Avoiding patient the morbidity of a total gastrectomy.
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Affiliation(s)
- Jaime Solano
- Department of General Surgery, Fundación Santa Fe de Bogotá, Bogota Dc, Colombia; Department of Gastroenterology and Endoscopy, Fundación Santa Fe de Bogotá, Bogota Dc, Colombia
| | - Gabriel Herrera
- Department of General Surgery, Fundación Santa Fe de Bogotá, Bogota Dc, Colombia; Deparmten of Ocologic Surgery, Fundación Santa Fe de Bogotá, Bogota Dc, Colombia
| | - Manuel Cadena
- Department of General Surgery, Fundación Santa Fe de Bogotá, Bogota Dc, Colombia
| | - Luis Felipe Cabrera
- Department of General Surgery, Fundación Santa Fe de Bogotá, Bogota Dc, Colombia; Departmen of General Surgery, Universidad El Bosque, Bogota, Colombia
| | - Efrain Isaac
- Department of General Surgery, Fundación Santa Fe de Bogotá, Bogota Dc, Colombia; Departmen of General Surgery, Universidad El Bosque, Bogota, Colombia
| | - Mauricio Pedraza
- Departmen of General Surgery, Universidad El Bosque, Bogota, Colombia.
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8
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Cieszczyk K, Pasnik I, Wronecki L, Ostrowska A, Bojar P, Marzec-Kotarska B, Szumilo J. Gastric lipomatosis. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2018. [DOI: 10.1515/cipms-2018-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Gastric lipomatosis is a condition characterized by the presence of multiple lipomas or diffuse mature adipose tissue infiltration within the gastric wall. The diffuse form is thought to be an extremely rare, with only few described cases. The lesion may be asymptomatic or associated with symptoms and signs depending on location and size. Treatment depends on clinical presentation, range and complications. In a symptomatic disease, it should be surgical, but conservative treatment is preferred for asymptomatic and solitary lesions. Among diagnostic methods, computed tomography and magnetic resonance imaging are thought to be the most valuable.
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Affiliation(s)
- Katarzyna Cieszczyk
- Department of Clinical Pathomorphology , Medical University of Lublin , Jaczewskiego 8b, 20-090 Lublin , Poland
| | - Iwona Pasnik
- Department of Clinical Pathomorphology , Medical University of Lublin , Jaczewskiego 8b, 20-090 Lublin , Poland
| | - Lech Wronecki
- Department of Clinical Pathomorphology , Medical University of Lublin , Jaczewskiego 8b, 20-090 Lublin , Poland
| | - Anna Ostrowska
- Department of Clinical Pathomorphology , Medical University of Lublin , Jaczewskiego 8b, 20-090 Lublin , Poland
| | - Pawel Bojar
- Department of Clinical Pathomorphology , Medical University of Lublin , Jaczewskiego 8b, 20-090 Lublin , Poland
| | - Barbara Marzec-Kotarska
- Department of Clinical Pathomorphology , Medical University of Lublin , Jaczewskiego 8b, 20-090 Lublin , Poland
| | - Justyna Szumilo
- Department of Clinical Pathomorphology , Medical University of Lublin , Jaczewskiego 8b, 20-090 Lublin , Poland
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9
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Aşkan G, Bağci P, Hameed M, Baştürk O. Dedifferentiated Liposarcoma of the Gastroesophageal Junction. Turk Patoloji Derg 2018; 34:104-107. [PMID: 25690861 DOI: 10.5146/tjpath.2014.01297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Liposarcoma is one of the most common sarcomas in adults, but very rarely presents as a primary in the upper gastrointestinal system. Herein, we present a 71-year-old male patient who underwent wedge excision biopsy twice and then fine needle aspiration and total gastrectomy for a recurrent gastroeosophageal junction mass. In microscopic sections, both well-differentiated and dedifferentiated components were seen. Tumor cells were positive for MDM2, CDK4 and negative for CD117, DOG1, CD34, SMA, Desmin, S-100, HMB45, SOX10, AE1/AE3, CAM5.2, CK18. Fluorescence in situ hybridization (FISH) was performed and MDM2 gene (12q15) amplification was detected. According to these findings, a diagnosis of dedifferentiated liposarcoma was supported. We believe this is the first reported case of dedifferentiated liposarcoma of the gastroesophageal junction.
