A Case of Duodenal Lipoma Removed by Endoscopic Polypectomy

Abstract

A rare case of duodenal lipoma removed by endoscopic polypectomy is presented herein. A 64-year-old female was found to have a polypoid lesion in the duodenum on gastrointestinal endoscopic examination. Endoscopy revealed a submucosal tumor located on the second portion. Endoscopic ultrasonography (EUS) demonstrated a homogenous, hyperechoic mass continuous with the submucosal layer, suggesting a lipoma. Because of the likelihood of the tumor ultimately causing obstruction or bleeding, endoscopic polypectomy was performed. There were no complications after treatment.

Sporadic duodenal polyps: classification, investigation, and management

“…Characteristic endoscopic features include the "cushion" or "pillow" sign (the names refer to ease of indentation with biopsy forceps), and the "tenting" sign (characterized by the ease with which the overlying mucosa can be lifted). Fat may protrude when a lesion is biopsied [107,108].…”

“…Lipomas are removed when they are large and/or symptomatic, and to evaluate their histology, particularly when liposarcoma must be ruled out. Endoscopic excision is ideal if lesions are pedunculated or small [105,107]. Laparoscopy, laparotomy with local excision, or duodenectomy may be required for larger complex polyps, in patients with obstructive symptoms or intussusception, and in those in whom malignancy is likely [103,104].…”