Gastric antral lipoma presenting as gastric outlet obstruction

Abstract

A 52-year-old male presented with upper abdominal pain and intermittent vomiting of a year's duration. Physical examination and clinical chemistry were normal. Upper gastrointestinal endoscopy revealed a submucosal lesion in the pyloroantral region with normal overlying mucosa. Contrast-enhanced computed tomography (CECT) scan of the abdomen (Fig. 1) showed an intramural lesion with low attenuation in the pyloroantral region with obstruction. Endoscopic ultrasound-guided fine-needle aspiration cytology revealed a well-defined hyperechoic submucosal lesion composed of adipose tissue. A limited resection with gastroduodenostomy was done. The operative specimen showed a submucosal lipoma (Fig. 2). Gastric lipomas accounts for 3 % of all benign tumors of the stomach. They are usually asymptomatic but may present with gastric outlet obstruction, hematemesis, or iron deficiency anemia [1,2]. CECT is diagnostic because of the low attenuation factor but does not differentiate liposarcoma. References 1. Bijlani RS, Kulkarni VM, Shahani RB, Shah HK, Dalvi A, Samsi AB. Gastric lipoma presenting as obstruction and hematemesis. J Postgrad Med. 1993;39:42-3. 2. Ramaraj R, Roberts SA, Clarke G, Williams G, Thomas GA. A rare case of iron deficiency. Eur J Gastroenterol Hepatol. 2012;24:82-3.Fig. 1 CECT of the abdomen showing a 3 cm × 2.5 cm × 1.5 cm (arrow) low-attenuation (−89 Hounsfield units) lesion in the pyloroantral region with mild proximal gastric dilatation Fig. 2 Surgical specimen showing the submucosal lesion (thick arrow) and the proximal resection margin (thin arrow)