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Affiliation(s)
- Gökçe Aşkan
- Departments of Pathology, Marmara University Faculty of Medicine, İSTANBUL, TURKEY
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10
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Girardot-Miglierina A, Clerc D, Suter M. Gastric liposarcoma in a patient with severe obesity. Ann R Coll Surg Engl 2018; 100:e88-e90. [PMID: 29484946 PMCID: PMC5958859 DOI: 10.1308/rcsann.2018.0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2017] [Indexed: 01/11/2023] Open
Abstract
Liposarcoma is the most common soft tissue sarcoma in adults. Predominant locations are the limbs and retroperitoneum. Intra-abdominal liposarcoma represents only 2% of all cases and visceral location is exceptional. Gastric liposarcoma is extremely rare, with fewer than 20 cases reported. The treatment of choice is wide en-bloc surgical resection. If the tumour arises in the area of the cardia, resection involves resection of the proximal stomach as well as the distal oesophagus. Traditional reconstruction with oesophagogastrostomy often leads to troublesome reflux. We report a case of gastric liposarcoma arising in the gastro-oesophageal junction in a severely obese patient.
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Affiliation(s)
| | - D Clerc
- Department of Surgery, Riviera-Chablais Hospital, Monthey, Switzerland
| | - M Suter
- Department of Surgery, Riviera-Chablais Hospital, Monthey, Switzerland
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11
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Aoyama S, Ami K, Fukuda A, Imai K, Chong JM, Ando M. Gastric lipomatosis treated by total gastrectomy: a case report. Surg Case Rep 2017; 3:126. [PMID: 29247384 PMCID: PMC5732123 DOI: 10.1186/s40792-017-0404-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/03/2017] [Indexed: 11/18/2022] Open
Abstract
Background 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. Here, we present the case of a patient with gastric lipomatosis treated by total gastrectomy. Case presentation A 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. Conclusions Surgical treatment is a highly effective treatment for symptomatic gastric lipomatosis with extensive involvement or multiple lipomas and can be used for patient diagnosis.
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Affiliation(s)
- Shota Aoyama
- Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation, Toshima Hospital, 33-1, Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan.
| | - Katsunori Ami
- Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation, Toshima Hospital, 33-1, Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Akira Fukuda
- Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation, Toshima Hospital, 33-1, Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Kenichiro Imai
- Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation, Toshima Hospital, 33-1, Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Ja-Mun Chong
- Department of Pathology, Tokyo Metropolitan Health and Medical Treatment Corporation, Toshima Hospital, Tokyo, Japan
| | - Masayuki Ando
- Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation, Toshima Hospital, 33-1, Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
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12
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Abstract
Angiolipoma is a benign tumor composed of adipose tissue and proliferating blood vessels that is commonly found in the subcutaneous tissue of the trunk and extremities. Gastric angiolipoma is a rare entity, and to the best of our knowledge, only 4 cases have been reported in the English-language literature thus far. These tumors may present as gastrointestinal bleeding and anemia or with obstructive symptoms. Accurate preoperative diagnosis is challenging because of nonspecific clinical symptoms and lack of specific findings on imaging studies. The correct diagnosis is usually made by histopathologic examination. The clinical significance lies in being aware of this rare entity in the stomach and distinguishing it from other benign and malignant gastric neoplasms that may be in the differential diagnosis. We herein discuss the clinical presentation, radiologic and histopathologic features, ancillary studies, differential diagnosis, and treatment and prognosis of this rare entity.
