Gastric lipoma

Clinical History

Vague abdominal pain and epigastric discomfort, persisting for several months

Imaging Findings

The patient was referred by his family physician to our hospital´s surgery department, with complaints of vague abdominal pain and epigastric discomfort, persisting for several months. The physical examination was unremarkable. A double contrast barium examination of the oesophagus, stomach and duodenum was requested. It demonstrated a mass located in the greater curvature side of the gastric body and antrum, with a smooth contour and an intact overlying mucosa, suggesting a submucosal origin. It measured 12 cm. Given these findings a computerized tomography of the abdomen was performed several days later, without oral or intravenous contrast material, confirming the findings of the upper GI series (gastric submucosal mass), with an attenuation value of -104 HU, allowing the diagnosis.

Discussion

Most gastric neoplasms are malignant, benign neoplasms are rare. Gastric lipomas account for only 5% of all gastrointestinal (GI) lipomas, and represent only 3% of all benign neoplasms. Lipomas can occur anywhere in the GI tract from the esophagus to the rectum. Lipomas of the GI tract are submucosal tumours composed of mature adipose tissue, and are usually detected incidentally. However large lipomas may have ulcerations as a result of pressure necrosis of the overlying mucosa an can be associated with upper GI bleeding. Lipomas tend to occur as solitary lesions, most frequently in the gastric antrum. Barium studies typically reveal a smooth submucosal mass or an ulcerated lesion. At computerized tomography (CT), lipomas usually appear as a well-circumscribed submucosal mass, with uniform fat attenuation. Therefore a gastric lipoma (as in any other GI location)can be diagnosed with CT.

Differential Diagnosis List

Final Diagnosis

Gastric lipoma

URL:	https://www.eurorad.org/case/487
DOI:	10.1594/EURORAD/CASE.487
ISSN:	1563-4086