Lipoma gástrico: relato de caso

Abstract

We report a case of gastric lipoma, a rare benign stomach tumor. There are approximately 200 cases previously described in literature. A male, 62-year-old patient with no clinical complaint presented a tumor lesion in the stomach antrum found in a routine upper endoscopy. A surgical resection (subtotal gastrectomy) was done and the histological examination showed submucosal lipoma without signs of malignancy. This report points to the growth of routine examination in the current clinical practice and the dilemma brought by overdiagnosis.

Gastric lipoma and pyloric obstruction in a 51-year-old woman

“…This 51-year-old female presented with clinical features typical of gastrointestinal obstruction and her age was in accordance with the mean age of patients at diagnosis of gastric lipomas 5,8 . However, no specific symptoms could hardly contribute to raise suspicion about gastric lipoma, and the final diagnosis was based on imaging investigation and further histopathology studies.…”

“…The first two biopsy procedures did not furnished enough tissue to histopathology analysis, phenomenon that is frequently reported in literature 3-5,8,9 . The tissue samples from the third biopsy, which was guided by endoscopic ultrasound, revealed the origin of the tumor -a classical lipoma. Surgical approach was done, as most of the authors recommend for symptomatic patients [3][4][5][7][8][9]11 . The occurrence of pyloric stenosis was an expected complication of the atypical gastrectomy, because the tumor resection was performed at the antrum, and with a large free surgical margin.…”

“…They can be under recognized or misdiagnosed by more common masses 5 like gastrointestinal stromal tumor, leiomyoma, fibroma, neurilemmoma, adenomyoma, Brunner's gland adenoma, and heterotopic pancreas 2 . The first description of gastric lipoma is attributed to Cruveilhier (1842) 8 . There are only about 220 cases of gastric lipomas described in the literature 2,5,8 , around 10% are intramural or subserosal, while the vast majority have origin in the submucosa 5,[7][8][9][10] .…”

“…There are only about 220 cases of gastric lipomas described in the literature 2,5,8 , around 10% are intramural or subserosal, while the vast majority have origin in the submucosa 5,[7][8][9][10] . The etiology of lipoma remains unknown 2,6,8 , and it may constitute an acquired condition or an embryological misplacement 6 . The tumor is constituted by well differentiated adipocytes with a fibrous capsule, and if sectioned it grossly appears as an yellowish tissue 2,3,5,7,10 .…”

“…The tumor is constituted by well differentiated adipocytes with a fibrous capsule, and if sectioned it grossly appears as an yellowish tissue 2,3,5,7,10 . Although more commonly located in the gastric antrum (75%) 2 , these tumors may be found at any site of the stomach [4][5][6][7][8][9][10] . Gastric lipoma is a rare benign condition, which may mimic malignancy of the stomach.…”