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Affiliation(s)
| | - Dipti M Karamchandani
- From the Department of Pathology, Penn State Milton S. Hershey Medical Center & Penn State College of Medicine, Hershey, Pennsylvania
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13
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Elhjouji A, Jaiteh L, Mahfoud T, Belhamidi S, Bounaim A, AitAli A, Sair K, Zentar A. Giant Gastric Liposarcoma: A Fatal Exceptional Location. J Gastrointest Cancer 2017; 47:482-485. [PMID: 26558372 DOI: 10.1007/s12029-015-9779-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Abderrahman Elhjouji
- Department of General Surgery, Mohamed V Military Hospital, Souissi University, Rabat, Morocco.
| | - Lamin Jaiteh
- Department of General Surgery, Mohamed V Military Hospital, Souissi University, Rabat, Morocco
| | - Tarik Mahfoud
- Department of Oncology, Mohamed V Military Hospital, Souissi University, Rabat, Morocco
| | - Said Belhamidi
- Department of General Surgery, Mohamed V Military Hospital, Souissi University, Rabat, Morocco
| | - Ahmed Bounaim
- Department of General Surgery, Mohamed V Military Hospital, Souissi University, Rabat, Morocco
| | - Abdelmounaim AitAli
- Department of General Surgery, Mohamed V Military Hospital, Souissi University, Rabat, Morocco
| | - Khalid Sair
- Department of General Surgery, Mohamed V Military Hospital, Souissi University, Rabat, Morocco
| | - Aziz Zentar
- Department of General Surgery, Mohamed V Military Hospital, Souissi University, Rabat, Morocco
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14
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Shin YK, Kim HC, Yang DM, Kim SW, Rhee SJ, Shin JS, Won KY. A Case of Fibrovascular Polyp of the Stomach: Sonographic and Computed Tomographic Findings. IRANIAN JOURNAL OF RADIOLOGY 2016; 13:e28230. [PMID: 27882201 PMCID: PMC5116173 DOI: 10.5812/iranjradiol.28230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 03/19/2015] [Accepted: 04/02/2015] [Indexed: 11/29/2022]
Abstract
Fibrovascular polyps are rare, pedunculated, tumor-like lesions that are usually found in the esophagus; occurrence in the stomach is very rare. To our knowledge, sonographic and CT findings of a fibrovascular polyp in the stomach have never been reported. Here, we report a case of a fibrovascular polyp that was identified in the gastric antrum and prolapsed into the duodenal bulb. Sonography revealed a hyperechoic polypoid mass in the gastric antrum, which prolapsed into the duodenal bulb upon a change in the patient’s position. CT also revealed a pedunculated polypoid mass with an inner fatty component.
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Affiliation(s)
- Yun Kyung Shin
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Hyun Cheol Kim
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
- Corresponding author: Hyun Cheol Kim, Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea. Tel: +82-24406185, Fax: +82-24406932, E-mail:
| | - Dal Mo Yang
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang Won Kim
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sun Jung Rhee
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jong Soo Shin
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Kyu Yeoun Won
- Department of Pathology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
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15
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Affiliation(s)
- Ying Hang
- Department of Emergency, Ren Ji Hospital
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16
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Wang L, Chen P, Zong L, Wang GY, Wang H. Colon angiolipoma with intussusception: a case report and literature review. World J Surg Oncol 2013; 11:69. [PMID: 23497239 PMCID: PMC3608256 DOI: 10.1186/1477-7819-11-69] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 02/23/2013] [Indexed: 12/23/2022] Open
Abstract
Angiolipomas are frequently observed benign tumors. They have a typical vascular component and are often located in subcutaneous tissues, and more rarely, in the gastrointestinal tract. We present the case of a 58-year-old man who complained of abdominal discomfort in the left lower quadrant and two to three bloody stools a day without any obvious etiology. These symptom became more severe in the next three days, due to a large angiolipoma located in the descending colon, which was diagnosed intraoperatively. In a literature review, we found only 22 cases of angiolipomas involving the gastrointestinal tract which are reported in the literature from 1960 to 2012 in PubMed; the key words used in the search are gastrointestinal tract angiolipoma, esophagus, stomach, duodenum, intestine, ileocecal junction, colon, rectum angiolipomas. Colon angiolipoma with intussusception, as seen in this case, is rare and may require emergent surgical intervention.
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Affiliation(s)
- Lei Wang
- Department of Gastrointestinal Surgery, Su Bei People's Hospital of Jiangsu Province, Yangzhou University, Yangzhou 225001, Jiangsu Province, China
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17
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Virmani V, Khandelwal A, Sethi V, Fraser-Hill M, Fasih N, Kielar A. Neoplastic stomach lesions and their mimickers: spectrum of imaging manifestations. Cancer Imaging 2012; 12:269-78. [PMID: 22935192 PMCID: PMC3458788 DOI: 10.1102/1470-7330.2012.0031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This review illustrates a wide spectrum of gastric neoplasms with emphasis on imaging findings helpful in characterizing various gastric neoplasms. Both the malignant and benign neoplasms along with focal gastric masses mimicking tumour are illustrated. Moreover, imaging clues to reach an accurate diagnosis are emphasized.
