Giant gastric lipoma presenting as GI bleed: Enucleation or Resection?

Abstract

HighlightsThe article represents giant gastric lipoma with serious GI bleeding. A rare finding of a rare disease that carries significant morbidity and mortality.To review the literature and to highlight the awareness of this disease and familiarity of its typical radiological findings for reaching proper diagnosis especially in acute setting.TO emphasize that stomach preserving surgery is an optimal surgical option (enucleation is better than resection).

Images of the month 2: A rare case of haematemesis from a gastric submucosal lesion

“…2 The latter is rare and only a few cases have been reported to date. [1][2][3] Our case illustrates rare bleeding from a large gastric lipomatous lesion due to extensive ulceration into the mucosa. The bleeding might have been aggravated by the use of the directly acting anticoagulant (edoxaban).…”

“…Management of gastric lipomas is not well described; the most common treatment modalities include partial gastrectomy, endoscopic resection or open enucleation. 3 Since this patient was an elderly man with multiple co-morbidities, a more conservative approach was taken, and no resection of the mass was planned. ■…”

Gastrointestinal bleeding as an initial manifestation of gastric lipoma: Case report and review of the literature

“…1,2,6,[13][14][15] The mean size of the lesion was 6.8 cm. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Eleven patients underwent surgical resection, and 5 patients underwent endoscopic resection. This current literature review is limited by the paucity of the literature, which is mainly based on single case reports that were reported retrospectively.…”

Giant symptomatic gastric lipoma: A case report and literature review

“…These tumors tend to occur in individuals aged 40–50 years 12]. Giant gastric lipomas have been described in 6 cases reported in the worldwide English literature since 1980 [ 4 ]. There are no known risk factors for the development of gastric lipoma but lipomas in general have been observed to occur at a higher rate in obese individuals and to expand during periods of rapid weight gain.…”

“…As these lesions are typically asymptomatic [ 2 ], they have the potential to grow unnoticed until they reach a size, ≥10 cm, when they are classified as giant gastric lipomas at which time they become symptomatic and necessitate management. Giant gastric lipomas are exceedingly rare, with 6 cases reported in the literature since 1980 [ [3] , [4] , [5] , [6] , [7] , [8] , [9] ].…”