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Abstract
Gastric lipomatosis is an extremely rare condition. We present a case of a 69-year-old woman admitted with epigastric soreness. Computerized tomography (CT) revealed extrinsically compressing, fat-containing mass lesions on the entire gastric wall of the antrum and body except for the lesser curvature. A subtotal gastrectomy was performed. Pathology findings confirmed a gastric lipomatosis with multiple gastric ulcerations and extensive disruptions of the muscular layers. This case and reports of other gastric lipomatosis cases indicate that CT should be used to characterize large submucosal masses because CT can show the specific nature and extent of the disease. We believe that surgical treatment is the most appropriate treatment for symptomatic gastric lipomatosis that shows extensive gastric involvement, or when there are multiple gastric lipomas.
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Affiliation(s)
- In Ho Jeong
- Department of Surgery, Jeju National University School of Medicine, Jeju, Korea
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19
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Soyer P, Boudiaf M, Nemeth J, Pocard M, Martin-Grivaud S, Duchat F, Tiah D, Hamzi L, Rymer R. [CT features of gastric liposarcoma]. JOURNAL DE RADIOLOGIE 2010; 91:571-573. [PMID: 20657357 DOI: 10.1016/s0221-0363(10)70090-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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20
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Ono S, Fujishiro M, Goto O, Kodashima S, Omata M. En bloc resection of cardia cancer and lipoma with endoscopic submucosal dissection. Dig Liver Dis 2009; 41:237. [PMID: 18657491 DOI: 10.1016/j.dld.2008.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 06/07/2008] [Accepted: 06/09/2008] [Indexed: 12/11/2022]
Affiliation(s)
- S Ono
- Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Bunkyo, Tokyo, Japan
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21
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Computed Tomographic and Magnetic Resonance Imaging Findings of Asymptomatic Intra-Abdominal Gastrointestinal System Lipomas. J Comput Assist Tomogr 2008; 32:841-7. [DOI: 10.1097/rct.0b013e318159a4b5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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22
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Abstract
A previous study showed that a gastric intramural radiolucent band seen on radiographs and a gastric intramural hypoattenuating layer seen on computed tomography were due to the presence of gastric submucosal fat in a cat. There is no known prevalence and distribution pattern of this gastric submucosal fat in cats. This study was carried out to determine the prevalence and distribution pattern of submucosal fat in cat stomachs. Histologic examination of 41 cat stomachs was performed after scheduled killing of cats, obtained from animal shelters. The results revealed that submucosal fat was present in all stomachs. However, thickness and distribution pattern of the submucosal fat varied.
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Affiliation(s)
- H G Heng
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907, USA.
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23
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Auguste T, Levard H, Mal F, Strauss C, Lemaistre AI, Gayet B. [A submucosal gastric tumor]. ACTA ACUST UNITED AC 2007; 144:261-3. [PMID: 17925725 DOI: 10.1016/s0021-7697(07)89540-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- T Auguste
- Département médico-chirurgical de pathologie digestive, Institut Mutualiste Montsouris-Paris, Université René Descartes-Paris 5, 42 boulevard Jourdan, Paris
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Tepetes K, Christodoulidis G, Spyridakis ME, Nakou M, Koukoulis G, Hatzitheofilou K. Liposarcoma of the stomach: A rare case report. World J Gastroenterol 2007; 13:4154-5. [PMID: 17696242 PMCID: PMC4205325 DOI: 10.3748/wjg.v13.i30.4154] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Liposarcoma is the most common soft tissue sarcoma and accounts for 15%-20% of all mesenchymal malignancies. The tumor occurs most frequently in the limbs, retroperitoneum and rarely has a visceral location. We report a case of a gastric liposarcoma in a male patient. A 68 years old male patient was admitted to hospital for abdominal discomfort and fullness lasting for a month. He reported rare episodes of vomiting. The CT examination revealed a large epigastric mass (8 cm x 4 cm) involving the lesser curvature of the stomach, in contact with the pancreas and gallbladder. Fatty areas within the mass were evident. A total gastrectomy together with cholecystectomy was performed. The histopathological diagnosis was a well differentiated liposarcoma. The patient did not undergo any adjuvant treatment, he is under close follow up and two years later he is disease free. We report this case due to the rarity of this tumor in the stomach (nine cases reported in the literature).
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Affiliation(s)
- Konstantinos Tepetes
- General Surgery Department, University Hospital of Larissa, Athinas street, 241220 Larissa, Greece.
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25
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Kacar S, Kuran S, Temucin T, Odemis B, Karadeniz N, Sasmaz N. Rectal angiolipoma: A case report and review of literature. World J Gastroenterol 2007; 13:1460-5. [PMID: 17457984 PMCID: PMC4146937 DOI: 10.3748/wjg.v13.i9.1460] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Angiolipoma is a rare vascular variant of the benign lipomatous tumors and is generally seen in subcutaneous tissues. We report a 70-year-old female with abdominal distension not related to rectal small polypoid mass with peduncule described as angiolipoma by histologically, and review the literature.
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Affiliation(s)
- Sabite Kacar
- Gastroenterology Department, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
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26
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Zak Y, Biagini B, Moore H, Desantis M, Ghosh BC. Submucosal resection of giant gastric lipoma. J Surg Oncol 2006; 94:63-7. [PMID: 16788947 DOI: 10.1002/jso.20551] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Yulia Zak
- Department of Surgery New York Harbor Healthcare System, Brooklyn Campus, State University of New York, Downstate Medical Center, Brooklyn, New York 11209, USA
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27
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Abstract
Angiolipoma, a common benign tumor mostly seen in the subcutaneous tissue, is a rare pathological condition in the gastrointestinal tract that is usually diagnosed postoperatively. In this case report, an angiolipoma was diagnosed preoperatively by imaging (including CT scans, abdominal echo, barium enema, and colonoscopy). This pathology was confirmed postoperatively. Computed tomography scan, abdominal echo, and barium enema images were presented.
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Affiliation(s)
- Yang-Yuan Chen
- Division of Hepatogastroenterology, Changhua Christian Hospital, Changhua, Taiwan, China.
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Affiliation(s)
- P Karila-Cohen
- Département d'Imagerie FMP, 24 rue Saint Victor, 75005 Paris
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Aubé C, Ridereau-Zins C, Croquet V, Pessaux P. Imagerie en coupes de l’estomac et du duodénum. ACTA ACUST UNITED AC 2004; 85:503-14. [PMID: 15184795 DOI: 10.1016/s0221-0363(04)97622-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Imaging of the stomach and duodenum provides an abundant semiology, which allows precise diagnosis. In this chapter we will review specific considerations related to CT, MRI and US imaging of the stomach and duodenum. Normal imaging features as well as the main gastric and duodenal diseases will be described and illustrated.
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Affiliation(s)
- C Aubé
- Services de Radiologie, CHU Angers.
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31
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Mouës CM, Steenvoorde P, Viersma JH, van Groningen K, de Bruïne JF. Jejunal intussusception of a gastric lipoma: a review of literature. Dig Surg 2003; 19:418-20. [PMID: 12435918 DOI: 10.1159/000065825] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Gastrointestinal intussusception is an uncommon condition caused by a pendunculated, gastric tumor being forced through the pyloric sphincter and into the duodenum. An extremely rare case of gastrojejunal intussusception caused by a giant gastric lipoma is described in this article. The patient presented with anemia and weight loss. Initial gastroduodenal endoscopy failed to establish the diagnosis but abdominal ultrasound and computed tomography revealed signs of intussusception possibly associated with a lipoma of the small bowel. At laparotomy a pendunculated, submucosal, gastric lipoma, measuring 10 x 5 cm was found to have been intussuscepted into the jejunum. It was reduced and removed through a gastrotomy. Recovery was uneventful.
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Affiliation(s)
- C M Mouës
- Department of Surgery, Spaarne Hospital, Haarlem, The Netherlands.
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